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March 1, 2000

High-Risk Surgery—Follow the Crowd

Author Affiliations

Author Affiliation: Veterans Affairs Medical Center, White River Junction, Vt, and Department of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH.

JAMA. 2000;283(9):1191-1193. doi:10.1001/jama.283.9.1191

Each year a large number of patients die following elective surgery. In the Medicare population alone, 17,000 patients died in 1995 after undergoing 10 types of elective procedures, such as coronary artery bypass surgery, carotid endarterectomy, and lung resection.1 Quality improvement initiatives at the local and regional levels may be important for reducing mortality at individual hospitals,2,3 but, for many procedures, choosing at which hospitals surgery is performed may be equally important for improving surgical quality.