Title: Proton pump inhibitor therapy after transcatheter angiography in refractory nonvariceal
acute upper gastrointestinal bleeding patients#a cohort study
Version: 0 Date: 09 Dec 2023
Reviewer's report:
Comments to the Author:
This study aimed to compare the effectiveness of high-dose proton pump inhibitors (PPIs) with
the standard regimen in reducing the rebleeding rate and mortality in patients with refractory
nonvariceal upper gastrointestinal bleeding (NVUGIB) after transcatheter angiography (TA).
These findings suggest that high-dose PPI treatment after TA was not superior to the standard-
dose regimen in reducing the 30-day all-cause mortality and rebleeding rate in refractory
NVUGIB patients, regardless of embolization. The results were consistent even after excluding
patients with cancer using a propensity score matching analysis.
Methods
1. This manuscript would benefit from a clearer definition of 'refractory gastrointestinal
bleeding.’ Is this term intended to encompass endoscopic treatment-resistant cases?
2. Elaboration of the criteria for employing transcatheter angiography in refractory NVUGIB
cases is needed for better understanding.
3. An explanation of the selection between high and standard PPI doses in this retrospective
study would clarify the methodology.
4. A detailed description of medication history, particularly regarding the recent use of PPIs,
would strengthen the reliability of the study.
5. The retrospective nature of this study warrants a comprehensive description of the treatment
selection process and medication criteria at your institution for patients with NVUGIB.
6. Specifying the criteria for chronic kidney disease, including the proportion of hemodialysis
patients, is crucial because of its potential impact on the results.
Results
1. The details of antithrombotic drugs, particularly the distinction between warfarin and DOACs,
needs to be addressed.
2. Data on antiplatelet agents is crucial.
3. Information regarding the prevalence of non-refractory NVUGIB and the success rates of
endoscopic hemostasis during the study period would provide valuable information.
4. Clarification of PPI use prior to TA and any associated thromboembolic events during the
study would be beneficial.
5. More information on patients' history of PPI use and the time from admission to TA would
add depth to the study.
Title: Proton pump inhibitor therapy after transcatheter angiography in refractory nonvariceal
acute upper gastrointestinal bleeding patients#a cohort study
Version: 0 Date: 09 Dec 2023
Reviewer's report:
Comments to the Author:
This study aimed to compare the effectiveness of high-dose proton pump inhibitors (PPIs) with
the standard regimen in reducing the rebleeding rate and mortality in patients with refractory
nonvariceal upper gastrointestinal bleeding (NVUGIB) after transcatheter angiography (TA).
These findings suggest that high-dose PPI treatment after TA was not superior to the standard-
dose regimen in reducing the 30-day all-cause mortality and rebleeding rate in refractory
NVUGIB patients, regardless of embolization. The results were consistent even after excluding
patients with cancer using a propensity score matching analysis.
Methods
1. This manuscript would benefit from a clearer definition of 'refractory gastrointestinal
bleeding.’ Is this term intended to encompass endoscopic treatment-resistant cases?
2. Elaboration of the criteria for employing transcatheter angiography in refractory NVUGIB
cases is needed for better understanding.
3. An explanation of the selection between high and standard PPI doses in this retrospective
study would clarify the methodology.
4. A detailed description of medication history, particularly regarding the recent use of PPIs,
would strengthen the reliability of the study.
5. The retrospective nature of this study warrants a comprehensive description of the treatment
selection process and medication criteria at your institution for patients with NVUGIB.
6. Specifying the criteria for chronic kidney disease, including the proportion of hemodialysis
patients, is crucial because of its potential impact on the results.
Results
1. The details of antithrombotic drugs, particularly the distinction between warfarin and DOACs,
needs to be addressed.
2. Data on antiplatelet agents is crucial.
3. Information regarding the prevalence of non-refractory NVUGIB and the success rates of
endoscopic hemostasis during the study period would provide valuable information.
4. Clarification of PPI use prior to TA and any associated thromboembolic events during the
study would be beneficial.
5. More information on patients' history of PPI use and the time from admission to TA would
add depth to the study.
Please review this paper.
user
Title: Proton pump inhibitor therapy after transcatheter angiography in refractory nonvariceal
acute upper gastrointestinal bleeding patients#a cohort study
Version: 0 Date: 09 Dec 2023
Reviewer's report:
Comments to the Author:
This study aimed to compare the effectiveness of high-dose proton pump inhibitors (PPIs) with
the standard regimen in reducing the rebleeding rate and mortality in patients with refractory
nonvariceal upper gastrointestinal bleeding (NVUGIB) after transcatheter angiography (TA).
These findings suggest that high-dose PPI treatment after TA was not superior to the standard-
dose regimen in reducing the 30-day all-cause mortality and rebleeding rate in refractory
NVUGIB patients, regardless of embolization. The results were consistent even after excluding
patients with cancer using a propensity score matching analysis.
Methods
1. This manuscript would benefit from a clearer definition of 'refractory gastrointestinal
bleeding.’ Is this term intended to encompass endoscopic treatment-resistant cases?
2. Elaboration of the criteria for employing transcatheter angiography in refractory NVUGIB
cases is needed for better understanding.
3. An explanation of the selection between high and standard PPI doses in this retrospective
study would clarify the methodology.
4. A detailed description of medication history, particularly regarding the recent use of PPIs,
would strengthen the reliability of the study.
5. The retrospective nature of this study warrants a comprehensive description of the treatment
selection process and medication criteria at your institution for patients with NVUGIB.
6. Specifying the criteria for chronic kidney disease, including the proportion of hemodialysis
patients, is crucial because of its potential impact on the results.
Results
1. The details of antithrombotic drugs, particularly the distinction between warfarin and DOACs,
needs to be addressed.
2. Data on antiplatelet agents is crucial.
3. Information regarding the prevalence of non-refractory NVUGIB and the success rates of
endoscopic hemostasis during the study period would provide valuable information.
4. Clarification of PPI use prior to TA and any associated thromboembolic events during the
study would be beneficial.
5. More information on patients' history of PPI use and the time from admission to TA would
add depth to the study.
assistant