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ARTICLE |

Preoperative Prediction of Postoperative Delirium-Reply FREE

Edward R. Marcantonio, MD; Lee Goldman, MD; Thomas H. Lee, MD
JAMA. 1994;271(20):1574-1574. doi:10.1001/jama.1994.03510440033018
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In Reply.  —We disagree strongly with the substantive issues raised by Drs Carson, O'Hara, Kushins, and Rozner and even more strongly with their philosophical undertone. Our article and their letters should stand or fall based on scientific quality and the ensuing objective debate, rather than on the basis of anyone's board-certification status, previous publication record, or institutional affiliation. Our perioperative research project is a joint effort of our departments of medicine, surgery, anesthesiology, and orthopedics. Although our current article did not include one of our anesthesiologic coinvestigators as an author, one anesthesiologist is the principal investigator of a study of the determinants of postoperative pain control and two others are coauthors of a report on the influence of perioperative medications on the incidence of postoperative delirium.1 We deeply resent any disparaging implications regarding our outstanding department of anesthesiology or the collegiality of our research effort, and we trust that

REFERENCES

Marcantonio ER, Juarez G, Goldman L, et al.  The role of medications in the development of postoperative delirium. J Am Geriatr Soc . 1992;;40:SA1.
Raby KE, Barry J, Creager MA, Cook EF, Weisberg MC, Goldman L.  Detection and significance of intraoperative and postoperative myocardial ischemia in peripheral vascular surgery. JAMA . 1992;;268:222-220.
Mangano DT, Browner WS, Hollenberg M, London MJ, Tubau JF, Tateo IM.  Association of perioperative myocardial ischemia with cardiac morbidity and mortality in men undergoing noncardiac surgery: the Study of the Perioperative Ischemia Research Group. N Engl J Med . 1990;;323:1781-1788.

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Marcantonio ER, Juarez G, Goldman L, et al.  The role of medications in the development of postoperative delirium. J Am Geriatr Soc . 1992;;40:SA1.
Raby KE, Barry J, Creager MA, Cook EF, Weisberg MC, Goldman L.  Detection and significance of intraoperative and postoperative myocardial ischemia in peripheral vascular surgery. JAMA . 1992;;268:222-220.
Mangano DT, Browner WS, Hollenberg M, London MJ, Tubau JF, Tateo IM.  Association of perioperative myocardial ischemia with cardiac morbidity and mortality in men undergoing noncardiac surgery: the Study of the Perioperative Ischemia Research Group. N Engl J Med . 1990;;323:1781-1788.
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To understand the clinical management of acute heart failure syndromes.
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