Volume 10, Number 9—September 2004
Dispatch
Barriers to Creutzfeldt-Jakob Disease Autopsies, California
Janice K. Louie*†
, Shilpa S. Gavali*, Ermias D. Belay‡, Rosalie Trevejo†, Lucinda H. Hammond*, Lawrence B. Schonberger‡, and Duc J. Vugia*†
, Shilpa S. Gavali*, Ermias D. Belay‡, Rosalie Trevejo†, Lucinda H. Hammond*, Lawrence B. Schonberger‡, and Duc J. Vugia*†
Table 2
Perceptions of California neurologists, pathologists, and neuropathologists regarding performance of autopsy in Creutzfeldt-Jakob disease (CJD)
| Characteristic | Neurologists n/N (%) | Pathologists n/N (%) | Neuropathologists n/N (%) |
|---|---|---|---|
| Important reasons to obtain autopsy for CJD patients | |||
| Autopsy is needed to confirm CJD diagnosis | – | 92/197 (47) | 11/21 (52) |
| Autopsy is needed to rule out variant CJD or other TSEa forms | 168/231 (73) | 87/193 (45) | 12/20 (60) |
| Barriers to performing autopsy and histopathologic analysis for CJD | |||
| Clinicians do not feel autopsy is required for diagnosis | 94/221 (43) | 72/198 (36) | 7/21 (33) |
| Facilities not able/willing to perform autopsies on CJD patients | 75/234 (32) | 111/210 (53) | 8/22 (36) |
| Families are reluctant to give consent for autopsy | 192/242 (79) | 57/202 (28) | 6/22 (27) |
| Cost of autopsy is a concern to patient’s family | 113/234 (48) | 34/202 (17) | 8/20 (40) |
| Cost of autopsy is a concern to hospital/institution | 78/234 (34) | 40/199 (20) | 8/21 (38) |
| Infection control is a concern regarding autopsy | 102/235 (44) | 143/185 (77) | 9/11 (82) |
| Facilities are inadequate to perform autopsy | – | 24/185 (13) | 5/11 (45) |
| Infection control is a concern regarding histopathologic evaluation | – | 62/111 (56) | 4/8 (50) |
| No available pathologists experienced in recognizing histopathologic features of CJD | – | 69/111 (62) | 1/8 (13) |
aTSE, transmissible spongiform encephalopathy.
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