| Summary: | Subrata Kumar Singha,1 Habib MR Karim,1 Antonio Esquinas2 1Department of Anaesthesia, AIIMS Raipur, Raipur, India; 2ICU, Hospital Morales, Murcia, SpainCorrespondence: Subrata Kumar SinghaDepartment of Anaesthesia, AIIMS, 3rd Floor, Major OT, Trauma Building, PO: Tatibandh, Raipur 492099, CG, IndiaEmail subratsingh@gmail.com We have read the study by Liao et al published in your journal with great interest.1 The article evaluates the effects of COPD on the outcome of laparoscopic cholecystectomy. Although COPD is a well-known risk for postoperative pulmonary complications, it is interesting to know this association from this matched study with a relatively larger sample. The authors' findings and conclusions are relevant, but we consider that a few other aspects need to be taken into account from the practical point of view.Firstly, from the methodological point of view, although the cohort was matched for age and gender, their comorbidities were very much different and may have affected the outcome measures like use of supports, ie, vasopressors, hemodialysis (HD), mechanical ventilation (MV), intensive care unit (ICU) stay, etc. Inclusion of patients with only COPD in the COPD group or using multivariate analysis may have helped in determining the real impact caused by COPD. In addition, the time period considered, ie, 1997–2013, is too long and the management strategy, especially for COPD patients, has evolved/changed a lot, diluting the applicability in the current practice.View the original paper by Liao KM and colleaguesA response to the letter has been publshed
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