Title: Is Serum Albumin a Pivotal Biomarker in Anticipating Acute Pancreatitis Outcomes?
Version: 4 Date: 21 May 2024
Reviewer:  Saurabh Dawra
Reviewer's report:
Congratulations to the authors on a neatly written manuscript. However, a few queries need to
be addressed
1. In the exclusion criteria: kindly enumerate all the pathological conditions you have excluded.
Your statement ‘Conditions with an underlying pathology that could affect serum albumin
levels, particularly diseases such as malabsorption, chronic pancreatitis, liver cirrhosis, chronic
renal disease, albuminuria’ seems vague. This being a retrospective study how have you
excluded all these conditions especially albuminuria. Do you regularly check the same in your
centre?
2. What about the physiological conditions associated with hypoalbuminemia? As I understand
majority of participants in your study are females? Nutritional status? Baseline anaemia?
3. How many of your patients were diabetics? This single disease can alter the interpretation
of your results
4. At what point were the serum albumin levels measured for co-relation? At baseline? If
yes, then how can one co-relate organ failure that occurred early in disease process to WON/
Pseudocyst which presumably would occur at least 04 weeks after disease onset?
5. Do you have serial albumin measurements? were they different in severe pancreatitis vs
moderately severe vs mild AP
6. The ‘Discussion’ part needs to emphasize the pathophysiology as to why are your results
significant in some conditions e.g WON and not in others like pseudocyst? Is the level of
inflammation different?
7. What about sepsis/ infection. None of your patients had infection?? This can alter the results
of your study
Title: Is Serum Albumin a Pivotal Biomarker in Anticipating Acute Pancreatitis Outcomes?
Version: 4 Date: 21 May 2024
Reviewer:  Saurabh Dawra
Reviewer's report:
Congratulations to the authors on a neatly written manuscript. However, a few queries need to
be addressed
1. In the exclusion criteria: kindly enumerate all the pathological conditions you have excluded.
Your statement ‘Conditions with an underlying pathology that could affect serum albumin
levels, particularly diseases such as malabsorption, chronic pancreatitis, liver cirrhosis, chronic
renal disease, albuminuria’ seems vague. This being a retrospective study how have you
excluded all these conditions especially albuminuria. Do you regularly check the same in your
centre?
2. What about the physiological conditions associated with hypoalbuminemia? As I understand
majority of participants in your study are females? Nutritional status? Baseline anaemia?
3. How many of your patients were diabetics? This single disease can alter the interpretation
of your results
4. At what point were the serum albumin levels measured for co-relation? At baseline? If
yes, then how can one co-relate organ failure that occurred early in disease process to WON/
Pseudocyst which presumably would occur at least 04 weeks after disease onset?
5. Do you have serial albumin measurements? were they different in severe pancreatitis vs
moderately severe vs mild AP
6. The ‘Discussion’ part needs to emphasize the pathophysiology as to why are your results
significant in some conditions e.g WON and not in others like pseudocyst? Is the level of
inflammation different?
7. What about sepsis/ infection. None of your patients had infection?? This can alter the results
of your study
Please review this paper.
user
Title: Is Serum Albumin a Pivotal Biomarker in Anticipating Acute Pancreatitis Outcomes?
Version: 4 Date: 21 May 2024
Reviewer:  Saurabh Dawra
Reviewer's report:
Congratulations to the authors on a neatly written manuscript. However, a few queries need to
be addressed
1. In the exclusion criteria: kindly enumerate all the pathological conditions you have excluded.
Your statement ‘Conditions with an underlying pathology that could affect serum albumin
levels, particularly diseases such as malabsorption, chronic pancreatitis, liver cirrhosis, chronic
renal disease, albuminuria’ seems vague. This being a retrospective study how have you
excluded all these conditions especially albuminuria. Do you regularly check the same in your
centre?
2. What about the physiological conditions associated with hypoalbuminemia? As I understand
majority of participants in your study are females? Nutritional status? Baseline anaemia?
3. How many of your patients were diabetics? This single disease can alter the interpretation
of your results
4. At what point were the serum albumin levels measured for co-relation? At baseline? If
yes, then how can one co-relate organ failure that occurred early in disease process to WON/
Pseudocyst which presumably would occur at least 04 weeks after disease onset?
5. Do you have serial albumin measurements? were they different in severe pancreatitis vs
moderately severe vs mild AP
6. The ‘Discussion’ part needs to emphasize the pathophysiology as to why are your results
significant in some conditions e.g WON and not in others like pseudocyst? Is the level of
inflammation different?
7. What about sepsis/ infection. None of your patients had infection?? This can alter the results
of your study
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