Evidence map›Paper›PMID 40441763›Full record

ArticleBMJ open2025

Does the change in Liver Frailty Index over the first week of hospitalisation predict mortality in patients with acute-on-chronic liver failure? A prospective cohort study from a Slovak liver centre.

Ľubomír Skladaný, Dávid Líška, Klaudia Mesiková, Daniel Havaj, Sveltana Adamcová-Selčanová, Karolína Šulejová, Daniela Žilinčanová, Pavel Kohout

Abstract read
In one paragraph

Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Ľubomír SkladanýDepartment of Hepatology, Gastroenterology, and Transplantation, 2nd Department of Medicine, Slovak Medical University Faculty of Medicine, F. D. Roosevelt Hospital, Banska Bystrica, Slovakia.
Dávid LíškaFaculty of Sport Science and Health, Matej Bel University, Banska Bystrica, Slovakia david.liska27@gmail.com.ORCID http://orcid.org/0000-0002-5700-1341
Klaudia MesikováF.D. Roosevelt University Hospital of Banská Bystrica, Banská Bystrica, Slovakia.
Daniel HavajDepartment of Hepatology, Gastroenterology, and Transplantation, 2nd Department of Medicine, Slovak Medical University Faculty of Medicine, F. D. Roosevelt Hospital, Banska Bystrica, Slovakia.
Sveltana Adamcová-SelčanováDepartment of Hepatology, Gastroenterology, and Transplantation, 2nd Department of Medicine, Slovak Medical University Faculty of Medicine, F. D. Roosevelt Hospital, Banska Bystrica, Slovakia.
Karolína ŠulejováDepartment of Hepatology, Gastroenterology, and Transplantation, 2nd Department of Medicine, Slovak Medical University Faculty of Medicine, F. D. Roosevelt Hospital, Banska Bystrica, Slovakia.
Daniela ŽilinčanováDepartment of Hepatology, Gastroenterology, and Transplantation, 2nd Department of Medicine, Slovak Medical University Faculty of Medicine, F. D. Roosevelt Hospital, Banska Bystrica, Slovakia.
Pavel KohoutDepartment of Internal Medicine, Third Faculty of Medicine, Charles University Prague and Teaching Thomayer Hospital, Prague, Czech Republic.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveHospital admissions for advanced chronic liver disease (ACLD) are associated with increased mortality, disability, a decline in quality of life and significant economic costs. Being admitted to the hospital usually indicates a triggering event that disrupted a previously stable condition, leading to decompensation or complications of ACLD. The most acute and severe manifestation of this imbalance is acute-on-chronic liver failure (ACLF), a syndrome representing a critical juncture. Reliable prognostic stratification of patients admitted with ACLF could facilitate the systematic delivery of tailored care, ranging from palliative care to intensive interventions like extracorporeal liver support devices and prioritised liver transplantation. Disease-specific prognostic tools, such as the Model for End-Stage Liver Disease score, are effective but have limitations, particularly in reflecting a patient's potential for recovery. The concept of the body's functional reserve in the context of ACLD/ACLF is gaining attention, with the Liver Frailty Index (LFI) potentially emerging as a recommended diagnostic tool.

methodsPatients were selected from our cirrhosis registry (RH7). The LFI serves as an indicator of the patient's prognosis. The LFI measurement takes place at two time intervals: on the patient's admission and after 7 days of hospitalisation.

resultsOur RH7 registry included 154 patients (15.1%) who were diagnosed with ACLF. The primary cause of the underlying ACLD was alcohol-associated liver disease in the majority (79.8%) of cases. The mean value of LFI at admission was 4.50 (± 0.94). When patients with liver cirrhosis were categorised into three subgroups based on the LFI on day 7, survival exhibited a statistically significant decrease (p≤0.05) across all three ACLF grades. This decline in survival was observed from the 'improved LFI' cohort, through the 'stable LFI' group, to the 'worsened LFI' group.

conclusionThe impact of day 7 LFI on the survival of patients with ACLF is notable. Nevertheless, it does not markedly enhance the predictive capability of the LFI assessed on admission. Consequently, the initial LFI on day 1 continues to be the most valuable and commonly used instrument for promptly recognising individuals with ACLF.

Indexed as

Acute-On-Chronic Liver FailureFrailtyHospitalizationLiverAdultAgedFemaleHumansMaleMiddle AgedPrognosisProspective StudiesSeverity of Illness IndexSlovakiaFrailtyMortalityRehabilitation medicine

Identifiers

PMID40441763
PMCPMC12121596

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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.