Clinical Characteristics of Venous Thrombosis Associated with Peripherally Inserted Central Venous Catheter in Premature Infants
Round 1
Reviewer 1 Report
Dear Authors!
I have one major and some minor remarks.
Major
You found two possible risk factors for venous thrombosis in a univariate analysis, which are mother’s autoimmune disease and use of anticoagulation (by mother, if I understand right). But, I see that thrombocytosis and thrombocytopenia could be also a potential risk factors. P-values are close to 0.2 which is more or less acceptable for a small sample. I recommend to perform multivariate analysis in attempt to confirm if mother’s autoimmune disease is a true independent risk factor. You can include in a calculation thrombocytosis and thrombocytopenia also.
Minor
Abstract
I would prefer to see a structured Abstract with Background, Materials, Results and Conclusions section
Materials and Methods
You mentioned total number of medical records that were analyzed to retrieve data on venous thrombosis in the Results section (3043). But, it has to be mentioned in Materials in Methods also.
Statistical analysis: as I see you compared categorical variables also. Please, mention what test did you use.
Line 57. The statement “They were hospitalized during the same period” has to be removed as it repeats in line 59.
Line 61. Was based, not “is based”
Results
Details of anticoagulation in those who experienced vein thrombosis has to be place in this section. I mean what is written in lines 212-217.
As it was one serious adverse event while on anticoagulation (intracranial hemorrage) I recommend to add a subsection “Complications of anticoagulation”
Table 1. No need in a row with Z/t/χ²
Table 2. No need in a column with Z/t/χ²
Lines 98-99. Please, reformulate this as to make it more understandable.
Line 105. What does “noble vein” mean?
Line 126. What does “thrombus duration” mean? Do you mean that thrombus resolved during this period? If so, then you should better you term “complete resolution”.
Discussion
Line 207. What does “blood routine” mean?
Lines 223-224. It seems you have meant that anti-Xa monitoring for those who receive anticoagulation?
Conclusions
You obtained data on rate of venous thrombosis and possible risk factor only. So, conclusions have to contain just this information.
Author Response
Answer to REVISER 1
Thanks for suggestions.
Major
You found two possible risk factors for venous thrombosis in a univariate analysis, which are mother’s autoimmune disease and use of anticoagulation (by mother, if I understand right). But, I see that thrombocytosis and thrombocytopenia could be also a potential risk factors. P-values are close to 0.2 which is more or less acceptable for a small sample. I recommend to perform multivariate analysis in attempt to confirm if mother’s autoimmune disease is a true independent risk factor. You can include in a calculation thrombocytosis and thrombocytopenia also.
Answer:
After the factors with P ≤ 0.2 were included in multivariate analysis, P > 0.05, and the difference was not statistically significant.
Minor
Abstract
I would prefer to see a structured Abstract with Background, Materials, Results and Conclusions section
Answer:I have revised in the manuscript.
Materials and Methods
You mentioned total number of medical records that were analyzed to retrieve data on venous thrombosis in the Results section (3043). But, it has to be mentioned in Materials in Methods also.
Answer:I have added the total number of PICC placements to the Materials and methods section.
Statistical analysis: as I see you compared categorical variables also. Please, mention what test did you use.
Answer:Categorical variables were assessed through the χ2 or the Fisher exact test, as appropriate.It is in lines 82 and 83.
Line 57. The statement “They were hospitalized during the same period” has to be removed as it repeats in line 59.
Answer:I have removed this sentence.
Line 61. Was based, not “is based”
Answer:I have revised.
Results
Details of anticoagulation in those who experienced vein thrombosis has to be place in this section. I mean what is written in lines 212-217.
Answer:I have revised.
As it was one serious adverse event while on anticoagulation (intracranial hemorrage) I recommend to add a subsection “Complications of anticoagulation”
Answer:I have added this section.
Table 1. No need in a row with Z/t/χ²
Answer:I have deleted.
Table 2. No need in a column with Z/t/χ²
Answer:I have deleted.
Lines 98-99. Please, reformulate this as to make it more understandable.
Answer:Vascular selection for PICC catheterization：the upper extremities include (Guiyao vein, axillary vein, and cephalic vein), and the blood vessels of the lower extremities are the great saphenous vein.
Line 105. What does “noble vein” mean?
Answer:Guiyao vein.
Line 126. What does “thrombus duration” mean? Do you mean that thrombus resolved during this period? If so, then you should better you term “complete resolution”.
Answer:Your understanding is right.I have revised.
Discussion
Line 207. What does “blood routine” mean?
Answer:It means routine blood test.
Lines 223-224. It seems you have meant that anti-Xa monitoring for those who receive anticoagulation?
Answer:Yes.If the hospital can do it, it can decrease the adverse side of anticoagulation.
Conclusions
You obtained data on rate of venous thrombosis and possible risk factor only. So, conclusions have to contain just this information.
Answer:I have revised.
Answer to REVISER 2
Thanks for suggestions.
The importance of the findings of this study has been further emphasized in the conclusion.
Author Response File: 
Author Response.docx
Reviewer 2 Report
The study is interesting and may have important clinical implications. The authors aimed to analyze clinical characteristics and risk factors for peripherally inserted central catheter placement in premature infants. Even if the number of patients included in the study is very small, I consider that the results presented may have important clinical implications. I think that the study may be published after a few minor revisions. I consider that the authors should better emphasize the importance of the results obtained and also should address the future scope and topics that are important and that could not be covered in the manuscript.
Author Response
Thanks for suggestions.
The importance of the findings of this study has been further emphasized in the conclusion.
Author Response File: Author Response.docx
Round 2
Reviewer 1 Report
Dear Authors!
Thank you for addressing my remarks. I'm Ok with the paper now
Author Response
Thanks very much for your advice.
Author Response File: Author Response.docx
