ArticleHepatology communications2025
Long-term outcomes after ICU admission in critically ill patients with liver cirrhosis: An Australian state-wide cohort study.
Article in Hepatology communications, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Beyond the Tipping Point: Advances in the Diagnosis and Management of Acute-on-Chronic Liver Failure and End-Stage Liver Disease.Diagnostics (Basel, Switzerland) · 2026Review
- Beyond traditional-the sick cirrhosis patient scores integrating cytokine and immune profiling for precision prognosis in hospitalized cirrhosis patients may help predict infection, ICU admission and long-term death post hospitalization.Frontiers in medicine · 2026Article
- Age as a key predictor of 6-week mortality in cirrhotic patients with acute gastrointestinal bleeding: a retrospective cohort study.Frontiers in medicine · 2026Article
- Prognostic significance of lymphocyte PD-1 expression in combination with clinical scoring systems in patients with liver cirrhosis complicated by sepsis.Frontiers in immunology · 2026Article
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6 authors.
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Abstract
backgroundPatients with liver cirrhosis requiring intensive care unit (ICU) admission have a high in-hospital mortality, yet long-term mortality and predictors of mortality in survivors remain unknown.
methodsAll patients with liver cirrhosis admitted to 27 ICUs in Victoria, Australia, between 2007 and 2018 reported to the Australian and New Zealand Intensive Care Society Adult Patient Database were included. Poisson regression and Cox regression were used to explore factors associated with in-hospital mortality and all-cause 12-month mortality. Liver transplantation was considered a censoring event.
resultsA total of 5725 cirrhosis patients (3565 patient-years) were included. All-cause 12-month mortality was 43.8% (95% CI 42.5-45.1) and reduced over time (HR 0.979 per year, 95% CI 0.967-0.991). On multivariable analysis, factors associated with in-hospital death (risk ratio-RR, 95% CI) included ACLF (acute-on-chronic liver failure) (1.73, 1.57-1.90), decompensated cirrhosis (1.31, 1.13-1.51), ALBI (albumin-bilirubin) grade 3 versus 2 (1.65, 1.45-1.87), APACHE-III ICU admission diagnosis of sepsis (1.43 vs. upper gastrointestinal bleeding, 1.24-1.66) or liver failure (1.81 vs. upper gastrointestinal bleeding, 1.55-2.12) and older age. On multivariable analysis of 4068 transplant-free hospital survivors, 12-month mortality was influenced by (HR, 95% CI) liver disease severity (1.37 ALBI grade 3 vs. 2, 1.15-1.64) and decompensated cirrhosis (1.25, 1.06-1.49) rather than ACLF (0.88, 0.75-1.03).
conclusionsLong-term mortality in liver cirrhosis patients admitted to the ICU is substantial but has decreased over time. ACLF confers a higher risk of in-hospital but not long-term death in hospital survivors. Cirrhosis severity and decompensation increase the risk of in-hospital and long-term mortality.
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