Title: Socioeconomic Burden of Patients Hospitalized for Fecal Impaction: A Nationwide
Retrospective Observational Study
Version: 0 Date: 03 May 2025
Reviewer's report:
Please see suggestions for few changes and comments below:
Prior to last sentence in background:
most aged country in the world -> the world's oldest country
In definitions and outcomes I would use "and"instead of "or" between the codes provided, all
these codes were included
In the study participants: Please clarify why FI development after admission was excluded? it
is not clear or easily understandable and how it affects results and outcomes of this study
Study Participants
This study included patients diagnosed with FI at the time of admission between April 2016
and March 2023. The exclusion criteria were age younger than 16 years, pregnancy, and FI
development after admission.
Please add "may have had biased..” below instead of "have biased.."
Previous studies may have biased characteristics owing to their small size and specifically
targeted populations, leading to inaccurate mortality rates.
Statistical analysis
Replace semicolons with commas in below
“using the variables of age; sex; pathway to admission; arrival by emergency ambulance; annual
number of FIs per hospital; Charlson comorbidity index; history of constipation;”
Discussion: the fact that constipation contributed to lower mortality may have more underlying
reason than positive/preventive effect of its management on FI development. Perhaps an
underreported diagnosis of constipation?  Maybe clarify further how constipation was coded in
relation to admission source, and or otherwise.
Limitations:
"Second, although the DPC database is comprehensive for inpatients,"
Change intpatients to inpatient hospitalizations, admission, or something similar with context
to "inpatients"
Interesting study, otherwise, would be more striking if there were other than US comparisons,
if any, additionally available studies.  reference 14 you have used and available US data is
administrative database which is inferior as a database compared to yours in this setting as per
description there are more clinical datavariables.
Title: Socioeconomic Burden of Patients Hospitalized for Fecal Impaction: A Nationwide
Retrospective Observational Study
Version: 0 Date: 03 May 2025
Reviewer's report:
Please see suggestions for few changes and comments below:
Prior to last sentence in background:
most aged country in the world -> the world's oldest country
In definitions and outcomes I would use "and"instead of "or" between the codes provided, all
these codes were included
In the study participants: Please clarify why FI development after admission was excluded? it
is not clear or easily understandable and how it affects results and outcomes of this study
Study Participants
This study included patients diagnosed with FI at the time of admission between April 2016
and March 2023. The exclusion criteria were age younger than 16 years, pregnancy, and FI
development after admission.
Please add "may have had biased..” below instead of "have biased.."
Previous studies may have biased characteristics owing to their small size and specifically
targeted populations, leading to inaccurate mortality rates.
Statistical analysis
Replace semicolons with commas in below
“using the variables of age; sex; pathway to admission; arrival by emergency ambulance; annual
number of FIs per hospital; Charlson comorbidity index; history of constipation;”
Discussion: the fact that constipation contributed to lower mortality may have more underlying
reason than positive/preventive effect of its management on FI development. Perhaps an
underreported diagnosis of constipation?  Maybe clarify further how constipation was coded in
relation to admission source, and or otherwise.
Limitations:
"Second, although the DPC database is comprehensive for inpatients,"
Change intpatients to inpatient hospitalizations, admission, or something similar with context
to "inpatients"
Interesting study, otherwise, would be more striking if there were other than US comparisons,
if any, additionally available studies.  reference 14 you have used and available US data is
administrative database which is inferior as a database compared to yours in this setting as per
description there are more clinical datavariables.
Please review this paper.
user
Title: Socioeconomic Burden of Patients Hospitalized for Fecal Impaction: A Nationwide
Retrospective Observational Study
Version: 0 Date: 03 May 2025
Reviewer's report:
Please see suggestions for few changes and comments below:
Prior to last sentence in background:
most aged country in the world -> the world's oldest country
In definitions and outcomes I would use "and"instead of "or" between the codes provided, all
these codes were included
In the study participants: Please clarify why FI development after admission was excluded? it
is not clear or easily understandable and how it affects results and outcomes of this study
Study Participants
This study included patients diagnosed with FI at the time of admission between April 2016
and March 2023. The exclusion criteria were age younger than 16 years, pregnancy, and FI
development after admission.
Please add "may have had biased..” below instead of "have biased.."
Previous studies may have biased characteristics owing to their small size and specifically
targeted populations, leading to inaccurate mortality rates.
Statistical analysis
Replace semicolons with commas in below
“using the variables of age; sex; pathway to admission; arrival by emergency ambulance; annual
number of FIs per hospital; Charlson comorbidity index; history of constipation;”
Discussion: the fact that constipation contributed to lower mortality may have more underlying
reason than positive/preventive effect of its management on FI development. Perhaps an
underreported diagnosis of constipation?  Maybe clarify further how constipation was coded in
relation to admission source, and or otherwise.
Limitations:
"Second, although the DPC database is comprehensive for inpatients,"
Change intpatients to inpatient hospitalizations, admission, or something similar with context
to "inpatients"
Interesting study, otherwise, would be more striking if there were other than US comparisons,
if any, additionally available studies.  reference 14 you have used and available US data is
administrative database which is inferior as a database compared to yours in this setting as per
description there are more clinical datavariables.
assistant