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Although the dichotomous stratification into a compensated and decompensated state reflects a prognostic water\u2010shed moment and remains to hold its prognostic validity, it represents an oversimplification of clinical realities. A broadening understanding of pathophysiological mechanisms underpinning decompensation have led to the identification of distinct prognostic subgroups, associated with different clinical courses following decompensation. Data provided by the PREDICT study uncovered three distinct sub\u2010phenotypes of acute decompensation (AD). Moreover, acute\u2010on\u2010chronic liver failure (ACLF) has been established as a distinct clinical entity for many years, which is associated with a high short\u2010term mortality. Recently, non\u2010acute decompensation (NAD) has been proposed as a distinct pathway of decompensation, complementing current concepts of the spectrum of decompensation. In contrast to AD, NAD is characterized by a slow and progressive development of complications, which are often presented at first decompensation and\/or in patients in an earlier stage of chronic liver disease. Successful treatment of AD or NAD may lead to a clinical stabilization or even the concept of recompensation. This review aims to provide an overview on current concepts of decompensation and to delineate recent advances in our clinical and pathophysiological understanding.<\/jats:p>","DOI":"10.1111\/liv.15861","type":"journal-article","created":{"date-parts":[[2024,3,1]],"date-time":"2024-03-01T04:28:58Z","timestamp":1709267338000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Acute and non\u2010acute decompensation of liver cirrhosis"],"prefix":"10.1111","volume":"45","author":[{"given":"Martin S.","family":"McCoy","sequence":"first","affiliation":[{"name":"Department of Internal Medicine B University of M\u00fcnster  M\u00fcnster Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Angeli","sequence":"additional","affiliation":[{"name":"European Foundation for Study of Chronic Liver Failure  Barcelona 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