{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T05:47:32Z","timestamp":1780638452714,"version":"3.54.1"},"reference-count":39,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,5,19]],"date-time":"2021-05-19T00:00:00Z","timestamp":1621382400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["JGH Open"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aim<\/jats:title><jats:p>Acute\u2010on\u2010chronic liver failure (ACLF) is a transpiring entity, which possesses high short\u2010term\/early mortality (28\u2009days). Several mortality predictors have been studied, but none were proved reliable. Serum ferritin, an acute phase reactant and marker of hepatic necro\u2010inflammation, is found to predict mortality in multiple liver diseases. We aimed to evaluate the role of serum ferritin and other clinical features, biochemical parameters and conventional scoring systems in predicting early mortality among ACLF.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A prospective cohort study was done from October 2017 to March 2019 at a tertiary care (non\u2010transplant) center in eastern India. A total of consecutive 50 ACLF patients diagnosed, based on Asia Pacific Association for the Study of liver disease definition, were investigated for ferritin and other laboratory parameters on day\u20100, day\u20107, and followed up for 28\u2009days.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Although the majority did not have organ failure (ACLF grade 0) according to European Association for Study of Liver\u2010chronic liver failure sequential organ failure assessment criteria, early mortality was high (56%). On undergoing univariate analysis, multiple variables (ascites, HE, creatinine, total leucocyte count (TLC), bilirubin, albumin) predicted mortality. However, on multivariate analysis, only total bilirubin independently predicted. None of the scores on day\u20100 were predictive, while model for end\u2010stage liver disease [area under the receiver operating characteristics (AUROC)\u20100.703, 95% confidence interval [CI]: 0.535\u20130.859] and Child\u2013Turcotte\u2013Pugh (AUROC\u20100.697, 95% CI: 0.550\u20130.855) on day\u20107 did.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>ACLF is a dynamic process; day\u20107 assessment with above predictors, to be considered a milestone for prognostication and opting treatment modalities. Serum ferritin does not predict early mortality in ACLF.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jgh3.12557","type":"journal-article","created":{"date-parts":[[2021,5,19]],"date-time":"2021-05-19T15:17:14Z","timestamp":1621437434000},"page":"686-694","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Predictors of early mortality among patients with acute\u2010on\u2010chronic liver failure"],"prefix":"10.1002","volume":"5","author":[{"given":"Bershic","family":"Valantine","sequence":"first","affiliation":[{"name":"Department of General Medicine IMS and SUM Hospital, Siksha 'O' Anusandhan, Deemed to be University  Bhubaneswar India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nabakishore","family":"Sundaray","sequence":"additional","affiliation":[{"name":"Department of General Medicine IMS and SUM Hospital, Siksha 'O' Anusandhan, Deemed to be University  Bhubaneswar India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debakanta","family":"Mishra","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology IMS and SUM Hospital, Siksha 'O' Anusandhan, Deemed to be University  Bhubaneswar India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samir","family":"Sahu","sequence":"additional","affiliation":[{"name":"Department of General Medicine IMS and SUM Hospital, Siksha 'O' Anusandhan, Deemed to be University  Bhubaneswar India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jimmy","family":"Narayan","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology IMS and SUM Hospital, Siksha 'O' Anusandhan, Deemed to be University  Bhubaneswar India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baikuntha N","family":"Panda","sequence":"additional","affiliation":[{"name":"Department of General Medicine IMS and SUM Hospital, Siksha 'O' Anusandhan, Deemed to be University  Bhubaneswar India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6247-1180","authenticated-orcid":false,"given":"Ayaskanta","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology IMS and SUM Hospital, Siksha 'O' Anusandhan, Deemed to be University  Bhubaneswar India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,5,19]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0122158"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12072-008-9106-x"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2013.02.042"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1053\/jhep.2001.22172"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2010.11.008"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-198510000-00009"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01709751"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2004.10.019"},{"issue":"2","key":"e_1_2_7_10_1","first-page":"7","article-title":"Cytokines and liver failure: modification of TNF\u2010Alfa and IL\u20106 in patients with acute on chronic liver decompensation treated with Molecular Adsorbent Recycling System (MARS)","volume":"74","author":"Ambrosino G","year":"2003","journal-title":"Acta Biomed."},{"key":"e_1_2_7_11_1","first-page":"121","article-title":"Elevated serum ferritin levels: associated diseases and clinical significance","volume":"101","author":"Koduri PR","year":"1996","journal-title":"Am. 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