ArticleFrontiers in medicine2026
Evaluating the diagnostic and prognostic utility of serum DLL1 in acute-on-chronic liver failure patients with bacterial infections.
Article in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The diagnosis of bacterial infections (BIs) in patients with acute-on-chronic liver failure (ACLF) remains a formidable clinical challenge, directly impacting mortality rates. Current biomarkers are often confounded by the profound systemic inflammation inherent to ACLF itself. The objective of this study was to evaluate the diagnostic and prognostic utility of serum Delta-like ligand 1 (DLL1) in ACLF patients with BIs. Methods: This retrospective diagnostic study utilized a pre-established, prospectively maintained ACLF cohort ( Results: In the ACLF cohort, serum DLL1 concentrations were significantly elevated in BI patients compared with their noninfected counterparts ( Conclusion: Serum DLL1 represents a robust and clinically deployable diagnostic biomarker for BI in patients with ACLF, and its performance is minimally affected by underlying hepatic dysfunction. The synergistic CRP-DLL1 dual-marker model demonstrated enhanced diagnostic discrimination, significantly outperforming the individual biomarkers. Notably, the DLL1 level was not an independent predictor of mortality in this population with concurrent infection.
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