Title: Association between lactate-to-albumin ratio and all-cause mortality in critically
ill cirrhotic patients with sepsis: A retrospective analysis of the MIMIC-IV database
Version: 2 Date: 11 Jan 2025
Reviewer's report:
I have reviewed with interest the manuscript by Ma et al. investigating lactate-to-albumin
ratio (LAR) in critically ill cirrhotic patients with sepsis. The authors present a well-conducted
retrospective analysis of the MIMIC-IV database, examining whether this simple ratio of two
routine laboratory values can predict mortality in this high-risk patient population. Their work
is methodologically sound, using appropriate statistical methods including multiple regression
models and careful adjustment for confounding factors. The large sample size of almost 2,000
patients provides adequate power, and the clinical question is certainly relevant, as better
prognostic tools for patients with both cirrhosis and sepsis are urgently needed. The authors
demonstrate that a LAR above 1.05 is associated with increased mortality and that adding
LAR to existing scoring systems modestly improves their predictive accuracy. However, I must
point out that there are already multiple published papers evaluating LAR in various patient
populations using the MIMIC database, including works by Gharipour et al. and others. While
this manuscript is well-written and methodologically sound, I do not believe it adds substantially
new insights to the existing literature. Therefore, I would suggest that the authors consider
reformatting their findings as a brief letter to the editor, focusing on the specific aspects unique
to the cirrhosis population, rather than a full original research article.
e.g.: https://pubmed.ncbi.nlm.nih.gov/36591285/ and https://
pubmed.ncbi.nlm.nih.gov/39624213/ and https://www.frontiersin.org/journals/cardiovascular-
medicine/articles/10.3389/fcvm.2024.1486697/full and many many more!
Title: Association between lactate-to-albumin ratio and all-cause mortality in critically
ill cirrhotic patients with sepsis: A retrospective analysis of the MIMIC-IV database
Version: 2 Date: 11 Jan 2025
Reviewer's report:
I have reviewed with interest the manuscript by Ma et al. investigating lactate-to-albumin
ratio (LAR) in critically ill cirrhotic patients with sepsis. The authors present a well-conducted
retrospective analysis of the MIMIC-IV database, examining whether this simple ratio of two
routine laboratory values can predict mortality in this high-risk patient population. Their work
is methodologically sound, using appropriate statistical methods including multiple regression
models and careful adjustment for confounding factors. The large sample size of almost 2,000
patients provides adequate power, and the clinical question is certainly relevant, as better
prognostic tools for patients with both cirrhosis and sepsis are urgently needed. The authors
demonstrate that a LAR above 1.05 is associated with increased mortality and that adding
LAR to existing scoring systems modestly improves their predictive accuracy. However, I must
point out that there are already multiple published papers evaluating LAR in various patient
populations using the MIMIC database, including works by Gharipour et al. and others. While
this manuscript is well-written and methodologically sound, I do not believe it adds substantially
new insights to the existing literature. Therefore, I would suggest that the authors consider
reformatting their findings as a brief letter to the editor, focusing on the specific aspects unique
to the cirrhosis population, rather than a full original research article.
e.g.: https://pubmed.ncbi.nlm.nih.gov/36591285/ and https://
pubmed.ncbi.nlm.nih.gov/39624213/ and https://www.frontiersin.org/journals/cardiovascular-
medicine/articles/10.3389/fcvm.2024.1486697/full and many many more!
Please review this paper.
user
Title: Association between lactate-to-albumin ratio and all-cause mortality in critically
ill cirrhotic patients with sepsis: A retrospective analysis of the MIMIC-IV database
Version: 2 Date: 11 Jan 2025
Reviewer's report:
I have reviewed with interest the manuscript by Ma et al. investigating lactate-to-albumin
ratio (LAR) in critically ill cirrhotic patients with sepsis. The authors present a well-conducted
retrospective analysis of the MIMIC-IV database, examining whether this simple ratio of two
routine laboratory values can predict mortality in this high-risk patient population. Their work
is methodologically sound, using appropriate statistical methods including multiple regression
models and careful adjustment for confounding factors. The large sample size of almost 2,000
patients provides adequate power, and the clinical question is certainly relevant, as better
prognostic tools for patients with both cirrhosis and sepsis are urgently needed. The authors
demonstrate that a LAR above 1.05 is associated with increased mortality and that adding
LAR to existing scoring systems modestly improves their predictive accuracy. However, I must
point out that there are already multiple published papers evaluating LAR in various patient
populations using the MIMIC database, including works by Gharipour et al. and others. While
this manuscript is well-written and methodologically sound, I do not believe it adds substantially
new insights to the existing literature. Therefore, I would suggest that the authors consider
reformatting their findings as a brief letter to the editor, focusing on the specific aspects unique
to the cirrhosis population, rather than a full original research article.
e.g.: https://pubmed.ncbi.nlm.nih.gov/36591285/ and https://
pubmed.ncbi.nlm.nih.gov/39624213/ and https://www.frontiersin.org/journals/cardiovascular-
medicine/articles/10.3389/fcvm.2024.1486697/full and many many more!
assistant