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In an endeavor to find the cause of the marked increase in the mortality of acute appendicitis, which amounted to 22.3 per cent in the United States and 18 per cent in Philadelphia between the years 1913 and 1923, Dr. A. A. Cairns, the director of the department of public health, authorized a survey of the hospitals of the city to determine the cause of this increase. The clinical records of 5,121 patients in 27 hospitals have been studied. To insure uniformity, the survey was made by one person with the assistance of another. An attempt was made to obtain the following from each clinical record: name, age, sex, time in hospital, family
physician, surgeon, whether or not a laxative had been given before operation, time between onset of symptoms and operation, temperature and pulse, nausea and vomiting, recurrent attacks, leukocyte counts, kind of anesthesia, type of incision, pathologic changes,
BOWER JO. ACUTE APPENDICITIS: A SURVEY OF ITS INCIDENCE AND CARE IN PHILADELPHIA. JAMA. 1931;96(18):1461–1465. doi:10.1001/jama.1931.02720440009003
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