{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T03:56:09Z","timestamp":1775447769762,"version":"3.50.1"},"reference-count":20,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T00:00:00Z","timestamp":1774828800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background and Aims: Ascites is a common complication of cirrhosis. Its presence is associated with poorer outcomes. This study evaluates the association between ascites burden, including absolute thickness and longitudinal changes as a surrogate parameter of ascites volume and dynamics, and transplant-free survival in patients with cirrhosis. Methods: In this prospective single-center study, patients with cirrhosis underwent blood analysis, physical examination, and standardized ultrasound assessment of ascites at inclusion and after 3 months. Ascites burden was assessed by measuring ascites thickness in predefined abdominal compartments, which served as a surrogate for ascites volume. A 12-month follow-up recorded clinical progress, hospitalizations, decompensation, liver failure, transplantation, and death. Results: A total of 272 patients with cirrhosis (males 60%, median age 56 years, median MELD-Na 14) were included. Among them, 40 (15%) died or underwent liver transplantation during follow-up. These patients had significantly greater ascites thickness in all abdominal compartments at both time points as compared to survivors (all p &lt; 0.001). In univariable analyses, greater baseline ascites thickness was associated with adverse outcome, with the strongest association observed for perisplenic ascites (OR 1.13, 95% CI 1.06\u20131.21; p &lt; 0.001). In multivariate analysis, only baseline perihepatic ascites remained significantly associated with the endpoint (OR = 1.05, 95% CI [1.00\u20131.11], p = 0.045). The decrease in perisplenic ascites thickness during follow-up was in turn significantly associated with reduced risk of death or transplantation (OR 0.85, 95% CI [0.72\u20130.96], p = 0.017). Conclusions: In this prospective cohort, greater ascites thickness was associated with adverse outcomes in cirrhosis. Baseline perihepatic ascites and dynamic changes in perisplenic ascites emerged as potentially informative markers; however, these findings should be interpreted cautiously and require validation in larger cohorts.<\/jats:p>","DOI":"10.3390\/jcm15072635","type":"journal-article","created":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T15:20:47Z","timestamp":1774884047000},"page":"2635","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prognostic Relevance of Ascites Volume and Dynamics in Outpatients with Cirrhosis: A Prospective Cohort Study"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-7235-7338","authenticated-orcid":false,"given":"Moritz","family":"Passenberg","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Hepatology and Transplant Medicine, Medical Faculty, University of Duisburg-Essen, 45147 Essen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clara","family":"Guntlisbergen","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hepatology and Transplant Medicine, Medical Faculty, University of Duisburg-Essen, 45147 Essen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nargiz","family":"Nuruzade","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hepatology and Transplant Medicine, Medical Faculty, University of Duisburg-Essen, 45147 Essen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan","family":"Best","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hepatology and Transplant Medicine, Medical Faculty, University of Duisburg-Essen, 45147 Essen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dieter P.","family":"Hoyer","sequence":"additional","affiliation":[{"name":"Department of General, Visceral and Transplantation Surgery, Medical Faculty, University of Duisburg-Essen, 45147 Essen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ulf","family":"Neumann","sequence":"additional","affiliation":[{"name":"Department of General, Visceral and Transplantation Surgery, Medical Faculty, University of Duisburg-Essen, 45147 Essen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hartmut","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hepatology and Transplant Medicine, Medical Faculty, University of Duisburg-Essen, 45147 Essen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1474-7733","authenticated-orcid":false,"given":"Katharina","family":"Willuweit","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hepatology and Transplant Medicine, Medical Faculty, University of Duisburg-Essen, 45147 Essen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1031-6418","authenticated-orcid":false,"given":"Georgios","family":"Konstantis","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hepatology and Transplant Medicine, Medical Faculty, University of Duisburg-Essen, 45147 Essen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8216-0064","authenticated-orcid":false,"given":"Jassin","family":"Rashidi-Alavijeh","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hepatology and Transplant Medicine, Medical Faculty, University of Duisburg-Essen, 45147 Essen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"European Association for The Study of the Liver (2016). 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