Title: Establishment and evaluation of a prediction model for acute gastrointestinal injury in
patients with prolonged disorder of consciousness
Version: 2 Date: 19 Jul 2022
Reviewer's report:
The aim of the paper is to develop a tool to predict acute gastrointestinal injury in prolonged
DOC patients. The authors employed logistic regression analysis using pre-selected  risk factors
and  demonstrated good characterics of the model. However, the selection of variables raises an
issue. The level of consciousness is considered to be an important clinical variable that affects
prognosis in pDOC patients [Giacino et al., 2018]. The authors included in their analysis only
GCS score as a covariate indicating clinical patient status; however, in pDOC patients GCS is
not a valid tool for the assessment of the level of consciousness [ACRM, BI-ISIG, DOC Task
Force, 2010; Royal College of Physicians National Clinical Guidelines for pDOC, 2020]. More
reliable instruments, such as CRS-R, or SMART, WNSSP etc., should be used to assess DOC
in this setting. A nominal variable indicating level of consciousness (UWS vs. MCS) might be
also included in the analysis.
Several minor issues to be addressed:
“chronic disturbance of consciousness” should be replaced with “chronic disorder of
consciousness”, as stated in recent guidelines [Kondziella et al., 2020; Giacino et al., 2018].
List of abbreviations should be arranged in alphabetical order.
Language proof reading might be useful to improve the text.
Title: Establishment and evaluation of a prediction model for acute gastrointestinal injury in
patients with prolonged disorder of consciousness
Version: 2 Date: 19 Jul 2022
Reviewer's report:
The aim of the paper is to develop a tool to predict acute gastrointestinal injury in prolonged
DOC patients. The authors employed logistic regression analysis using pre-selected  risk factors
and  demonstrated good characterics of the model. However, the selection of variables raises an
issue. The level of consciousness is considered to be an important clinical variable that affects
prognosis in pDOC patients [Giacino et al., 2018]. The authors included in their analysis only
GCS score as a covariate indicating clinical patient status; however, in pDOC patients GCS is
not a valid tool for the assessment of the level of consciousness [ACRM, BI-ISIG, DOC Task
Force, 2010; Royal College of Physicians National Clinical Guidelines for pDOC, 2020]. More
reliable instruments, such as CRS-R, or SMART, WNSSP etc., should be used to assess DOC
in this setting. A nominal variable indicating level of consciousness (UWS vs. MCS) might be
also included in the analysis.
Several minor issues to be addressed:
“chronic disturbance of consciousness” should be replaced with “chronic disorder of
consciousness”, as stated in recent guidelines [Kondziella et al., 2020; Giacino et al., 2018].
List of abbreviations should be arranged in alphabetical order.
Language proof reading might be useful to improve the text.
Please review this paper.
user
Title: Establishment and evaluation of a prediction model for acute gastrointestinal injury in
patients with prolonged disorder of consciousness
Version: 2 Date: 19 Jul 2022
Reviewer's report:
The aim of the paper is to develop a tool to predict acute gastrointestinal injury in prolonged
DOC patients. The authors employed logistic regression analysis using pre-selected  risk factors
and  demonstrated good characterics of the model. However, the selection of variables raises an
issue. The level of consciousness is considered to be an important clinical variable that affects
prognosis in pDOC patients [Giacino et al., 2018]. The authors included in their analysis only
GCS score as a covariate indicating clinical patient status; however, in pDOC patients GCS is
not a valid tool for the assessment of the level of consciousness [ACRM, BI-ISIG, DOC Task
Force, 2010; Royal College of Physicians National Clinical Guidelines for pDOC, 2020]. More
reliable instruments, such as CRS-R, or SMART, WNSSP etc., should be used to assess DOC
in this setting. A nominal variable indicating level of consciousness (UWS vs. MCS) might be
also included in the analysis.
Several minor issues to be addressed:
“chronic disturbance of consciousness” should be replaced with “chronic disorder of
consciousness”, as stated in recent guidelines [Kondziella et al., 2020; Giacino et al., 2018].
List of abbreviations should be arranged in alphabetical order.
Language proof reading might be useful to improve the text.
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