Reviewer's report
Title:Clinical significance of serum triglyceride elevation at early stage of acute
biliary pancreatitis
Version:2Date:13 October 2014
Reviewer: Luca Frulloni
Reviewer's report:
Major Compulsory Revisions
The paper from Cheng et al. describe the role of elevation of TG in patients with
acute biliary pancreatitis. The clinical question is important and the results seems
to clear demonstrate that hypertrigliceridemia may affect the clinical outcome of
the disease, in term of organ failure (particularly respiratory failure) and also
mortality. Indeed, to select a homogeneous group of patients (biliary pancreatitis)
is a good tool to investigate the potential role of elevation of TG in prognosis of
ABP.
1. A main remark is that the Auhtors did not clarify the TG cut off to divide
patients in normal and elevated TG levels.
2. Authors correctly evaluated the presence of necrosis in <30%, 30-50% and
>50%. However, no mention of the methods section. I suppose that they used
the Balthazar classification on CT, but they have to state that in method section.
3. I suggest also to separate organ failure in transient and persistent, to graduate
it.
4. APACHE 2 score is not a prognostic score, but it is able to evaluate the
severity of the disease in the day when calculated. So, was APACHE2 score
calculated at the admission in all patients?
5. The Authors reported the data of many parameters in severe acute
pancreatitis following Atlanta revised criteria. I suggest to include in figure 3 and
4 also data on mild and moderate-severe pancreatitis.
6. I sugegst also to insert mortality and need for surgery surgery in table 4 .
7. No data are reported about jaundice and cholangitis in these patients, that
correlate with prognosis. I strongly suggest to insert these clinical data.
7. ERCP and endoscopic sphincterotomy have been reported as able to modify
prognosis in severe ABP, particularly in patients with jaundice and cholangitis. I
suggest to insert these data.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
no at all
Reviewer's report
Title:Clinical significance of serum triglyceride elevation at early stage of acute
biliary pancreatitis
Version:2Date:13 October 2014
Reviewer: Luca Frulloni
Reviewer's report:
Major Compulsory Revisions
The paper from Cheng et al. describe the role of elevation of TG in patients with
acute biliary pancreatitis. The clinical question is important and the results seems
to clear demonstrate that hypertrigliceridemia may affect the clinical outcome of
the disease, in term of organ failure (particularly respiratory failure) and also
mortality. Indeed, to select a homogeneous group of patients (biliary pancreatitis)
is a good tool to investigate the potential role of elevation of TG in prognosis of
ABP.
1. A main remark is that the Auhtors did not clarify the TG cut off to divide
patients in normal and elevated TG levels.
2. Authors correctly evaluated the presence of necrosis in <30%, 30-50% and
>50%. However, no mention of the methods section. I suppose that they used
the Balthazar classification on CT, but they have to state that in method section.
3. I suggest also to separate organ failure in transient and persistent, to graduate
it.
4. APACHE 2 score is not a prognostic score, but it is able to evaluate the
severity of the disease in the day when calculated. So, was APACHE2 score
calculated at the admission in all patients?
5. The Authors reported the data of many parameters in severe acute
pancreatitis following Atlanta revised criteria. I suggest to include in figure 3 and
4 also data on mild and moderate-severe pancreatitis.
6. I sugegst also to insert mortality and need for surgery surgery in table 4 .
7. No data are reported about jaundice and cholangitis in these patients, that
correlate with prognosis. I strongly suggest to insert these clinical data.
7. ERCP and endoscopic sphincterotomy have been reported as able to modify
prognosis in severe ABP, particularly in patients with jaundice and cholangitis. I
suggest to insert these data.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
no at all
Please review this paper.
user
Reviewer's report
Title:Clinical significance of serum triglyceride elevation at early stage of acute
biliary pancreatitis
Version:2Date:13 October 2014
Reviewer: Luca Frulloni
Reviewer's report:
Major Compulsory Revisions
The paper from Cheng et al. describe the role of elevation of TG in patients with
acute biliary pancreatitis. The clinical question is important and the results seems
to clear demonstrate that hypertrigliceridemia may affect the clinical outcome of
the disease, in term of organ failure (particularly respiratory failure) and also
mortality. Indeed, to select a homogeneous group of patients (biliary pancreatitis)
is a good tool to investigate the potential role of elevation of TG in prognosis of
ABP.
1. A main remark is that the Auhtors did not clarify the TG cut off to divide
patients in normal and elevated TG levels.
2. Authors correctly evaluated the presence of necrosis in <30%, 30-50% and
>50%. However, no mention of the methods section. I suppose that they used
the Balthazar classification on CT, but they have to state that in method section.
3. I suggest also to separate organ failure in transient and persistent, to graduate
it.
4. APACHE 2 score is not a prognostic score, but it is able to evaluate the
severity of the disease in the day when calculated. So, was APACHE2 score
calculated at the admission in all patients?
5. The Authors reported the data of many parameters in severe acute
pancreatitis following Atlanta revised criteria. I suggest to include in figure 3 and
4 also data on mild and moderate-severe pancreatitis.
6. I sugegst also to insert mortality and need for surgery surgery in table 4 .
7. No data are reported about jaundice and cholangitis in these patients, that
correlate with prognosis. I strongly suggest to insert these clinical data.
7. ERCP and endoscopic sphincterotomy have been reported as able to modify
prognosis in severe ABP, particularly in patients with jaundice and cholangitis. I
suggest to insert these data.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
no at all
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