Cell-Free DNA in Plasma and Serum Indicates Disease Severity and Prognosis in Blunt Trauma Patients

Round 1

Reviewer 1 Report

-Title: The study refers only to blunt trauma patients and not in trauma patients collectively 

-It is not justified why penetrating trauma is excluded. The same study must concern penetrating trauma also as another study arm. 

-Thermal/Chemical injuries probably excluded also? it is not clarified in the exclusion criteria

-Table 1: in the "injured body region" the term external refers to what?

      survival of first week is presented only for the patients with SMT

-Materials and Methods, first paragraph, line8 (114), must be corrected 

-What about cfDNA levels and morbidity ?

-what about penetrating trauma and thermal injuries? Why not studying cfDNA levels in these groups also?

-Any recommendations for future studies in military trauma as well which has deferent mechanisms? 

-references might be slightly fewer 

 

 

 

Author Response

Please see the attachment 

Author Response File: Author Response.docx

Reviewer 2 Report

Journal: Diagnostics (ISSN 2075-4418)

Manuscript ID: diagnostics-2244470

Type: Article

Title:

Cell-free DNA in plasma and serum indicates disease severity and prognosis in trauma patients

Authors:

Inga Maria Trulson , Juliane Stahl , Stefan Margraf , Martin Scholz , Eduard Höcherl , Konrad Wolf , Jürgen Durner , Frank Klawonn , Stefan Holdenrieder *

Section:

Pathology and Molecular Diagnostics

Special Issue

Cell-Free Nucleic Acids—New Insights into Physico-Chemical Properties, Analytical Considerations, and Clinical Applications

Aim of the study: Authors propose an easy-to-handle and quick method for cfDNA quantification in serum or plasma and show their potential together with other lab-based markers for the estimation of trauma severity and early hospital mortality in patients with multiple trauma, in comparison with already established routine laboratory biomarkers.

Ø  Results

Line 212: Figure 3: Correlation plot needs more clarification to be simpler for readers

Line 264: NFN: Do you mean femur neck fracture, FNF?

Line 278: R=0.41, p<0.001; R=0.42, p=0.001……….kindly revise p values

Fig.7.A and Fig.8.A……. The x & y axis titles should be more obvious

Line 288: sensitivities of 42 at 90% specificity………..42%

Ø  Discussion

Line 334-338: Different mechanism of cfDNA release from damaged, dying or stimulated cells are discussed……Reformulate this sentence

Line 338: [11,28] [45]: Do you mean [11,28,45]

Line 378: the adverse prognosis could e.g. result in more invasive treatment choices……………what do you mean by could e.g. result ?

Ø  Limitations of the study, conclusion and recommendations are all fulfilled and discussed  

 

Author Response

Please see the attachment 

Author Response File: Author Response.docx