Review for 10.1186/s12876-023-02768-6 (2023)

Reviewer’s report
Title: 
Risk stratification based on acute-on-chronic liver failure in
cirrhotic patients hospitalized for acute variceal bleeding
Version: 
0 
Date: 
24 Oct 2022
Reviewer's report:
AVB is the main cause of death in patients with liver cirrhosis. Zhu et al.
discussed the main factors related to mortality rate in patients with liver cirrhosis
combined with AVB, which is a significant work. However, I have some
concerns as following, which might be helpful to improve manuscript.
Major concerns
1. HCC is one of the main causes of death in patients with liver disease, and
HCC was not excluded in this study, which may interfere with the true value of
mortality rate of patients with liver cirrhosis combined with AVB. Patients with
HCC are recommended to be excluded.
2. Immunosuppressive therapy, human immunodeficiency virus infection (HIV),
pregnancy, extrahepatic tumor, serious extrahepatic diseases unrelated to liver
cirrhosis, et. al. can affect the judgment of mortality rate of patients with liver
cirrhosis combined with AVB, and it is better to exclude these interference
factors.
Minor point
1. Page19 line 1-2, CLIF-ACLF score is omitted here.
2. Please state the diagnostic criteria for cirrhosis complications.
3. Please show how many patients in this study received liver transplantation.
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Is the study design appropriate to answer the research question (including the use
of appropriate controls), and are the conclusions supported by the evidence
presented?
Yes
Are the methods sufficiently described to allow the study to be repeated?
Yes
Is the use of statistics and treatment of uncertainties appropriate?
Yes
Is the presentation of the work clear?
Yes
Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
Yes