Review for 10.1186/s12876-020-01268-1 (2020)

Reviewer’ s report
Title: Initially Elevated Arterial Lactate as an Independent Predictor of Poor Outcomes in Severe
Acute Pancreatitis
Version: 0Date: 02 Jul 2019
Reviewer: Giuseppe Brisinda
Reviewer's report:
Please include all comments for the authors in this box rather than uploading your report as an
attachment. Please only upload as attachments annotated versions of manuscripts, graphs,supporting materials or other aspects of your report which cannot be included in a textformat.Please overwrite this text when adding your comments to the authors.I read the manuscriptwith great interest. The results showed that compared to normal arterial lactate levels, patients withelevated arterial lactate levels show significantly higher incidences of multiple persistent organfailure, death, septic shock, pancreatic and loco regional infection, abdominal compartmentsyndrome, and a need for ventilator support. Arterial lactate levels ≥4 mmol/L had a high hazard
ratio for predicting mortality due to pancreatitis. The results indicate that initially elevated arteriallactate is independently associated with poor outcomes and death in patients with severe acutepancreatitis and may serve as an early high-risk stratification indicator.The results of the study arereally interesting. The patient population under examination is well selected and conspicuous. Iagree with the authors that initially elevated arterial lactate is an early high-risk prognostic index.
Are the methods appropriate and well described?
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Yes
Does the work include the necessary controls?
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YesAre the conclusions drawn adequately supported by the data shown?
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YesAre you able to assess any statistics in the manuscript or would you recommend an
additional statistical review?If an additional statistical review is recommended, please specify what aspects require furtherassessment in your comments to the editors.
I recommend additional statistical review
Quality of written English
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AcceptableDeclaration of competing interests
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