ArticleDigestive diseases and sciences2021
Hospitalizations for Acute on Chronic Liver Failure at Academic Compared to Non-academic Centers Have Higher Mortality.
Article in Digestive diseases and sciences, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 20 citations in OpenAlex.
- Regional variations and trends in liver transplantation practices across Europe.JHEP reports : innovation in hepatology · 2025Article
- Delay in Paracentesis and Clinical Outcomes in Hospitalized Patients with Cirrhosis and Ascites.Journal of clinical and translational hepatology · 2025Article
- Prospective study on time-to-tertiary care in alcohol-associated hepatitis: space-time coordinates as prognostic tool and therapeutic target.Alcohol and alcoholism (Oxford, Oxfordshire) · 2025Observational
- Gut Bacteria in Alcohol-Associated Liver Disease.Clinics in liver disease · 2024Review
- Fecal gelatinase does not predict mortality in patients with alcohol-associated hepatitis.Microbial cell (Graz, Austria) · 2024Article
- Association of Previous Gastric Bypass Surgery and Patient Outcomes in Alcohol-Associated Cirrhosis Hospitalizations.Digestive diseases and sciences · 2023Article
- Screening, Diagnosis, and Treatment of Alcohol-Related Liver Disease and Alcohol-Associated Hepatitis.Gastroenterology & hepatology · 2022Article
- Racial and Health Disparities among Cirrhosis-related Hospitalizations in the USA.Journal of clinical and translational hepatology · 2022Article
- Effect of rifaximin on infections, acute-on-chronic liver failure and mortality in alcoholic hepatitis: A pilot study (RIFA-AH).Liver international : official journal of the International Association for the Study of the Liver · 2022Observational
- The Jieduan-Niwan (JDNW) Formula Ameliorates Hepatocyte Apoptosis: A Study of the Inhibition of E2F1-Mediated Apoptosis Signaling Pathways in Acute-on-Chronic Liver Failure (ACLF) Using Rats.Drug design, development and therapy · 2021Article
- Higher Frequency of Hospital-Acquired Infections but Similar In-Hospital Mortality Among Admissions With Alcoholic Hepatitis at Academic vs. Non-academic Centers.Frontiers in physiology · 2020Article
- Early Liver Transplantation: An Evolving Therapeutic Option for Alcohol-Associated Liver Disease.Journal of clinical and experimental hepatologyArticle
- Liver Transplantation in Alcohol-related Liver Disease and Alcohol-related Hepatitis.Journal of clinical and experimental hepatologyReview
- A cross-sectional study to estimate the cost of managing patients with acute on chronic liver failure at a tertiary care centre.Medical journal, Armed Forces IndiaArticle
Corrections and comments
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Authors and funding
8 authors at 6 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
aimAcute on chronic liver failure (ACLF) in patients with cirrhosis has high short-term mortality. Data comparing ACLF admissions to academic centers (AC) and non-academic centers (NAC) are scanty.
methodsNational Inpatient Sample (2006-2014) was queried for admissions with cirrhosis and ACLF using the ICD-09 codes, and was stratified to AC or NAC.
resultsOf 1,928,764 admissions with cirrhosis (2006-2014), 112,174 (5. 9%) had ACLF. 6.7% of 1,018,568 cirrhosis admissions to AC had ACLF versus 5% of 910,196 admissions to NAC, P < 0.0001. Proportion of ACLF admissions to AC increased from 49% during 2006-2008 to 59% during 2012-2014. In a cohort of 73,630 ACLF admissions (36,615 each to AC and NAC) matched for patient demographics, cirrhosis etiology, number of comorbidities, elective versus emergent admission, ACLF grade, and type of organ failure. In-hospital mortality declined by 7% over the study period, but remained higher in AC (46% vs. 42%, P < 0.001), with 11% increased odds for in-hospital mortality compared to admission to NAC. Further admissions to AC versus NAC had higher median (IQR) length of stay at 13 (6-25) versus 11 (5-20) days, with higher median (IQR) hospital charges: 138,239 (66,772-275,603) versus 116,209 (55,767-232,699) USD, P < 0.001 for both.
conclusionPatients with ACLF have high in-hospital mortality. Further, this is higher among admissions to AC. Although the in-hospital mortality is improving, strategies are needed on early identification of patients with futility of care for early discussion on goals of care, and optimal utilization of hospital resources among admissions with ACLF.
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