To the Editor: Terrando et al made an important point in stressing the early delirium and later ongoing aspects of postoperative cognitive decline. However, the possible role of alcohol could and should have been the major thrust of the discussion, not just a passing reference in Table 1. The following case illustrates this role. A 74-year-old patient, about to undergo a "redo" of his prosthetic aortic valve, was asked if he took alcohol, to which he replied, "Just a couple of whiskeys with dinner." The surgeon, being reassured, proceeded to operate. Postoperatively, the patient developed acute delirium tremens, fell out of bed, and fractured his hip.
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