ArticleGut and liver2026
Prognostic Role of Acute-on-Chronic Liver Failure in Acute Variceal Bleeding: A Multicenter Retrospective Study in Australia.
Article in Gut and liver, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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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
2 citing papers in PubMed.
- Article
- 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
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background/Aims: Acute variceal bleeding (AVB) is a life-threatening complication of cirrhosis that can precipitate acute-on-chronic liver failure (ACLF), leading to poor outcomes. This multicenter retrospective study evaluated the impact of ACLF on the long-term outcomes of patients admitted with AVB and compared the performance of prognostic scores in predicting 1-year mortality. Methods: A total of 168 patients with cirrhosis admitted with AVB between January 2013 and December 2022 were included. ACLF was diagnosed using the Chronic Liver Failure-Consortium Organ Failure (CLIF-C OF) score at admission and reassessed at 48 hours. Prognostic scores including the Child-Pugh, AIMS65, and CLIF-C model scores were evaluated. Multivariable logistic regression analysis was performed to identify predictors of 6-week rebleeding, and Kaplan-Meier analysis was conducted to assess survival outcomes. Results: ACLF was present at admission in 21 patients (12.5%) and developed within 48 hours in two (1.2%). Although ACLF at admission was associated with a higher unadjusted 1-year mortality rate, it was not independently predictive after adjusting for hepatic reserve (Child-Pugh score) and age (hazard ratio, 0.97; 95% confidence interval, 0.32 to 2.94; p=0.951). The Child-Pugh score was the strongest predictor of the 1-year mortality rate (area under the receiver operating characteristic curve=0.718). The absence of hepatic encephalopathy independently predicted 6-week rebleeding (p=0.015). Endoscopy timing (<12 hours vs ≥12 hours) did not influence the 6-week mortality rate, rebleeding, or the 1-year survival rate in either the ACLF or non-ACLF group. Conclusions: Although ACLF identifies patients with AVB at high risk, it primarily reflects the severity of the underlying liver dysfunction rather than serving as an independent predictor. Management should prioritize stabilization and optimization prior to endoscopy and individualized follow-up to evaluate transplant candidacy.
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