{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T10:29:45Z","timestamp":1791973785984,"version":"4.4.0"},"reference-count":48,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,5,28]],"date-time":"2021-05-28T00:00:00Z","timestamp":1622160000000},"content-version":"vor","delay-in-days":27,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["UEG Journal"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Recently, based on data from the PREDICT study, the European Foundation for the Study of Chronic Liver Failure (EF\u2010CLIF) consortium proposed pathophysiological\/prognostic groups in hospitalized patients with cirrhosis: stable decompensated cirrhosis (SDC), unstable decompensated cirrhosis (UDC), pre\u2010acute\u2010on\u2010chronic liver failure (pre\u2010ACLF), and ACLF. We evaluated the outcomes of these subgroups in a real\u2010life cohort of hospitalized patients with cirrhosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with cirrhosis developing first AD between 09\/2010 and 12\/2017 at the Vienna General Hospital were evaluated for this retrospective analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Two hundred and ten patients with cirrhosis (aged 57.6\u00a0\u00b1\u00a011.8\u00a0years) including <jats:italic>n<\/jats:italic>\u00a0=\u00a045 (21.4%) SDC, <jats:italic>n<\/jats:italic>\u00a0=\u00a0100 (47.6%) UDC, <jats:italic>n<\/jats:italic>\u00a0=\u00a028 (13.3%) pre\u2010ACLF, and <jats:italic>n<\/jats:italic>\u00a0=\u00a037 (17.6%) with ACLF were considered. The proposed AD subgroups discriminated between patients with favorable (1\u2010year mortality: SDC: 6.7% and UDC: 19.6%) and dismal prognosis (90\u2010day mortality: pre\u2010ACLF: 42.9%). Interestingly, systemic inflammation gradually increased (e.g., C\u2010reactive protein, SDC: 0.9\u00a0mg\/dl, vs. UDC: 2.0\u00a0mg\/dl vs. pre\u2010ACLF: 3.2\u00a0mg\/dl, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001) while renal function was progressively deteriorating (creatinine levels, SDC: 0.8\u00a0mg\/dl vs. UDC: 0.9\u00a0mg\/dl vs. pre\u2010ACLF: 1.2\u00a0mg\/dl, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001) across prognostic subgroups in patients with cirrhosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>The recently proposed pathophysiological\/prognostic EF\u2010CLIF subgroups are also reproduceable in a real\u2010life cohort of cirrhotic patients. As ACLF is a common and important complication, patients at risk of pre\u2010ACLF at index AD should be evaluated and if disease proceeds, been treated early and aggressively to avoid excessive mortality.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ueg2.12089","type":"journal-article","created":{"date-parts":[[2021,5,29]],"date-time":"2021-05-29T01:10:04Z","timestamp":1622250604000},"page":"427-437","source":"Crossref","is-referenced-by-count":34,"title":["Patterns of acute decompensation in hospitalized patients with cirrhosis and course of acute\u2010on\u2010chronic liver failure"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6708-3061","authenticated-orcid":false,"given":"Lorenz","family":"Balcar","sequence":"first","affiliation":[{"name":"Department of Internal Medicine III Division of Gastroenterology and Hepatology Medical University of Vienna  Vienna Austria"},{"name":"Vienna Hepatic Hemodynamic Laboratory Medical University of Vienna  Vienna 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