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The aim of this study was to analyze the impact of serum thyroid-stimulation hormone (TSH) levels on the prognosis of patients with hepatitis B virus (HBV)-related acute-on-chronic liver failure (ACLF).\n<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>This retrospective cohort study included 1,862 patients with HBV-related ACLF. Risk factors associated with 30-day and 90-day survival, hazard ratios (HRs), and 95% confidence intervals (CIs) for TSH were estimated using Cox proportional hazards regression. The Area Under the ROC curve (AUROC) analysis was carried out, and the cut-off values were calculated. After grouping by the cut-off value, survival was compared between the groups using the log-rank test. This study data is from the \u201cSurvival Cohort Study (SCS)\u201d, which has been registered at ClinicalTrials.gov (NCT03992898).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Multivariate analysis indicated that an elevated TSH level was a highly significant predictor for 30-day survival (HR\u2009=\u20090.743, 95% CI: 0.629\u20130.878, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) and 90-day survival (HR\u2009=\u20090.807, 95% CI: 0.717\u20130.909, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). The AUROC of TSH level for 30-day and 90-day mortality were 0.655 and 0.620, respectively, with the same best cut-off values of 0.261 \u00b5IU\/mL. Log-rank test showed that the group with higher TSH level had higher 30-day (78.5%, 95% CI: 76.1%-80.9% vs. 56.9%, 95% CI: 53.4%-60.4%; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) and 90-day survival rate (61.5%, 95% CI: 58.6%-64.4% vs. 42.8%, 95% CI: 39.3%-46.3%; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). Similar findings were observed in subgroups analysis. After adjusting for age and other risk factors, the higher level of TSH remained associated with 30-day survival (HR\u2009=\u20090.602, 95% CI: 0.502\u20130.721, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) and 90-day survival (HR\u2009=\u20090.704, 95% CI, 0.609\u20130.814, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Serum TSH level significantly correlate with HBV-related ACLF patients\u2019 survival and may be of value for predicting 30-day and 90-day survival of patients with HBV-related ACLF.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12876-022-02406-7","type":"journal-article","created":{"date-parts":[[2022,7,7]],"date-time":"2022-07-07T10:10:44Z","timestamp":1657188644000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["The impact of serum thyroid-stimulation hormone levels on the outcome of hepatitis B virus related acute-on-chronic liver failure: an observational study"],"prefix":"10.1186","volume":"22","author":[{"given":"Jun-feng","family":"Chen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei-zhen","family":"Weng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miao","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiao-hua","family":"Peng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing","family":"Xiong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jian-rong","family":"He","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shao-quan","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hui-juan","family":"Cao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bin","family":"Gao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deng-na","family":"Lin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan","family":"Gao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhi-liang","family":"Gao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4069-6287","authenticated-orcid":false,"given":"Bing-liang","family":"Lin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,7,7]]},"reference":[{"issue":"4","key":"2406_CR1","doi-asserted-by":"publisher","first-page":"353","DOI":"10.1007\/s12072-019-09946-3","volume":"13","author":"SK Sarin","year":"2019","unstructured":"Sarin SK, Choudhury A, Sharma MK, Maiwall R, Mahtab MA, Rahman S, et al. 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The study protocol was approved by the Ethics Committee on Clinical Trials of the Third Affiliated Hospital of Sun Yat-sen University, and the requirement for written informed consent was waived.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not Applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"330"}}