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December 6, 1995

Complication Rates as a Measure of Quality of Care-Reply

Author Affiliations

University of Pennsylvania Philadelphia

JAMA. 1995;274(21):1674-1675. doi:10.1001/jama.1995.03530210028020

In Reply.  —Dr Daley and colleagues suggest our complication rate1 was too high, citing the prospective study by Hammermeister et al.2 That study analyzed only 10 complications. We analyzed more types of complications (eg, we added pneumonia), hence our overall rate was higher. Comparable complications yielded similar rates in the study by Hammermeister et al and in our study (eg, the rates were 2.1% vs 1.36% for stroke, 1.6% vs 1.76% for coma, and 7.8% vs 7.18% for mechanical ventilation, respectively). Daley et al mistakenly attribute the difference in complication rates to the nature of the data collected, rather than to the different complications included for analysis. There is no indication that the difference in rates reflects any inadequacy of either the data or definitions used in our study.We only counted events as complications if there was no notation of that same event at the time the

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