Reviewer ’s report  
 
Title: Initially Elevated Arterial Lactate as an Independent Predictor of Poor Outco mes in Severe 
Acute Pancreatitis  
 
Version: 0 Date: 03 Jul 2019  
 
Reviewer: J Wan  
 
Reviewer's report:  
 
Reviewer: This paper showed us the initially elevated la ctate might use as an independent 
predictor for poor outcomes in severe acute pancreatitis. The study provided some evidence for 
the clinical use of lactate, but there are still some concerns:  
 
1) The data of lactate have been collected over a period of 5 years. Can the authors 
confirm that the reference values for this assay have not changed over this period?  
 
2) As you mentioned in the paper, septic shock is one of the main observational outcomes . 
Please the authors add the criteria?  
 
3) In the discussion section, please explain the possible mechanism of lactate associated 
with pancreatitis  
 
4) This study is a retrospective study, and a prospective large samples study should be 
designed to verif y this conclusion in the future.  
 
5) Please utilise the assistance of a Professional English Language editing service - the 
manuscript is ridden with language errors throughout, which distracts readersfrom the 
message the authors wish to get across.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the autho rs. 
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the a uthors.  
 
Yes 
 
Are you able to assess any statistics in the manus cript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1.  Have you in the past five years received reimbursements, f ees, funding, or salary 
from an organisation that may in any way gain or lose financially from the 
publi cation of this manuscript, either now or in the future?  
 
2.  Do you hold any stocks or shares in an organisation t hat may in any way gain or 
lose financially from the publication of this manuscript, either now or in the 
future?  
 
3.  Do you hold or are you curr ently applying for any patents  relating to the content 
of the manuscript?  
 
4.  Have you received reimbursements, fees, funding, or salary from an organization 
that holds or has applied for patents relating to the content of the manuscript?  
 
5.  Do you have any  other financial competing interests?  
 
6.  Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have  no competing interests' 
below. If your reply is yes to any, please give details below.  
 
None  
 
I agree to the open peer review policy of the journal. I understan d that my name will be included 
on my report to the authors and, if the manuscript is accepted f or publication, my named report 
including any attachments I upload wi ll be posted on the website along with the authors' 
responses. I agree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my named report can be in cluded as confidential comments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Reviewer ’s report  
 
Title: Initially Elevated Arterial Lactate as an Independent Predictor of Poor Outco mes in Severe 
Acute Pancreatitis  
 
Version: 0 Date: 03 Jul 2019  
 
Reviewer: J Wan  
 
Reviewer's report:  
 
Reviewer: This paper showed us the initially elevated la ctate might use as an independent 
predictor for poor outcomes in severe acute pancreatitis. The study provided some evidence for 
the clinical use of lactate, but there are still some concerns:  
 
1) The data of lactate have been collected over a period of 5 years. Can the authors 
confirm that the reference values for this assay have not changed over this period?  
 
2) As you mentioned in the paper, septic shock is one of the main observational outcomes . 
Please the authors add the criteria?  
 
3) In the discussion section, please explain the possible mechanism of lactate associated 
with pancreatitis  
 
4) This study is a retrospective study, and a prospective large samples study should be 
designed to verif y this conclusion in the future.  
 
5) Please utilise the assistance of a Professional English Language editing service - the 
manuscript is ridden with language errors throughout, which distracts readersfrom the 
message the authors wish to get across.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the autho rs. 
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the a uthors.  
 
Yes 
 
Are you able to assess any statistics in the manus cript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1.  Have you in the past five years received reimbursements, f ees, funding, or salary 
from an organisation that may in any way gain or lose financially from the 
publi cation of this manuscript, either now or in the future?  
 
2.  Do you hold any stocks or shares in an organisation t hat may in any way gain or 
lose financially from the publication of this manuscript, either now or in the 
future?  
 
3.  Do you hold or are you curr ently applying for any patents  relating to the content 
of the manuscript?  
 
4.  Have you received reimbursements, fees, funding, or salary from an organization 
that holds or has applied for patents relating to the content of the manuscript?  
 
5.  Do you have any  other financial competing interests?  
 
6.  Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have  no competing interests' 
below. If your reply is yes to any, please give details below.  
 
None  
 
I agree to the open peer review policy of the journal. I understan d that my name will be included 
on my report to the authors and, if the manuscript is accepted f or publication, my named report 
including any attachments I upload wi ll be posted on the website along with the authors' 
responses. I agree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my named report can be in cluded as confidential comments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Please review this paper.
user
Reviewer ’s report  
 
Title: Initially Elevated Arterial Lactate as an Independent Predictor of Poor Outco mes in Severe 
Acute Pancreatitis  
 
Version: 0 Date: 03 Jul 2019  
 
Reviewer: J Wan  
 
Reviewer's report:  
 
Reviewer: This paper showed us the initially elevated la ctate might use as an independent 
predictor for poor outcomes in severe acute pancreatitis. The study provided some evidence for 
the clinical use of lactate, but there are still some concerns:  
 
1) The data of lactate have been collected over a period of 5 years. Can the authors 
confirm that the reference values for this assay have not changed over this period?  
 
2) As you mentioned in the paper, septic shock is one of the main observational outcomes . 
Please the authors add the criteria?  
 
3) In the discussion section, please explain the possible mechanism of lactate associated 
with pancreatitis  
 
4) This study is a retrospective study, and a prospective large samples study should be 
designed to verif y this conclusion in the future.  
 
5) Please utilise the assistance of a Professional English Language editing service - the 
manuscript is ridden with language errors throughout, which distracts readersfrom the 
message the authors wish to get across.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the autho rs. 
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the a uthors.  
 
Yes 
 
Are you able to assess any statistics in the manus cript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1.  Have you in the past five years received reimbursements, f ees, funding, or salary 
from an organisation that may in any way gain or lose financially from the 
publi cation of this manuscript, either now or in the future?  
 
2.  Do you hold any stocks or shares in an organisation t hat may in any way gain or 
lose financially from the publication of this manuscript, either now or in the 
future?  
 
3.  Do you hold or are you curr ently applying for any patents  relating to the content 
of the manuscript?  
 
4.  Have you received reimbursements, fees, funding, or salary from an organization 
that holds or has applied for patents relating to the content of the manuscript?  
 
5.  Do you have any  other financial competing interests?  
 
6.  Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have  no competing interests' 
below. If your reply is yes to any, please give details below.  
 
None  
 
I agree to the open peer review policy of the journal. I understan d that my name will be included 
on my report to the authors and, if the manuscript is accepted f or publication, my named report 
including any attachments I upload wi ll be posted on the website along with the authors' 
responses. I agree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my named report can be in cluded as confidential comments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
assistant