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February 12, 1968

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

Author Affiliations

From Stanford University, Palo Alto, Calif (Dr. Moses), and Harvard University, Cambridge, Mass (Dr. Mosteller).

JAMA. 1968;203(7):492-494. doi:10.1001/jama.1968.03140070048010

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