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Institutional Differences in Postoperative Death Rates Commentary on Some of the Findings of the National Halothane Study

Lincoln E. Moses, PhD; Frederick Mosteller, PhD
JAMA. 1968;203(7):492-494. doi:10.1001/jama.1968.03140070048010.
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The National Halothane Study was designed to examine the possible association of halothane anesthesia and postoperative massive hepatic necrosis. It was a retrospective survey of the incidence of fatal massive hepatic necrosis and overall death rate following general anesthesia in 34 hospitals for the four-year period from 1959 through 1962. A summary of the observed incidences of liver necrosis and mortality following halothane anesthesia and following use of other general anesthetic agents has been published in The Journal.1 One important by-product of the study was the finding of large differences in postoperative mortality occurring among the participating institutions. The following communication represents a summary of the statistical analysis of these institutional differences and a discussion of their possible significance.

Death rates for the six-week period following surgery varied widely among the 34 institutions cooperating in this study. These death rates ranged from 0.27% to 6.40%, a 24-fold ratio. In


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