Evidence map›Paper›PMID 42867522›Full record

ArticleWiener klinische Wochenschrift2026

Dynamic course and outcomes of acute-on-chronic liver failure in the intensive care unit : Insights from a real-world cohort.

Patrick Haselwanter, Max Oberweger, Marian Strunz, Petrus Aho, Lorenz Balcar, Georg Semmler, Benedikt Simbrunner, Bernhard Scheiner, Albert Friedrich Stättermayer, Marlene Riedl-Wewalka and 5 more

Abstract read
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In one paragraph

Article in Wiener klinische Wochenschrift, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

15 authors.

Patrick HaselwanterDepartment of Medicine III, Division of Gastroenterology and Hepatology, Intensive Care Unit 13H1, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
Max OberwegerDepartment of Medicine III, Division of Gastroenterology and Hepatology, Intensive Care Unit 13H1, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
Marian StrunzDepartment of Medicine III, Division of Gastroenterology and Hepatology, Intensive Care Unit 13H1, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
Petrus AhoDepartment of Medicine III, Division of Gastroenterology and Hepatology, Intensive Care Unit 13H1, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
Lorenz BalcarDepartment of Medicine III, Division of Gastroenterology and Hepatology, Intensive Care Unit 13H1, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
Georg SemmlerDepartment of Medicine III, Division of Gastroenterology and Hepatology, Intensive Care Unit 13H1, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
Benedikt SimbrunnerDepartment of Medicine III, Division of Gastroenterology and Hepatology, Intensive Care Unit 13H1, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
Bernhard ScheinerDepartment of Medicine III, Division of Gastroenterology and Hepatology, Intensive Care Unit 13H1, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
Albert Friedrich StättermayerDepartment of Medicine III, Division of Gastroenterology and Hepatology, Intensive Care Unit 13H1, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
Marlene Riedl-WewalkaDepartment of Medicine III, Division of Gastroenterology and Hepatology, Intensive Care Unit 13H1, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
Monika SchmidDepartment of Medicine III, Division of Gastroenterology and Hepatology, Intensive Care Unit 13H1, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
Thomas ReibergerDepartment of Medicine III, Division of Gastroenterology and Hepatology, Intensive Care Unit 13H1, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
Michael TraunerDepartment of Medicine III, Division of Gastroenterology and Hepatology, Intensive Care Unit 13H1, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
Christian ZaunerDepartment of Medicine III, Division of Gastroenterology and Hepatology, Intensive Care Unit 13H1, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
Mathias Schneeweiss-GleixnerDepartment of Medicine III, Division of Gastroenterology and Hepatology, Intensive Care Unit 13H1, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria. mathias.schneeweiss@meduniwien.ac.at.ORCID http://orcid.org/0009-0001-5296-1212

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAcute-on-chronic liver failure (ACLF) frequently requires intensive care unit (ICU) management, yet real-world data on dynamic disease course, organ support and mortality predictors in critically ill ACLF patients remain scarce.

methodsAll ACLF patients admitted to a tertiary care hepatology ICU between 2013 and 2023 were analyzed in this retrospective single-center study for ACLF grade trajectories, organ support, and independent predictors of 90-day mortality.

resultsAmong 209 patients (228 admissions), 54.4% had ACLF grade 3 at ICU admission (median CLIF‑C ACLF 56). Most patients required vasopressors (86.8%), invasive mechanical ventilation (59.6%), and renal replacement therapy (53.5%). The ICU and 90-day survival were 56.1% and 34.2%, respectively. One third of the patients (33.3%) showed improvement in ACLF grade during the ICU stay, including grade 3 patients, indicating meaningful reversibility under comprehensive organ support. The CLIF‑C ACLF score (OR: 1.07, 95% CI: 1.03-1.11, p < 0.001) and the peak noradrenaline dose (OR: 13.5, 95% CI: 3.18-69.7, p < 0.001) were identified as independent predictors of 90-day mortality.

conclusionCritically ill ACLF patients retain potential for partial recovery under full organ support, justifying ICU escalation even in grade 3 disease. Peak noradrenaline dose, alongside the established prognostic scores, provides a readily available parameter to guide individualized decision-making regarding full organ support or timely de-escalation.

Indexed as

Critical careEpidemiologyLiver cirrhosisOrgan failureOrgan supportPrognosis

Identifiers

PMID42867522

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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.