Observational studyHepatology international2026
Diabetes mellitus is linked to higher mortality in alcohol-related acute-on-chronic liver failure.
Observational study in Hepatology international, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 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
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Who cites it
5 citing papers in PubMed.
- Acute-on-chronic liver failure following pneumonia in an elderly woman with metabolic dysfunction-associated steatotic liver cirrhosis.Clinical journal of gastroenterology · 2026Article
- Methodological reflections on vasoconstrictor use in refractory ascites: bridging trial rigor and real-world relevance.Hepatology international · 2026Article
- Optimizing therapeutic plasma exchange in Wilson disease-related liver failure: toward precision bridging strategies.Hepatology international · 2025Article
- Plasma exchange in pediatric Wilson's disease: long-term efficacy and patient selection.Hepatology international · 2025Article
- Midodrine with albumin synergy in refractory ascites management.Hepatology international · 2025Article
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Authors and funding
100 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAcute-on-chronic liver failure (ACLF) is a rapidly progressive syndrome marked by high short-term mortality. While diabetes mellitus (DM) is known to worsen liver-related outcomes, its specific impact on alcohol-related ACLF (ALD-ACLF) remains underexplored. This study aimed to assess the prognostic impact of DM on 90-day outcomes in ALD-ACLF using data from the APASL ACLF Research Consortium (AARC) database.
methodsThis observational study involved data from 5612 ACLF patients with documented 90-day outcomes. We identified 2096 patients with ALD-ACLF precipitated by alcoholic hepatitis. Patients with non-ALD etiologies, mixed etiologies, or non-alcoholic precipitants were excluded. Diabetic and non-diabetic patients were compared using 1:2 propensity score matching based on key baseline covariates. Survival outcomes were assessed using Kaplan-Meier analysis and multivariable Cox regression.
resultsAfter matching, 109 diabetic patients were compared with 218 well-matched non-diabetic controls. Diabetic patients had significantly lower overall survival (32 vs. 57%) and transplant-free survival (31 vs. 50%) compared to non-diabetics (log-rank p < 0.001). On multivariable Cox regression, DM was independently associated with increased 90-day mortality (HR 1.739, 95% CI 1.262-2.395, p < 0.001), along with elevated serum lactate (HR 1.187 per mmol/L, p < 0.001) and creatinine (HR 1.267 per mg/dL, p < 0.001).
conclusionDiabetes mellitus is a significant independent predictor of mortality in patients with ALD-ACLF. These findings highlight the need for early identification and integrated management of diabetes in ACLF care pathways to improve clinical outcomes.
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Registered trials
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 Socratic graph.