LAUSR

We greatly appreciate their interest in our study [1]. They indicated that the incidence of delirium was relatively lower in our cohort, referring that in a medical ward. However, the prevalence of delirium in patients admitted to medical wards is not necessarily as same as in those with acute heart failure (AHF). Indeed, its incidence in our study (23%) is consistent with previous reports regarding AHF (15% to 35%) [2–4]. We agree with their comment that delirium may be a strong risk factor for in-hospital death. Although the difference did not reach statistical significance, our findings indicated that in-hospital mortality in patients with delirium was more than two-fold compared to those without (3.6 vs. 1.5%, p=0.11). Our negative resultmight be influenced by limited sample size and number of events in our cohort. In our study, BNP level on admission was not a significant determinant of out-of-hospital death. However, we used the BNP level on admission for the analyses to assess the interaction between the development of delirium and the severity of heart failure at initial presentation. The long-term prognostic significance of BNP level on admission is reported to be less than that at discharge [5]. Therefore,