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This study aims to analyze the frequency and associated factors of recompensation in patients with alcohol-related cirrhosis following the first decompensation and evaluate the prognosis based on recompensation status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective cohort study was conducted at a tertiary care hospital in South Korea between 2017 and 2022. We enrolled 184 consecutive patients with alcohol-related cirrhosis presenting with a first decompensating event. According to the Baveno VII criteria, recompensation was defined as alcohol abstinence, improvement in liver function, and resolution of ascites\/encephalopathy (off diuretics\/lactulose) and absence of recurrent variceal bleeding (for at least 12 months). Patients were followed for outcomes including further decompensation, liver transplantation, or death.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 184 patients, 45 (24.5%) achieved abstinence-induced recompensation while 38 (20.6%) died during the index hospitalization. In the multivariable Fine-Gray competing risk regression analysis, a lower baseline Child-Pugh score (sHR\u2009=\u20090.77, 95% CI\u2009=\u20090.61\u20130.98,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.032) and lower MELD score (sHR\u2009=\u20090.93, 95% CI\u2009=\u20090.88\u20130.99,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.023) were independent factors associated with recompensation. Among the 146 survivors, 51 (34.9%) died, 10 (6.8%) underwent liver transplantation, and 95 (65.1%) experienced further decompensation. Time-dependent multivariable Cox regression analysis showed that recompensation decreased the risk of death or liver transplantation by 96% (HR\u2009=\u20090.04, 95% CI\u2009=\u20090.01\u20130.30,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.002) and the risk of further decompensation by 75% (HR\u2009=\u20090.25, 95% CI\u2009=\u20090.13\u20130.48,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Approximately one-fourth of the patients with alcohol-related cirrhosis achieved recompensation after first decompensation, which was strongly associated with reduced mortality and lower risk of further decompensation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12876-026-04651-6","type":"journal-article","created":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T02:53:12Z","timestamp":1770000792000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Recompensation following first decompensation in patients with alcohol-related cirrhosis"],"prefix":"10.1186","volume":"26","author":[{"given":"Ji Yoon","family":"Kwak","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hankyu","family":"Jeon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyeon Uk","family":"Kwon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae Eun","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji Hee","family":"Han","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jung Woo","family":"Choi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ra Ri","family":"Cha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae Min","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sang Soo","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,2]]},"reference":[{"issue":"9682","key":"4651_CR1","doi-asserted-by":"publisher","first-page":"2223","DOI":"10.1016\/S0140-6736(09)60746-7","volume":"373","author":"J Rehm","year":"2009","unstructured":"Rehm J, Mathers C, Popova S, Thavorncharoensap M, Teerawattananon Y, Patra J. 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