PONE-D-23-42266Intra-abdominal Hematomas and Identifiable Risk Factors in Patients Receiving Subcutaneous EnoxaparinPLOS ONE

Dear Dr. Lager,

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Gagandeep Dhillon, MD, MBA

Academic Editor

PLOS ONE

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Additional Editor Comments:

Dear authors,

I hope you are doing well. Congratulation on doing a great job with the study. The information in this report was well researched, planned, and executed. The work quality is good but needs minor changes including grammar and sentence restructuring. The study has a well defined objective and the fact that it was conducted in a 350-bed community hospital makes its findings more applicable to similar healthcare settings. I was also impressed with the evaluation of various risk factors, including age, gender, renal function, and weight, as it provides a comprehensive understanding of the patient population at risk. However, the sample size of 19 patients is relative small and being a retrospective study, it is susceptible to inherent biases, and causality cannot be definitively established. Overall. it addresses a clinically relevant issue.

Please look at the comments made by the reviewers and address them. Also, I had a few questions for you.

1. “Each CT scan was reviewed personally by a single physician to confirm clinically significant bleeding to ensure relevant cases were identified.”

Is the physician one of the authors?

2. “With COVID-19 patients receiving intermediate or therapeutic dose anticoagulation, Interleukin – 6 blockade, steroids, all increases the risk for major bleeding”

Please elaborate on this

3. What was the lovenox dose used for orbidly obese with a BMI of 30 kg/m2?

I look forward to receiving your response.

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: No

Reviewer #2: Yes

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3. Have the authors made all data underlying the findings in their manuscript fully available?

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Reviewer #1: Yes

Reviewer #2: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

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Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

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Reviewer #1: This study provides crucial insights into enoxaparin-associated abdominal hematomas, emphasizing risk factors such as age, renal impairment, and obesity. Despite its retrospective design and limited sample size, the findings align with existing literature, contributing valuable knowledge to guide clinicians in cautious enoxaparin dosing.

Reviewer #2: The authors did great job looking into the incidence of abdominal hematoma after enoxaparin use. This is a retrospective study, which have a few limitations and well mentioned in the discussion. It would be great to add more information about the concurrent presence or absence of COVID-19 infections in those patients included in analysis. It would appropriate to add year after November at one place. Overall, it is well written.

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Reviewer #1: Yes: Ripudaman Munjal

Reviewer #2: No

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Intra-abdominal Hematomas and Identifiable Risk Factors in Patients Receiving Subcutaneous Enoxaparin

PONE-D-23-42266R1

Dear Dr. Lager,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

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Kind regards,

Gagandeep Dhillon, MD, MBA

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Dear authors

I wanted to take a moment to commend you on the changes you made to your article based on the recommendations I provided. Your dedication to improving the quality and effectiveness of your work is truly admirable.

The revisions you implemented demonstrate not only your receptiveness to feedback but also your ability to thoughtfully incorporate suggestions into your writing. The adjustments have significantly enhanced the overall clarity and impact of the article.

Reviewers' comments: