Review for 10.1186/s12876-020-01437-2 (2020)

Reviewer’ s report
Title: A novel predictive model based on inflammatory markers to assess the prognosis of patients
with HBV-related acute-on-chronic liver failure:a retrospective cohort study
Version: 1Date: 28 Oct 2019
Reviewer: Huadong Yan
Reviewer's report:
Li qiang and colleagues have written a paper finding that A model named RNTIC based on
inflammatory markers to assess the prognosis of patients with HBV-related acute-on chronic liverfailure in a retrospective cohort of 577 patients. However, there are many important details notincluded in this paper that need clarification.1) Patients and methodsa. Study cohort: The study retrospectively enrolled consecutive patients diagnosed with HBV-ACLF in the Affiliated Hospital of Southwest Medical University as a derivation cohort and theFirst People's Hospital of Neijiang and Second People's Hospital of Yibin as a validation cohort.APASL criteria was used to define ACLF patients.You only enrolled HBV ACLF patients fromChinese hospitals.So you should tell how many patients were diagnosed with Chinese criteria?b.Inclusion/exclusion: you lack a consort diagram.you excluded Patients with cardiac diseases,endocrinological disorders, hematological disease and other types of cancer were excluded. Co-infection with human immunodeficiency virus, hepatitis A, C, D, and E viruses or other hepatitisviruses, autoimmune diseases, alcoholic liver disease, drug-induced liver injury,coexistenthepatocellular carcinoma, and any other serious medical illness or patients who had received anyimmunotherapy, liver transplantation or artificial liver support were also excluded. How about the
numbers? How many patients with previous decompensation of cirrhosis were included in the
study? All patients with HCC were excluded in the study? All patients with artificial liver supportwere excluded in the study?We need information on if pts were lost to follow up. If so how many.What information was collected?c. management for patients :How about the management for patients during hospital? Anydifference between the derivation cohort and the validation cohort?d. Statistical analysis:We see you list many statistic methods like the Kaplan-Meier method andROC not seen in the paper.2) Results and discussiona. In table1 and table4,bacterial infection should be added as an important complication for ACLFpatients.CTP score and CLIF-SOFA score were now also important model for ACLF patients. Nodata of admission bacterial infection in this cohort was given. More details of infection atadmission and during hospital stay (if possible)including sites of infection, species of bacterialculture positive should be given.b. I can not see the figure1 and figure2.c. NLR was so low in the validation cohort(1.92 V 4.84),why?d. In table 3 validation cohort data also should be added.e. CTP score and CLIF-SOFA score and MELD-na score should also be compared to the new
RNTIC score.
In summary,the auther find RNTIC score was useful for prediction 90 day mortality in HBV-
ACLF patients.But many important details not included in this paper that need clarification.
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
Yes
Does the work include the necessary controls?
If not, please specify which controls are required in your comments to the authors.
NoAre the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
NoAre 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 am able to assess the statistics
Quality of written English
Please indicate the quality of language in the manuscript:
Needs some language corrections before being publishedDeclaration of competing interests
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