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Patients were divided at admission into classical AD, single jaundice, or non\u2010AD non\u2010jaundice groups. Baseline characteristics, ACLF development, and short\u2010term outcomes were compared between groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 2645 cirrhotic patients, classical AD, single jaundice, and non\u2010AD non\u2010jaundice were observed in 2163 (81.78%), 267 (10.09%), and 215 (8.13%), respectively. The 90\u2010day liver transplant (LT)\u2010free mortality was comparable between single jaundice patients and classical AD patients (15.09% vs. 17.81%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.266), but significantly higher than non\u2010AD non\u2010jaundice patients (2.45%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01). The prevalence of ACLF (16.10% vs. 16.09%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20091.000) and pre\u2010ACLF (9.36% vs. 6.43%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.094) were comparable between the single jaundice and classical AD groups. Intrahepatic precipitants, particularly hepatitis B flare with hepatitis B virus (HBV) reactivation (odds ratio [OR] 2.69;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002), spontaneous hepatitis B flare with high HBV\u2010DNA load (OR 23.75;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), superimposed hepatitis A\/E virus infection on HBV infection (OR 13.40;\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001) and hepatotoxic drug usage (OR 3.64;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) were associated with single jaundice.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Cirrhotic inpatients with single jaundice show comparably high short\u2010term mortality and ACLF risk to those with classical AD. Single jaundice shall be considered as an AD event and is predominantly triggered by intrahepatic insults, warranting surveillance equivalent to classical AD and prioritized management of the precipitants.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1751-2980.70075","type":"journal-article","created":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T07:46:36Z","timestamp":1792050396000},"page":"323-333","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Single Jaundice in Cirrhosis: A Neglected Acute Decompensation of Acute\u2010on\u2010Chronic Liver Failure and Mortality"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9176-8856","authenticated-orcid":false,"given":"Xin","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Renji Hospital, School of Medicine Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, NHC Key Laboratory of Digestive Diseases  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xian Bo","family":"Wang","sequence":"additional","affiliation":[{"name":"Center of Integrative Medicine, Beijing Ditan Hospital Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Institute of Infection and Immunology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology  Wuhan Hubei Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2884-071X","authenticated-orcid":false,"given":"Wen Ting","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Southwest Hospital Third Military Medical University (Army Medical University)  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4646-6186","authenticated-orcid":false,"given":"Xiu Hua","family":"Jiang","sequence":"additional","affiliation":[{"name":"Hepatology Unit, Department of Infectious Diseases, Nanfang Hospital Southern Medical University  Guangzhou Guangdong Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Hunan Key Laboratory of Viral Hepatitis, Xiangya Hospital Central South University  Changsha Hunan Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0401-535X","authenticated-orcid":false,"given":"Zhong Ji","family":"Meng","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease, Hubei Clinical Research Center for Precise Diagnosis and Treatment of Liver Cancer Taihe Hospital, Hubei University of Medicine  Shiyan Hubei Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan Hang","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Hepatology The First Hospital of Jilin University  Changchun Jilin Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhi Ping","family":"Qian","sequence":"additional","affiliation":[{"name":"Department of Liver Intensive Care Unit Shanghai Public Health Clinical Center, Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Liu","sequence":"additional","affiliation":[{"name":"Tianjin Institute of Hepatology, Nankai University Second People's Hospital  Tianjin China"},{"name":"Department of Infectious Diseases and Hepatology The Second Hospital of Shandong University  Jinan Shandong Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5532-7551","authenticated-orcid":false,"given":"Xiao Bo","family":"Lu","sequence":"additional","affiliation":[{"name":"Infectious Disease Center The First Affiliated Hospital of Xinjiang Medical University  Urumqi Xinjiang Uygur Autonomous Region China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9392-7176","authenticated-orcid":false,"given":"Yu","family":"Shi","sequence":"additional","affiliation":[{"name":"The State Key Laboratory for Diagnosis and Treatment of Infectious Diseases The First Affiliated Hospital of School of Medicine, Zhejiang University  Hangzhou Zhejiang Province China"},{"name":"Collaborative Innovation Center for Diagnosis and Treatment of Infectious Disease  Hangzhou Zhejiang Province China"},{"name":"National Clinical Research Center of Infectious Disease  Hangzhou Zhejiang Province 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