Title: Elevated Serum Ferritin Levels are Associated with Severity and Prognosis of Severe
Acute Pancreatitis: A Preliminary Cohort Study
Version: 1 Date: 17 May 2022
Reviewer's report:
Wang et al have, in a retrospective single center cohort study, investigated whether the levels of
serum ferritin might be correlated with disease severity in AP.
I find this study very interesting, involving reliable statistic methods and novel findings in the
field of AP.
However, the manuscript needs revision.
General comments
The manuscript is great in need of English language revision and general writing corrections.
Abstract
It would be interesting if the authors could present specific data and numbers also in the abstract
regarding the “significant increase in the proportion of patients with severe AP and a higher
proportion of SIRS in comparison…”
Introduction
Is it possible to present, in a more profound way, more about the physio-pathological scenario
regarding SF and different inflammatory diseases? Is there any data on sepsis for example?
Methods
# Why were patients > 80 years excluded? And patients with pancreatic tumors? Please explain
thus further in the manuscript
# What does it mean that a SF-level of >275 is ‘positive’?
# In the logistic regression analysis – did the authors adjust for any variable such as age, sex etc?
# Have the authors investigated a possible association between specific organ failures and SF
levels?
Results
# Which are the systemic complications in Fig 1H? Please specify
# Figure 1 presents median levels of SF in different scenarios. However in the manuscript the
authors write that the levels are ‘positively correlated’… However, THIS figure doesn’t show
the results of a correlation test? Compared to Fig 2
# Please describe, in more detail, the complications investigated regarding SF levels
# The authors claim that ‘logistic regression analysis indicated that serum SF was an independent
risk factor for SAP and organ failure….’ However what the authors have demonstrated is an
association between SF and SAP and SF OF, no investigation of risk factors has been performed.
Discussion
# were the positive correlations found between SF and ALT, AST etc expected?
# Although the authors found an association between SF levels and SAP and organ failure this
relationship is very weak when considering the odds ratios which need to be highlighted in the
manuscript
# The authors claim in the Discussion section that AP is a non-infectious disease, however this
not really the truth depending on which phase of the disease that’s in focus.
# Have the results from this study been confirmed in previous studies?
# The authors claim that SF ‘can be used as an ideal biomarker to predict the severity of AP’ – this
seems too much as an exaggeration, and not a result that can be concluded from a retrospective
study with unvalidated results.
# Can the authors specify in the text which inflammatory mediators they are referring to
regarding the involvement in the iron metabolism?
Title: Elevated Serum Ferritin Levels are Associated with Severity and Prognosis of Severe
Acute Pancreatitis: A Preliminary Cohort Study
Version: 1 Date: 17 May 2022
Reviewer's report:
Wang et al have, in a retrospective single center cohort study, investigated whether the levels of
serum ferritin might be correlated with disease severity in AP.
I find this study very interesting, involving reliable statistic methods and novel findings in the
field of AP.
However, the manuscript needs revision.
General comments
The manuscript is great in need of English language revision and general writing corrections.
Abstract
It would be interesting if the authors could present specific data and numbers also in the abstract
regarding the “significant increase in the proportion of patients with severe AP and a higher
proportion of SIRS in comparison…”
Introduction
Is it possible to present, in a more profound way, more about the physio-pathological scenario
regarding SF and different inflammatory diseases? Is there any data on sepsis for example?
Methods
# Why were patients > 80 years excluded? And patients with pancreatic tumors? Please explain
thus further in the manuscript
# What does it mean that a SF-level of >275 is ‘positive’?
# In the logistic regression analysis – did the authors adjust for any variable such as age, sex etc?
# Have the authors investigated a possible association between specific organ failures and SF
levels?
Results
# Which are the systemic complications in Fig 1H? Please specify
# Figure 1 presents median levels of SF in different scenarios. However in the manuscript the
authors write that the levels are ‘positively correlated’… However, THIS figure doesn’t show
the results of a correlation test? Compared to Fig 2
# Please describe, in more detail, the complications investigated regarding SF levels
# The authors claim that ‘logistic regression analysis indicated that serum SF was an independent
risk factor for SAP and organ failure….’ However what the authors have demonstrated is an
association between SF and SAP and SF OF, no investigation of risk factors has been performed.
Discussion
# were the positive correlations found between SF and ALT, AST etc expected?
# Although the authors found an association between SF levels and SAP and organ failure this
relationship is very weak when considering the odds ratios which need to be highlighted in the
manuscript
# The authors claim in the Discussion section that AP is a non-infectious disease, however this
not really the truth depending on which phase of the disease that’s in focus.
# Have the results from this study been confirmed in previous studies?
# The authors claim that SF ‘can be used as an ideal biomarker to predict the severity of AP’ – this
seems too much as an exaggeration, and not a result that can be concluded from a retrospective
study with unvalidated results.
# Can the authors specify in the text which inflammatory mediators they are referring to
regarding the involvement in the iron metabolism?
Please review this paper.
user
Title: Elevated Serum Ferritin Levels are Associated with Severity and Prognosis of Severe
Acute Pancreatitis: A Preliminary Cohort Study
Version: 1 Date: 17 May 2022
Reviewer's report:
Wang et al have, in a retrospective single center cohort study, investigated whether the levels of
serum ferritin might be correlated with disease severity in AP.
I find this study very interesting, involving reliable statistic methods and novel findings in the
field of AP.
However, the manuscript needs revision.
General comments
The manuscript is great in need of English language revision and general writing corrections.
Abstract
It would be interesting if the authors could present specific data and numbers also in the abstract
regarding the “significant increase in the proportion of patients with severe AP and a higher
proportion of SIRS in comparison…”
Introduction
Is it possible to present, in a more profound way, more about the physio-pathological scenario
regarding SF and different inflammatory diseases? Is there any data on sepsis for example?
Methods
# Why were patients > 80 years excluded? And patients with pancreatic tumors? Please explain
thus further in the manuscript
# What does it mean that a SF-level of >275 is ‘positive’?
# In the logistic regression analysis – did the authors adjust for any variable such as age, sex etc?
# Have the authors investigated a possible association between specific organ failures and SF
levels?
Results
# Which are the systemic complications in Fig 1H? Please specify
# Figure 1 presents median levels of SF in different scenarios. However in the manuscript the
authors write that the levels are ‘positively correlated’… However, THIS figure doesn’t show
the results of a correlation test? Compared to Fig 2
# Please describe, in more detail, the complications investigated regarding SF levels
# The authors claim that ‘logistic regression analysis indicated that serum SF was an independent
risk factor for SAP and organ failure….’ However what the authors have demonstrated is an
association between SF and SAP and SF OF, no investigation of risk factors has been performed.
Discussion
# were the positive correlations found between SF and ALT, AST etc expected?
# Although the authors found an association between SF levels and SAP and organ failure this
relationship is very weak when considering the odds ratios which need to be highlighted in the
manuscript
# The authors claim in the Discussion section that AP is a non-infectious disease, however this
not really the truth depending on which phase of the disease that’s in focus.
# Have the results from this study been confirmed in previous studies?
# The authors claim that SF ‘can be used as an ideal biomarker to predict the severity of AP’ – this
seems too much as an exaggeration, and not a result that can be concluded from a retrospective
study with unvalidated results.
# Can the authors specify in the text which inflammatory mediators they are referring to
regarding the involvement in the iron metabolism?
assistant