{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:51:14Z","timestamp":1787028674118,"version":"build-2736575974"},"reference-count":26,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2020,4,26]],"date-time":"2020-04-26T00:00:00Z","timestamp":1587859200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["LA 2806\/2-1 and LA 2806\/5-1 to CML"],"award-info":[{"award-number":["LA 2806\/2-1 and LA 2806\/5-1 to CML"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: While systemic inflammation is recognized as playing a central role in the pathogenesis of organ failures in patients with liver cirrhosis, less is known about its relevance in the development of classical hepatic decompensation. Aim: To characterize the relationship between systemic inflammation, hemodynamics, and anemia with decompensation of liver cirrhosis. Methods: This is a post-hoc analysis of a cohort study of outpatients with advanced liver fibrosis or cirrhosis. Results: Analysis included 338 patients of whom 51 patients (15%) were hospitalized due to decompensation of liver cirrhosis during a median follow-up time of six months. In univariate analysis, active alcoholism (p = 0.002), model of end-stage liver disease (MELD) score (p = 0.00002), serum IL-6 concentration (p = 0.006), heart rate (p = 0.03), low arterial blood pressure (p &lt; 0.05), maximal portal venous flow (p = 0.008), and low hemoglobin concentration (p &lt; 0.00001) were associated with hospitalization during follow-up. Multivariate analysis revealed an independent association of low hemoglobin (OR = 0.62, 95% CI = 0.51\u20130.78, p = 0.001) and serum IL-6 concentration (OR = 1.02, 95% CI = 1.01\u20131.04, p = 0.03)\u2014but not of hemodynamic parameters\u2014with hepatic decompensation. An inverse correlation between hemoglobin concentration and portal venous flow (R = \u22120.362, p &lt; 0.0001) was detected for the non-hospitalized patients. Accuracy of baseline hemoglobin levels for predicting hospitalization (AUC = 0.84, p &lt; 0.000001) was high. Conclusion: Anemia and systemic inflammation, rather than arterial circulatory dysfunction, are strong and independent predictors of hepatic decompensation in outpatients with liver cirrhosis.<\/jats:p>","DOI":"10.3390\/jcm9051263","type":"journal-article","created":{"date-parts":[[2020,4,29]],"date-time":"2020-04-29T01:29:15Z","timestamp":1588123755000},"page":"1263","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Anemia and Systemic Inflammation Rather than Arterial Circulatory Dysfunction Predict Decompensation of Liver Cirrhosis"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3840-7140","authenticated-orcid":false,"given":"Christina","family":"Bothou","sequence":"first","affiliation":[{"name":"Department of Internal Medicine 1, Goethe-University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany"},{"name":"Klinik f\u00fcr Endokrinologie, Diabetologie und Klinische Ern\u00e4hrung, Universit\u00e4tsSpital Z\u00fcrich, Forschungslabor, Wagistrasse 21, 4. OG, CH-8952 Schlieren, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabrina","family":"R\u00fcschenbaum","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine 1, Goethe-University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8627-6088","authenticated-orcid":false,"given":"Alica","family":"Kubesch","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine 1, Goethe-University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonie","family":"Quenstedt","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine 1, Goethe-University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina","family":"Schwarzkopf","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine 1, Goethe-University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Welsch","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine 1, Goethe-University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Zeuzem","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine 1, Goethe-University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tania Mara","family":"Welzel","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine 1, Goethe-University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian Markus","family":"Lange","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine 1, Goethe-University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,4,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1134","DOI":"10.1053\/j.gastro.2009.02.038","article-title":"Burden of Digestive Diseases in the United States Part III: Liver, Biliary Tract, and Pancreas","volume":"136","author":"Everhart","year":"2009","journal-title":"Gastroenterology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1016\/j.jhep.2012.12.005","article-title":"The burden of liver disease in Europe: A review of available epidemiological data","volume":"58","author":"Blachier","year":"2013","journal-title":"J. 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