Title: Predicting Severity of Inpatient Acute Cholangitis : Combined Neutrophil-to-
Lymphocyte Ratio and Prognostic Nutritional Index
Version: 5 Date: 26 Nov 2024
Reviewer:  Giuseppe Guido Maria Scarlata
Reviewer's report:
This manuscript provides a thorough analysis of the study on acute cholangitis, with a clear
focus on inflammatory and nutritional biomarkers. The findings are compelling and supported
by statistical evidence.  However, i have some points to clarify:
1. The exclusion of patients with prior antibiotic treatment might introduce selection bias.
Consider discussing how this could influence the generalizability of the findings.
2. The inverse relationship of PNI and Albumin with disease severity is interesting. Discuss
why these markers are physiologically relevant to acute cholangitis severity and if other studies
corroborate this finding.
3. Some of the evaluated biomarkers were analyzed in this recent article (https://doi.org/10.3390/
medicina60111854). I suggest to cite it in the Discussion section.
4. Table 2 and Table 3: consider combining these into one table summarizing univariate and
multivariate analysis results to streamline the manuscript.
Title: Predicting Severity of Inpatient Acute Cholangitis : Combined Neutrophil-to-
Lymphocyte Ratio and Prognostic Nutritional Index
Version: 5 Date: 26 Nov 2024
Reviewer:  Giuseppe Guido Maria Scarlata
Reviewer's report:
This manuscript provides a thorough analysis of the study on acute cholangitis, with a clear
focus on inflammatory and nutritional biomarkers. The findings are compelling and supported
by statistical evidence.  However, i have some points to clarify:
1. The exclusion of patients with prior antibiotic treatment might introduce selection bias.
Consider discussing how this could influence the generalizability of the findings.
2. The inverse relationship of PNI and Albumin with disease severity is interesting. Discuss
why these markers are physiologically relevant to acute cholangitis severity and if other studies
corroborate this finding.
3. Some of the evaluated biomarkers were analyzed in this recent article (https://doi.org/10.3390/
medicina60111854). I suggest to cite it in the Discussion section.
4. Table 2 and Table 3: consider combining these into one table summarizing univariate and
multivariate analysis results to streamline the manuscript.
Please review this paper.
user
Title: Predicting Severity of Inpatient Acute Cholangitis : Combined Neutrophil-to-
Lymphocyte Ratio and Prognostic Nutritional Index
Version: 5 Date: 26 Nov 2024
Reviewer:  Giuseppe Guido Maria Scarlata
Reviewer's report:
This manuscript provides a thorough analysis of the study on acute cholangitis, with a clear
focus on inflammatory and nutritional biomarkers. The findings are compelling and supported
by statistical evidence.  However, i have some points to clarify:
1. The exclusion of patients with prior antibiotic treatment might introduce selection bias.
Consider discussing how this could influence the generalizability of the findings.
2. The inverse relationship of PNI and Albumin with disease severity is interesting. Discuss
why these markers are physiologically relevant to acute cholangitis severity and if other studies
corroborate this finding.
3. Some of the evaluated biomarkers were analyzed in this recent article (https://doi.org/10.3390/
medicina60111854). I suggest to cite it in the Discussion section.
4. Table 2 and Table 3: consider combining these into one table summarizing univariate and
multivariate analysis results to streamline the manuscript.
assistant