ArticleHepatology (Baltimore, Md.)2019
Incidence and Mortality of Acute-on-Chronic Liver Failure Using Two Definitions in Patients with Compensated Cirrhosis.
Article in Hepatology (Baltimore, Md.), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 89 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
89 citing papers in PubMed, 180 citations in OpenAlex.
- Models for acute on chronic liver failure development and mortality in a veterans affairs cohort.Hepatology international · 2020Trial
- Liver Failure versus Organ Failure in Acute-on-Chronic Liver Failure: Sequence and Consequence.Gut and liver · 2026Article
- Age-Stratified Mortality Outcomes Associated with Nonselective Beta-Blocker Use in Patients with Decompensated Cirrhosis.Journal of clinical medicine · 2026Article
- Clinical value and safety of liver biopsy in patients with liver failure.BMC gastroenterology · 2026Article
- Acute-on-chronic liver failure: From definition to pathogenesis and therapy.Chinese medical journal · 2026Review
- The Clinical Implications of Sex on Waitlist Outcomes in Patients With Acute-on-Chronic Liver Failure.Gastro hep advances · 2026Article
- Article
- [Clinical outcomes of small-size grafts in auxiliary liver transplantation for the treatment of portal hypertension].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2025Article
- Review
- CD45BMC gastroenterology · 2025Article
- Acute-on-Chronic Liver Failure: Steps Towards Consensus.Diagnostics (Basel, Switzerland) · 2025Review
- MicroRNA-124a/Sirtuin 1 pathway inhibits autophagy to promote hepatocyte apoptosis in acute-on-chronic liver failure.Molecular biology reports · 2025Article
- Mortality, Hepatic Decompensation, and Cardiovascular Outcomes in Lean vs. Non-lean MASLD Cirrhosis: A Veterans Affairs Cohort Study.Digestive diseases and sciences · 2025Article
- Acute-on-chronic liver failure (ACLF): the 'Kyoto Consensus'-steps from Asia.Hepatology international · 2025Review
- Development of a short-term prognostic model for hepatitis B-related acute-on-chronic liver failure in a dual-center cohort.Frontiers in medicine · 2025Article
- aCCI-HBV-ACLF: A Novel Predictive Model for Hepatitis B Virus-Related Acute-On-Chronic Liver Failure.Alimentary pharmacology & therapeutics · 2025Article
- Recent TIPS increases postoperative mortality: A national cohort study.Hepatology communications · 2024Article
- Preoperative Hepatology and Primary Care Visits Improve Postoperative Outcomes in Patients With Cirrhosis Undergoing Surgery.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2024Article
- Acute-on-chronic liver failure in metabolic dysfunction-associated fatty liver disease patients: a disease multiplier.Hepatology international · 2024Review
- Characterization of acute-on-chronic liver diseases: A multicenter prospective cohort study.World journal of hepatology · 2024Article
29 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
- Commented on by
- Commented on by
- Commented on by
- Commented on byReply.2019
Authors and funding
4 authors at 3 institutions in 1 country.
Funding
Abstract
The term acute-on-chronic liver failure (ACLF) is intended to identify patients with chronic liver disease who develop rapid deterioration of liver function and high short-term mortality after an acute insult. The two prominent definitions (European Association for the Study of the Liver [EASL] and Asian Pacific Association for the Study of the Liver [APASL]) differ, and existing literature applies to narrow patient groups. We sought to compare ACLF incidence and mortality among a diverse cohort of patients with compensated cirrhosis, using both definitions. This was a retrospective cohort study of patients with incident compensated cirrhosis in the Veterans Health Administration from 2008 to 2016. First ACLF events were identified for each definition. Incidence rates were computed as events per 1,000 person-years, and mortality was calculated at 28 and 90 days. Among 80,383 patients with cirrhosis with 3.35 years median follow-up, 783 developed EASL and APASL ACLF, 4,296 developed EASL ACLF alone, and 574 developed APASL ACLF alone. The incidence rate of APASL ACLF was 5.7 per 1,000 person-years (95% confidence interval [CI]: 5.4-6.0), and the incidence rate of EASL ACLF was 20.1 (95% CI: 19.5-20.6). The 28-day and 90-day mortalities for APASL ACLF were 41.9% and 56.1%, respectively, and were 37.6% and 50.4% for EASL ACLF. The median bilirubin level at diagnosis of EASL-alone ACLF was 2.0 mg/dL (interquartile range: 1.1-4.0). Patients with hepatitis C or nonalcoholic fatty liver disease had among the lowest ACLF incidence rates but had the highest short-term mortality. Conclusion: There is significant discordance in ACLF events by EASL and APASL criteria. The majority of patients with EASL-alone ACLF have preserved liver function, suggesting the need for more liver-specific ACLF criteria.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.