{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T21:35:16Z","timestamp":1779312916344,"version":"3.51.4"},"reference-count":52,"publisher":"BMJ","issue":"5","license":[{"start":{"date-parts":[[2025,5,28]],"date-time":"2025-05-28T00:00:00Z","timestamp":1748390400000},"content-version":"unspecified","delay-in-days":27,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,5,9]]},"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Hospital admissions for advanced chronic liver disease (ACLD) are associated with increased mortality, disability, a decline in quality of life and significant economic costs. Being admitted to the hospital usually indicates a triggering event that disrupted a previously stable condition, leading to decompensation or complications of ACLD. The most acute and severe manifestation of this imbalance is acute-on-chronic liver failure (ACLF), a syndrome representing a critical juncture. Reliable prognostic stratification of patients admitted with ACLF could facilitate the systematic delivery of tailored care, ranging from palliative care to intensive interventions like extracorporeal liver support devices and prioritised liver transplantation. Disease-specific prognostic tools, such as the Model for End-Stage Liver Disease score, are effective but have limitations, particularly in reflecting a patient\u2019s potential for recovery. The concept of the body\u2019s functional reserve in the context of ACLD\/ACLF is gaining attention, with the Liver Frailty Index (LFI) potentially emerging as a recommended diagnostic tool.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients were selected from our cirrhosis registry (RH7). The LFI serves as an indicator of the patient\u2019s prognosis. The LFI measurement takes place at two time intervals: on the patient\u2019s admission and after 7\u2009days of hospitalisation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Our RH7 registry included 154 patients (15.1%) who were diagnosed with ACLF. The primary cause of the underlying ACLD was alcohol-associated liver disease in the majority (79.8%) of cases. The mean value of LFI at admission was 4.50 (\u00b1 0.94). When patients with liver cirrhosis were categorised into three subgroups based on the LFI on day 7, survival exhibited a statistically significant decrease (p\u22640.05) across all three ACLF grades. This decline in survival was observed from the \u2018improved LFI\u2019 cohort, through the \u2018stable LFI\u2019 group, to the \u2018worsened LFI\u2019 group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The impact of day 7 LFI on the survival of patients with ACLF is notable. Nevertheless, it does not markedly enhance the predictive capability of the LFI assessed on admission. Consequently, the initial LFI on day 1 continues to be the most valuable and commonly used instrument for promptly recognising individuals with ACLF.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-100171","type":"journal-article","created":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T05:20:40Z","timestamp":1748496040000},"page":"e100171","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Does the change in Liver Frailty Index over the first week of hospitalisation predict mortality in patients with acute-on-chronic liver failure? A prospective cohort study from a Slovak liver centre"],"prefix":"10.1136","volume":"15","clinical-trial-number":[{"clinical-trial-number":"nct04767945","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"\u013dubom\u00edr","family":"Skladan\u00fd","sequence":"first","affiliation":[{"name":"Department of Hepatology, Gastroenterology, and Transplantation, 2nd Department of Medicine, Slovak Medical University Faculty of Medicine, F. D. Roosevelt Hospital, Banska Bystrica, Slovakia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5700-1341","authenticated-orcid":false,"given":"D\u00e1vid","family":"L\u00ed\u0161ka","sequence":"additional","affiliation":[{"name":"Faculty of Sport Science and Health, Matej Bel University, Banska Bystrica, Slovakia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Klaudia","family":"Mesikov\u00e1","sequence":"additional","affiliation":[{"name":"F.D. Roosevelt University Hospital of Bansk\u00e1 Bystrica, Bansk\u00e1 Bystrica, Slovakia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Havaj","sequence":"additional","affiliation":[{"name":"Department of Hepatology, Gastroenterology, and Transplantation, 2nd Department of Medicine, Slovak Medical University Faculty of Medicine, F. D. Roosevelt Hospital, Banska Bystrica, Slovakia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sveltana","family":"Adamcov\u00e1-Sel\u010danov\u00e1","sequence":"additional","affiliation":[{"name":"Department of Hepatology, Gastroenterology, and Transplantation, 2nd Department of Medicine, Slovak Medical University Faculty of Medicine, F. D. Roosevelt Hospital, Banska Bystrica, Slovakia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karol\u00edna","family":"\u0160ulejov\u00e1","sequence":"additional","affiliation":[{"name":"Department of Hepatology, Gastroenterology, and Transplantation, 2nd Department of Medicine, Slovak Medical University Faculty of Medicine, F. D. Roosevelt Hospital, Banska Bystrica, Slovakia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniela","family":"\u017dilin\u010danov\u00e1","sequence":"additional","affiliation":[{"name":"Department of Hepatology, Gastroenterology, and Transplantation, 2nd Department of Medicine, Slovak Medical University Faculty of Medicine, F. D. 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