Title: Mortality rates and risk factors in 1,412 Japanese patients with decompensated hepatitis
C virus-related cirrhosis: A retrospective long-term cohort study
Version: 2 Date: 01 Feb 2021
Reviewer's report:
This article explored the association of decompensated hepatitis C virus-related cirrhosis with
mortality rates and risk factors in 1,412 Japanese patients. Some comments are listed.
Tables and Figures section:
1. The authors mentioned that they were only able to evaluate PT-INR in this study in 60% of
all cases, therefore the number of patients who evaluate the laboratory tests should be listed in
the Table 1 in order to make the meaning explicitly.
2. The words “difficult to follow-up” should be revised as “lost to follow-up” in Figure legends.
3. In the last revision, the review had proposed that “sex” and “AST” in Table 2 was not included
in multiple factors, but the author didn’t give a convincing explanation. P values are indeed
<0.05.
Discussion section:
1. The authors emphasized that “This study shows that these patients have a favorable prognosis,
possibly due to symptomatic treatment.” in line 226-227, but there was not mentioned of
treatments in the original text, which hardly draw such the conclusion reasonably. The reason
is not explained in detail, which could be elaborated.
2. The words “In Japan, the most common cause of death is liver cancer.” in line 238-239 should
be supported by some references.
3. The Editor and Reviewers have raised questions about the importance of drug therapy and
MELD score in the last revision. If the author could not resolve these questions, it could be
explained in the Limitation Section. The words mentioned in the Response to the Reviewers
Letter that “Most of the HCC treatments for decompensated cirrhosis are TACE, but there are
some old cases and details are not available.” could be mentioned in the original text to explain
the limitation of drug therapy.
4. The information was confusing when talking about the parts marked in red, such as the words
“Liver transplant cases were not included in this study.” in line 263-264 were illogical in the
context.
5. The associated independent risk factors such as low estimated glomerular filtration rate, low
serum sodium level, low platelet count, and high #-glutamyl transferase and #-fetoprotein levels
(all patients) could be explained the relationship with the prognosis of decompensated HCV-
related cirrhosis in the Discussion.
Title: Mortality rates and risk factors in 1,412 Japanese patients with decompensated hepatitis
C virus-related cirrhosis: A retrospective long-term cohort study
Version: 2 Date: 01 Feb 2021
Reviewer's report:
This article explored the association of decompensated hepatitis C virus-related cirrhosis with
mortality rates and risk factors in 1,412 Japanese patients. Some comments are listed.
Tables and Figures section:
1. The authors mentioned that they were only able to evaluate PT-INR in this study in 60% of
all cases, therefore the number of patients who evaluate the laboratory tests should be listed in
the Table 1 in order to make the meaning explicitly.
2. The words “difficult to follow-up” should be revised as “lost to follow-up” in Figure legends.
3. In the last revision, the review had proposed that “sex” and “AST” in Table 2 was not included
in multiple factors, but the author didn’t give a convincing explanation. P values are indeed
<0.05.
Discussion section:
1. The authors emphasized that “This study shows that these patients have a favorable prognosis,
possibly due to symptomatic treatment.” in line 226-227, but there was not mentioned of
treatments in the original text, which hardly draw such the conclusion reasonably. The reason
is not explained in detail, which could be elaborated.
2. The words “In Japan, the most common cause of death is liver cancer.” in line 238-239 should
be supported by some references.
3. The Editor and Reviewers have raised questions about the importance of drug therapy and
MELD score in the last revision. If the author could not resolve these questions, it could be
explained in the Limitation Section. The words mentioned in the Response to the Reviewers
Letter that “Most of the HCC treatments for decompensated cirrhosis are TACE, but there are
some old cases and details are not available.” could be mentioned in the original text to explain
the limitation of drug therapy.
4. The information was confusing when talking about the parts marked in red, such as the words
“Liver transplant cases were not included in this study.” in line 263-264 were illogical in the
context.
5. The associated independent risk factors such as low estimated glomerular filtration rate, low
serum sodium level, low platelet count, and high #-glutamyl transferase and #-fetoprotein levels
(all patients) could be explained the relationship with the prognosis of decompensated HCV-
related cirrhosis in the Discussion.
Please review this paper.
user
Title: Mortality rates and risk factors in 1,412 Japanese patients with decompensated hepatitis
C virus-related cirrhosis: A retrospective long-term cohort study
Version: 2 Date: 01 Feb 2021
Reviewer's report:
This article explored the association of decompensated hepatitis C virus-related cirrhosis with
mortality rates and risk factors in 1,412 Japanese patients. Some comments are listed.
Tables and Figures section:
1. The authors mentioned that they were only able to evaluate PT-INR in this study in 60% of
all cases, therefore the number of patients who evaluate the laboratory tests should be listed in
the Table 1 in order to make the meaning explicitly.
2. The words “difficult to follow-up” should be revised as “lost to follow-up” in Figure legends.
3. In the last revision, the review had proposed that “sex” and “AST” in Table 2 was not included
in multiple factors, but the author didn’t give a convincing explanation. P values are indeed
<0.05.
Discussion section:
1. The authors emphasized that “This study shows that these patients have a favorable prognosis,
possibly due to symptomatic treatment.” in line 226-227, but there was not mentioned of
treatments in the original text, which hardly draw such the conclusion reasonably. The reason
is not explained in detail, which could be elaborated.
2. The words “In Japan, the most common cause of death is liver cancer.” in line 238-239 should
be supported by some references.
3. The Editor and Reviewers have raised questions about the importance of drug therapy and
MELD score in the last revision. If the author could not resolve these questions, it could be
explained in the Limitation Section. The words mentioned in the Response to the Reviewers
Letter that “Most of the HCC treatments for decompensated cirrhosis are TACE, but there are
some old cases and details are not available.” could be mentioned in the original text to explain
the limitation of drug therapy.
4. The information was confusing when talking about the parts marked in red, such as the words
“Liver transplant cases were not included in this study.” in line 263-264 were illogical in the
context.
5. The associated independent risk factors such as low estimated glomerular filtration rate, low
serum sodium level, low platelet count, and high #-glutamyl transferase and #-fetoprotein levels
(all patients) could be explained the relationship with the prognosis of decompensated HCV-
related cirrhosis in the Discussion.
assistant