Sir,

We read the paper entitled "Hot climate and perioperative outcome in elderly patient" published by Gautam *et al*.,  which was published in the last issue of *Indian Journal of Critical Care Medicine*,\[[@ref1]\] with much interest because of our similar climate in Bandarabbas, southern Iran. 

We exactly understand the differences between our elderly population in Bandarabbas and India where the mentioned study was done, but since no study is still available regarding this issue in this area, their results are useful for us. 

Authors answered some important questions regarding this issue, but before using their results in clinical practice it would be useful to answer other questions as well.  These questions should be answered in future researches. 

The authors have chosen a cut off value of 30°C in their study.  It is not clear whether this cut off value shows the best difference between the group of patients with hot climate and the control group?  So further studies are recommended for reaching to an optimum cut off point for hot climate. The results may be different in emergency surgeries.  It seems that the difference is more relevant in emergency surgeries, but interventions are more possible in elective surgeries. It seems that people who work in poor conditions are vulnerable to hot climate effects, but it should be noted that working in poor conditions may lead to their adaptation to these situations and they may better tolerate the hot climate. Also another important point is the type and duration of intervention before surgery in these patients and also the need for continuing it during and after surgery. 

Future researches may answer these questions.