We read with great interest the article by McGillicuddy and coworkers in the December 2009 issue of the Archives.1 They studied 292 patients aged 65 years or older who were undergoing emergency colorectal procedures. Thirty-five percent of patients experienced a total of 195 complications. One of the factors associated with in-hospital mortality was septic shock; this observation was not unexpected. The most common cause of mortality in general surgical intensive care units is sepsis leading to multiple organ failure. The mortality rate reported for cancer patients with septic shock admitted to the medical-surgical intensive care unit is nearly 54%.2