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- W1193464095 abstract "A study was made of the deaths following surgery on the gynecologic service of the Cook County Hospital for the five years from 1943 to 1947 and the results compared with those published from the same hospital in 1932. During the first five-year period, 6,022 gynecologic operations and during the second period 5,318 operations were performed. Two hundred thirteen deaths occurred during the first period but there were only 69 in the second. The mortality rate was 3.5 per cent for the first period and 1.3 per cent for the second period. There was a steady decrease in the number of deaths, the least number being recorded in 1946 and 1947 when the mortality rates were 0.70 and 0.67 per cent, respectively. During the twelve years which elapsed between the two studies, the type of surgery performed underwent considerable change. There was a much greater tendency to remove part or all of the adnexa at the time of hysterectomy and if it was necessary to remove all the adnexa, then the uterus was also removed. In the recent period the number of total hysterectomies rose from 350 to 1.033. There was a large increase in the number of vaginal hysterectomies, 158 having been performed during the first period and 531 during the second period. Peritonitis was the most frequent cause of death in both series. It was responsible for 48 per cent of the fatalities in the first period and 29 per cent in the second period. In 1946 and 1947 only 12.5 per cent of the deaths were due to infection and this further improvement was due to the use of penicillin. There were 35 deaths from hemorrhage and shock in the first period and only 13 in the second. The decrease was, in part, due to the development of the blood bank, permitting more widespread use of transfusions. The death rate from malignancy remained fairly constant, there being 16 deaths in the first period and 14 in the second. There was a marked decrease in deaths from pneumonia and atelectasis, there being 18 fatalities in the first period and only 4 in the second period. The decrease was due primarily to the sulfonamides, penicillin, early ambulation, and improved technique of anesthesia. There was a marked decline in deaths due to pulmonary embolism from 18 in the first period to 2 in the second. The decrease in the number of postoperative deaths with the second study is the result of a combination of factors. Among them have been the use of the sulfonamides, penicillin, and streptomycin, better preoperative and post-operative care, improved surgery, the blood bank, and early ambulation. Of equal significance has been the reorganization of the Department of Gynecology of the Cook County Hospital and the development of a comprehensive plan of resident training." @default.
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- W1193464095 date "1951-02-01" @default.
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- W1193464095 title "Analysis of deaths occurring in 5,318 gynecologic operations" @default.
- W1193464095 doi "https://doi.org/10.1016/0002-9378(51)90249-9" @default.
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