Prognostic Significance of The New Criteria for Acute Kidney Injury in Cirrhosis

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"documento" => "article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "fla" "cita" => "Ann Hepatol. 2018;17:470-5" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 206 "formatos" => array:3 [ "EPUB" => 10 "HTML" => 137 "PDF" => 59 ] ] "en" => array:10 [ "idiomaDefecto" => true "titulo" => "Alcohol Consumption Influences Clinical Outcome in Patients Admitted to a Referral Center for Liver Disease" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "470" "paginaFinal" => "475" ] ] "contieneResumen" => array:1 [ "en" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Suyan G.R. dos Santos, Angelo A. Mattos, Marcela M. Guimarães, Bibiana de S. Boger, Gabriela P. 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"documento" => "article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "fla" "cita" => "Ann Hepatol. 2018;17:444-60" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 350 "formatos" => array:3 [ "EPUB" => 11 "HTML" => 235 "PDF" => 104 ] ] "en" => array:11 [ "idiomaDefecto" => true "titulo" => "Antiproliferative Effects of Epigenetic Modifier Drugs through E-cadherin Up-regulation in Liver Cancer Cell Lines" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "444" "paginaFinal" => "460" ] ] "contieneResumen" => array:1 [ "en" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "f0020" "etiqueta" => "Figure 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 456 "Ancho" => 1057 "Tamanyo" => 60571 ] ] "descripcion" => array:1 [ "en" => "Effect of 5aza-dC and TSA on promoter methylation of the Wnt/β-catenin pathway antagonists. Average methylation levels of DKK3, SFRP1, WIF1, CDH1 gene promoters and LINE-1 sequences in HepG2 cells (A) and HuH7 cells (B). Methylation levels of each gene were compared between treated (5aza-dC+TSA) and non-treated (DMSO) cells. NT: non-tretaed and T: treated. The experiments were performed in triplicate and results correspond to means and the comparison of the differences of the means, between treated and non-treated cells, with 95°% confidence intervals ± SD. p < 0.05 denotes statistical significance. *p < 0.05, **p < 0.005, ***p < 0.0005." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Diego Uribe, Andres Cardona, Davide Degli Esposti, Marie-Pierre Cros, Cyrille Cuenin, Zdenko Herceg, Mauricio Camargo, Fabian M. Cortés-Mancera" "autores" => array:8 [ 0 => array:2 [ "nombre" => "Diego" "apellidos" => "Uribe" ] 1 => array:2 [ "nombre" => "Andres" "apellidos" => "Cardona" ] 2 => array:2 [ "nombre" => "Davide Degli" "apellidos" => "Esposti" ] 3 => array:2 [ "nombre" => "Marie-Pierre" "apellidos" => "Cros" ] 4 => array:2 [ "nombre" => "Cyrille" "apellidos" => "Cuenin" ] 5 => array:2 [ "nombre" => "Zdenko" "apellidos" => "Herceg" ] 6 => array:2 [ "nombre" => "Mauricio" "apellidos" => "Camargo" ] 7 => array:2 [ "nombre" => "Fabian M." "apellidos" => "Cortés-Mancera" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1665268119302005?idApp=UINPBA00004N" "url" => "/16652681/0000001700000003/v1_201905160920/S1665268119302005/v1_201905160920/en/main.assets" ] "en" => array:17 [ "idiomaDefecto" => true "titulo" => "Prognostic Significance of The New Criteria for Acute Kidney Injury in Cirrhosis" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "461" "paginaFinal" => "469" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Emilia T.O. Bansho, Pedro Eduardo S. Silva, Bruno S. Colombo, Leticia M. Wildner, Maria Luiza Bazzo, Esther B. Dantas-Corrêa, Leonardo L. Schiavon, Janaína L. Narciso-Schiavon" "autores" => array:8 [ 0 => array:3 [ "nombre" => "Emilia T.O." "apellidos" => "Bansho" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "**" "identificador" => "aff0010" ] ] ] 1 => array:3 [ "nombre" => "Pedro Eduardo S." "apellidos" => "Silva" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "**" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Bruno S." "apellidos" => "Colombo" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "**" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "Leticia M." "apellidos" => "Wildner" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "***" "identificador" => "aff0015" ] ] ] 4 => array:3 [ "nombre" => "Maria Luiza" "apellidos" => "Bazzo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "***" "identificador" => "aff0015" ] ] ] 5 => array:3 [ "nombre" => "Esther B." "apellidos" => "Dantas-Corrêa" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "**" "identificador" => "aff0010" ] ] ] 6 => array:3 [ "nombre" => "Leonardo L." "apellidos" => "Schiavon" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "**" "identificador" => "aff0010" ] ] ] 7 => array:4 [ "nombre" => "Janaína L." "apellidos" => "Narciso-Schiavon" "email" => array:1 [ 0 => "janaina.narciso@uol.com.br" ] "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "**" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Núcleo de Estudos em Gastroenterologia e Hepatologia, Internal Medicine Department, Federal University of Santa Catarina, Florianopolis, SC, Brazil." "etiqueta" => "*" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Professional Master Program in Intensive and Palliative Care, Health Sciences Center, Federal University of Santa Catarina, Florianopolis, SC, Brazil." "etiqueta" => "**" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Department of Clinical Analysis, University Hospital Polydoro Ernani de São Thiago-Federal University of Santa Catarina, Florianopolis, SC, Brazil." "etiqueta" => "***" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "*" "correspondencia" => "Corresponding author." ] ] ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "f0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 551 "Ancho" => 512 "Tamanyo" => 45775 ] ] "descripcion" => array:1 [ "en" => "Ninety-day cumulative survival rate of cirrhotic patients according to the stages of acute kidney injury (AKI). Surviva was significantly lower in the patients with AKI stages 2 and 3 than in those without AKI (P < 0.001, log-rank test). When individuals were compared according to the AKI stage, those with AKI stage 1 had higher survival than those with stage 2 (P = 0.022). No differences were observed between those in stages 2 and 3." ] ] ] "textoCompleto" => "IntroductionRenal dysfunction is a frequent and challenging complication of liver cirrhosis, and its definition has been extensively revised.<a class="elsevierStyleCrossRef" href="#bib0005">1</a> Twenty years ago, the proposed criteria to establish a significant reduction in glomerular filtration rate in cirrhotic patients, which by that time was defined as hepatorenal syndrome, were:<ul class="elsevierStyleList" id="l0005"><li class="elsevierStyleListItem" id="u0005">•Serum creatinine level higher than 1.5 mg/dL or</li><li class="elsevierStyleListItem" id="u0010">•24-h creatinine depuration of < 40 mL/min, excluding other causes of renal insufficiency.<a class="elsevierStyleCrossRef" href="#bib0010">2</a></li></ul>Recently, the acute kidney injury (AKI) network staging system was created, which is based on studies that showed that the risk of death and renal substitution therapy increases at each stage<a class="elsevierStyleCrossRef" href="#bib0015">3</a>,<a class="elsevierStyleCrossRef" href="#bib0020">4</a> and that AKI is associated with a greater risk of death.<a class="elsevierStyleCrossRef" href="#bib0025">5</a> Therefore, a small increase in serum creatinine level (e.g., 0.3 mg/dL or 50% higher than the basal) was established to be enough to diagnose AKI.<a class="elsevierStyleCrossRef" href="#bib0005">1</a>Despite the fact that the concept of AKI has been especially elaborated for patients at intensive care units (ICUs), this concept has been used for patients admitted for acute decompensation of cirrhosis. This is because, in addition to hepatorenal syndrome, this group of patients may develop renal insufficiency due to a series of other causes, particularly volume depletion, bacterial infections, administration of nephrotoxic drugs, exacerbation of chronic renal diseases, or a combination of factors.<a class="elsevierStyleCrossRef" href="#bib0030">6</a>,<a class="elsevierStyleCrossRef" href="#bib0035">7</a> Although clinical practice guidelines for AKI clearly states that etiology is important for therapy, it is not required for the diagnosis and staging of AKI.<a class="elsevierStyleCrossRef" href="#bib0005">1</a>Currently, AKI is classified into three stages according to the magnitude of increase in serum creatinine level as follows: stage 1 (elevation of creatinine level: < 2 times the basal value), stage 2 (2 or 3 times the basal value), and stage 3 (3 times the basal value).<a class="elsevierStyleCrossRef" href="#bib0005">1</a> Fagundes, et al. proposed the following new classification into 3 groups of risk:<ul class="elsevierStyleList" id="l0010"><li class="elsevierStyleListItem" id="u0015">•Patients with stage AKI 1 with a creatinine peak ≥ 1.5 mg/dL.</li><li class="elsevierStyleListItem" id="u0020">•Patients with stage 1 with a creatinine peak > 1.5 mg/dL, and</li><li class="elsevierStyleListItem" id="u0025">•Patients with stage 2 or 3 disease.<a class="elsevierStyleCrossRef" href="#bib0040">8</a></li></ul>In addition, in 2015, the Ascites International Club published the new resolutions for diagnosis and management of AKI in cirrhotic patients, including the cutoff point of 1.5 mg/dL for stage.<a class="elsevierStyleCrossRef" href="#bib0095">19</a>Considering that the prognostic significance of the new diagnostic criteria for AKI in cirrhosis is still unclear, this study aimed to describe the clinical characteristics of a group of individuals admitted for acute decompensation of the disease, identify the characteristics associated with AKI and 90-day mortality, and finally, determine the prognostic significance of new criteria for AKI in this population.Material and MethodsStudy SampleFrom January 2011 to October 2014, a prospective cohort study was performed, which included individuals consecutively admitted to the emergency service of a Brazilian tertiary hospital for acute decompensation of cirrhosis. The following exclusion criteria were used: admission for elective procedures, admissions not related to liver cirrhosis complications, hospitalization for less than 48 h, hepatocellular carcinoma outside Milan criteria, absence of laboratory data, and questionable diagnosis of liver cirrhosis. Repeated hospital admissions were excluded, and the most recent admission was considered for this analysis. All the patients were initially admitted in the emergency unit. The decision to transfer the patient to the ward or ICU was made by the assistant physician according to the severity of acute decompensation. The diagnosis of cirrhosis was established histologically (when available) or based on a combination of clinical, imaging, and laboratory findings in patients with evidence of portal hypertension.MethodsAcute liver decompensation was defined as the acute development of hepatic encephalopathy, large-volume ascites, gastrointestinal hemorrhage, bacterial infection, or any combination of these. AKI was defined on the first 48 h of admission as an increase in creatinine level ≥ 0.3 mg/dL in 48 h or ≥ 50% of the basal value, presumably occurring in the last 7 days. The last value of serum creatinine within the last 3 months before admission (when available) or the creatinine value at admission was used as baseline creatinine. The final creatinine was that of admission, in case of an available creatinine prior to hospitalization or 48-h creatinine when admission creatinine was considered the baseline creatinine. AKI was divided into stage 1 (elevation of creatinine level: < 2 times the basal), stage 2 (2 or 3 times), and stage 3 (> 3 times).<a class="elsevierStyleCrossRef" href="#bib0045">9</a> All patients were evaluated within 24 h after admission and, subsequently, within 48 h after admission by one of the researchers involved in the study. The following clinical variables were collected: age, sex, ethnicity, cirrhosis etiology, current complications of cirrhosis, classification of renal dysfunction at admission, infection within the first 48 h of hospitalization, and regular use of propranolol.All individuals were subjected to laboratory evaluation at admission and 48 h, and the following were assessed: creatinine, sodium, albumin, international normalized ratio (INR), total bilirubin level, platelet count, and C-reactive protein (CRP).Active alcoholism was defined as an average overall consumption of 21 or more drinks per week for men and 14 or more drinks per week for women during the 4 weeks before enrollment (one standard drink is equal to 12 g absolute alcohol).<a class="elsevierStyleCrossRef" href="#bib0050">10</a> The patients were monitored during hospitalization, and 90-day mortality was assessed through telephone enquiries in case of hospital discharge.Individuals with suspicion of bacterial infection at hospital admission were subjected to clinical examination in order to confirm this diagnosis and establish the main primary source of infection. The diagnosis of infection was performed according the guidelines established by the Centers for Disease Control.<a class="elsevierStyleCrossRef" href="#bib0055">11</a> Diagnostic paracentesis was performed in all patients with ascites at admission. Spontaneous bacterial peritonitis (SBP) was diagnosed when the neutrophil count in the ascitic fluid was ≥ 250 neutrophils/mm<a class="elsevierStyleCrossRef" href="#bib0015">3</a> in the absence of an intra-abdominal source of infection, regardless of negative culture result.<a class="elsevierStyleCrossRef" href="#bib0060">12</a> All the patients with SBP received ceftriaxone and intravenous albumin adjusted for weight, in the first and third days after diagnosis.Hepatic encephalopathy was graded according to the West-Haven criteria.<a class="elsevierStyleCrossRef" href="#bib0065">13</a> When present, a precipitant factor was investigated and lactulose administration was initiated, with adjusted dosage as needed. All patients with acute variceal bleeding received intravenous octreotide and an antibiotic (oral norfloxacin or intravenous ceftriaxone), and were subjected to emergency therapeutic endoscopy after stabilization. The severity of liver disease was estimated according to the Child-Pugh classification system<a class="elsevierStyleCrossRef" href="#bib0070">14</a> and through the model for end-stage liver disease (MELD),<a class="elsevierStyleCrossRef" href="#bib0075">15</a> calculated based on laboratory tests performed at admission. Acute-on-Chronic Liver Failure (ACLF) and the Chronic Liver Failure-Sequential Organ Failure Assessment (CLIF-SOFA) were defined as proposed by the European Association for the Study of Liver-Chronic Liver Failure (EASL-CLIF) Consortium.<a class="elsevierStyleCrossRef" href="#bib0080">16</a>Statistical analysesPatients were divided into two groups according to the presence or absence of AKI. The groups were compared regarding clinical and laboratory variables.The normality of the distribution of variables was determined by using the Kolmogorov-Smirnov test. The numerical variables with normal distribution were expressed as mean and standard deviation (SD), and compared by using the Student t test. The numerical variables with non-normal distributions were expressed as median and compared by using the Mann-Whitney U test. The qualitative variables were represented by frequency (%); and for its analysis, the χ<a class="elsevierStyleCrossRef" href="#bib0010">2</a> and Fisher exact tests were used, as necessary. Bivariate and multivariate analyses were performed to identify the variables associated with AKI and 90-day death or liver transplantation. Multiple logistic regression analysis (forward stepwise regression) was used to investigate the factors independently associated with 90-day death or liver transplantation. Kaplan-Meier curves were constructed after logistic regression analysis as a way of demonstrating the impact of different AKI categories in transplant-free survival. Differences in survival between the groups were compared by using the log-rank test.Statistical analysis was performed by Statistical Package for the Social Sciences software version 22.0 (IBM SPSS statistics, Chicago, Illinois, EUA). Results were considered significant when P values < 0.05.The study protocol is in agreement with the ethical guidelines of the Declaration of Helsinki and was approved by the local ethics research committee, under No. 252.709.ResultsCharacteristics of the sampleFrom January 2011 to October 2014, 336 admissions due to acute decompensation of hepatic cirrhosis were registered. When evaluated based only on the most recent hospitalization, 252 patients were considered for inclusion in the study. Twenty-two patients who were hospitalized for less than 48 h were excluded. Another three individuals who did not have laboratory data were excluded. Therefore, 227 patients were eligible for the study.The mean age was 53.9 ± 11.5 years, 72.7% described themselves as Caucasian or White and a male predominance was observed (72.7%). The mean MELD score was 16.84 ± 6.51, 41.3% of the patients were classified as Child-Pugh C and 24.7% presented ACLF (Grade 1 in 18.5%, Grade 2 in 4.4% and Grade 3 in 1.8%). Active alcoholism was reported by 37.0% of the patients. The main cirrhosis etiologies were alcohol intake (36.1%) and hepatitis C virus (HCV) (15.9%), whereas 22.9% presented both alcoholism and HCV. Previous cirrhosis decompensation was reported by 62.2% of patients.Variables associated with AKIAt admission, AKI was observed in 37.0% of the patients (stages 1, 2, and 3 in 27.8%, 4.8%, and 4.4%, respectively). Among the individuals who presented with AKI, 85.7% had pre renal insufficiency and 14.3% had hepatorenal syndrome. Patients with HRS type 1 with creatinine ≥ 1.5 mg/dL receive intravenous albumin for 48 h and, if they do not respond and there is no other obvious cause for renal dysfunction, they receive terlipressin-albumin. Among patients with hepatorenal syndrome type 1 in the first 3 days of hospital admission, none have survived despite medical efforts.As compared to patients without AKI, the AKI group had greater proportion of individuals with hepatic encephalopathy at admission (64.3% vs. 49.0%; P = 0.025), SBP (17.9% vs. 7.7%; P = 0.020), and bacterial infection (41.0% vs. 26.6%; P = 0.025). Regarding laboratory variables, individuals with AKI showed lower mean sodium levels (133.2 ± 6.4 vs. 136.0 ± 4.8 mEq/L; P < 0.001). As expected, patients with AKI showed greater mean MELD score (20.2 ± 7.3 vs. 15.0 ± 5.2; P < 0.001) and CLIF-SOFA score (7.4% ± 2.7 vs. 6.2% ± 2.9; P = 0.002), and higher proportion of individuals with ACLF (54.8% vs. 7.0%; P < 0.001) (<a class="elsevierStyleCrossRef" href="#t0005">Table 1</a>).<elsevierMultimedia ident="t0005"></elsevierMultimedia>Logistic regression analysis (forward conditional) was performed including the following variables with P < 0.050 in the bivariate analysis: hepatic encephalopathy, infection at admission, mean arterial pressure (MAP), and sodium levels. The variables intimately associated to renal dysfunction such as creatinine levels, MELD score, CLIF-SOFA score, and ACLF were not included in the multivariate analysis. We identified MAP (odds ratio [OR], 0.965; 95% confidence interval [CI], 0.943-0.987; P = 0.002) and sodium levels (OR, 0.920; 95% CI, 0.871-0.971; P = 0.003) as independently associated to AKI.Variables associated with 90-day death or liver transplantationAmong the individuals included in the study, 63 (27.7%) died and 5 (2.2%) were transplanted within 90 days after hospitalization. In the bivariate analysis (<a class="elsevierStyleCrossRef" href="#t0010">Table 2</a>), the 90-day death/liver transplantation was associated with a lower proportion of male patients (61.8% vs. 77.4%; P = 0.016) and a higher proportion of individuals with encephalopathy (72.1% vs. 47.2%; P = 0.001), ascites (76.5% vs. 37.1%; P < 0.001), bacterial infections (61.8% vs. 21.9%; P < 0.001), Child-Pugh class C (70.1% vs. 29.1%; P < 0.001), ACLF (51.5% vs. 13.2%; P < 0.001), and AKI (52.9% vs. 30.2%; P = 0.001). In addition, patients with poor outcome showed greater creatinine values (1.5 mg/dL vs. 1.0 mg/dL; P < 0.001), INR (1.6 vs. 1.4; P < 0.001), total bilirubin level (3.4 mg/dL vs. 1.7 mg/dL; P < 0.001), CRP level (29.7 mg/L vs. 9.5 mg/L; P = 0.001), lactate level (2.0 vs. 1.6 mEq/L; P = 0.014); MELD score (21.9 ± 6.9 vs. 14.8 ± 5.0; P < 0.001), and CLIF-SOFA score (8.1 ± 3.01 vs. 5.7 ± 2.2; P < 0.001), in addition to lower levels of albumin (2.0 ± 0.5 g/dL vs. 2.4 ± 0.7 g/dL; P < 0.001) and sodium (134.0 mEq/L vs. 136.0 mEq/L; P = 0.002). When individuals who died or were transplanted within 90 days after admission were compared to those who survived, no differences were observed regarding age, propranolol use, cirrhosis etiology, spontaneous bacterial peritonitis, and platelet count.<elsevierMultimedia ident="t0010"></elsevierMultimedia>The logistic regression analysis included the following variables with P < 0.010 in the bivariate analysis: AKI, ascites, encephalopathy, infection, cardiac frequency, sodium level, albumin level, INR, Child-Pugh class C, MELD score, CLIF-SOFA score, and ACLF. In this analysis, 90-day death/liver transplantation was related to ascites at admission (OR, 4.071; 95% CI, 1.860-8.907; P < 0.001), and higher values of CLIF-SOFA (OR, 1.652; 95% CI, 1.392-1.961; P < 0.001), but not to AKI.A subsequent analysis was performed to evaluate the effect of the final creatinine level in patients with AKI (AKI absent or with final creatinine < 1.5 mg/dL vs. AKI present with final creatinine level ≥ 1.5 mg/dL). In the bivariate analysis, 90-day death/liver transplantation was significantly higher among patients with AKI and final creatinine ≥ 1.5 mg/dL as compared to those with AKI and final creatinine < 1.5 mg/dL (58.8% vs. 21.6%; P < 0.001).We also performed a new regression analysis that included AKI with a final creatinine level ≥ 1.5 mg/dL, and the remaining variables with a P value < 0.10. Ninety-day death/liver transplantation was independently associated with the presence of ascites (OR, 3.768; 95% CI, 1.694-8.379; P = 0.001), higher CLIF-SOFA score (OR, 1.568; 95% CI, 1.319-1.864; P < 0.001), and AKI with a final Cr ≥1.5 mg/dL (OR, 2.602; 95% CI, 1.133-5.974; P = 0.024).<a class="elsevierStyleCrossRef" href="#f0005">Figures 1</a> and <a class="elsevierStyleCrossRef" href="#f0010">2</a> exhibited the Kaplan-Meier curves for mortality during the follow-up period, according to the presence and stage of AKI. There were no differences in 90-day transplant-free survival probability when patients without AKI were compared to those with AKI stage 1 (77.6% vs. 68.3%; P = 0.147). Furthermore, we observed a higher transplant-free survival probability among patients without AKI than among those with AKI stage 2 (77.6% vs. 36.4%; P < 0.001) and stage 3 (77.6% vs. 10.0%; P < 0.001). Individuals with AKI were compared according to stage (dysfunction degree) with a difference in transplant-free survival being observed between individuals in stages 1 and 2 (68.3% vs. 36.4%; P = 0.022), but not between stages 2 and 3 (36.4% vs. 10.0%; P = 0.124). When patients with AKI stage 1 and final creatinine < 1.5 mg/dL were compared with those without AKI, no differences were observed in 90-day transplant-free survival (81.8% vs. 76.6%; P = 0.669). On the other hand, individuals with AKI stage 1 and final creatinine level ≥ 1.5 mg/dL showed significantly lower transplant-free survival rates than those without AKI (53.3% vs. 77.6%; P = 0.006). Transplant-free survival rates were also significantly lower in patients with AKI stage 1 and final creatinine ≥ 1.5 mg/dL as compared to those with AKI and final creatinine < 1.5 mg/dL (53.3% vs. 81.8%; P = 0.025) (<a class="elsevierStyleCrossRef" href="#f0010">Figure 2</a>).<elsevierMultimedia ident="f0005"></elsevierMultimedia><elsevierMultimedia ident="f0010"></elsevierMultimedia>DiscussionCreatine is a nitrogenous organic acid synthesized in the liver before being stored in muscles where it is phosphorylated as creatinine. Creatinine production varies slightly from day to day and depends on muscle mass, protein intake, sex, age and ethnicity.<a class="elsevierStyleCrossRef" href="#bib0085">17</a> In cirrhotic patients, serum creatinine may overestimate renal function for several reasons, as hepatic dysfunction may result in a decrease in creatinine synthesis, including protein calorie malnutrition and loss of muscular mass, which are common during cirrhosis.<a class="elsevierStyleCrossRef" href="#bib0085">17</a>,<a class="elsevierStyleCrossRef" href="#bib0090">18</a>AKI, according to the International Club of Ascites consensus definition,<a class="elsevierStyleCrossRef" href="#bib0045">9</a> was found in 37% of our patients. The two main causes of AKI were prerenal insufficiency and hepatorenal syndrome, as described in the literature.<a class="elsevierStyleCrossRef" href="#bib0085">17</a> In previous studies, AKI prevalence ranges from 33% to 60% among individuals with decompensated cirrhosis and varies slightly according to the diagnostic criteria used<a class="elsevierStyleCrossRefs" href="#bib0095">19</a>–<a class="elsevierStyleCrossRef" href="#bib0110">22</a> and the cause of decompensation.<a class="elsevierStyleCrossRef" href="#bib0105">21</a> AKI occurred in 11% of patients with UGIH, 34% of patients with SBP, 27% patients with non-SBP bacterial infections, and in 40% to 49% of critically ill cirrhotic patients who required intensive therapy.<a class="elsevierStyleCrossRef" href="#bib0115">23</a>,<a class="elsevierStyleCrossRef" href="#bib0120">24</a>In the multivariate analysis, AKI was independently associated with lower MAP and sodium values. Similarly, Wong, et al. observed lower values of MAP (81 ± 16 vs. 85 ± 15 mmHg; P = 0.04) and sodium (131 ± 7 vs. 134 ± 6 mmol/L; P = 002) among individuals who developed AKI than among those without renal dysfunction.<a class="elsevierStyleCrossRef" href="#bib0125">25</a> Ruiz-DelArbol, et al. did not find any association between serum sodium and renal dysfunction, but described a significant reduction in MAP among individuals with AKI, suggesting that hemodynamic instability contributes to the worsening of renal function.<a class="elsevierStyleCrossRef" href="#bib0130">26</a> Therefore, maintaining the effective circulating volume is a strategy to prevent and treat renal dysfunction.Identifying clinical characteristics in the first 48 h after admission that could predict 90-day mortality is a useful strategy in the management of cirrhotic patients, as it allows early interventions that can influence prognosis. In the present study, the presence of ascites and higher CLIF-SOFA scores, but not AKI, were independently associated with 90-day death/liver transplantation in the initial regression analysis. However, when we took into consideration AKI with higher final creatinine levels, a subsequent regression analysis showed that AKI with a final Cr ≥ 1.5 mg/dL along with ascites and CLIF-SOFA were independent predictors of 90-day death/liver transplantation.The CLIF-SOFA score has been recently proposed by the EASL-CLIF consortium<a class="elsevierStyleCrossRef" href="#bib0080">16</a> and validated by our group.<a class="elsevierStyleCrossRef" href="#bib0135">27</a> Moreau, et al. described a 51.2% 90-day death/liver transplantation in patients with ACLF and that elevated CLIF-SOFA values would be independently associated with mortality.<a class="elsevierStyleCrossRef" href="#bib0080">16</a> These findings were very similar to those found in our study. The presence of ascites is regarded as a predictor of renal dysfunction,<a class="elsevierStyleCrossRef" href="#bib0140">28</a> and its association with mortality has been clearly described by Silva, et al., where the Kaplan-Meier 90-day survival probability was much higher (91.6%) for cirrhotic patients without ascites and ACLF at admission, and only 21.9% for patients with both complications.<a class="elsevierStyleCrossRef" href="#bib0135">27</a>Wong, et al. prospectively evaluated 337 patients with cirrhosis and infection and observed a greater proportion of patients with AKI who died within 30 days (34% vs. 7%).<a class="elsevierStyleCrossRef" href="#bib0110">22</a> Belcher, et al. evaluated 192 cirrhotic patients with renal dysfunction and observed that progression of AKI was associated with mortality (OR, 3.8; 95% CI, 1.3-11.1). A relevant question would be whether increased serum creatinine level is ≥ 0.3 mg/dL but < 1.5 mg/dL (AKI 1A) would be associated with higher mortality than that in patients with unchanged serum creatinine or increased serum creatinine level < 0.3 mg/dL.<a class="elsevierStyleCrossRef" href="#bib0145">29</a> The cutoff for creatinine value of 1.5 mg/dL was used in the traditional definition of hepatorenal syndrome.<a class="elsevierStyleCrossRef" href="#bib0010">2</a> Further dividing patients with stage 1 AKI into two groups (1A: creatinine level < 1.5 mg/dL and 1B: creatinine level ≥ 1.5 mg/dL) is a physiopathological approach, as it combines dynamic reduction in glomerular filtration rate (GFR), given by the increase in serum creatinine level, associated with a deep reduction in GFR, according to classical definition.<a class="elsevierStyleCrossRef" href="#bib0040">8</a> In our study, when patients without AKI were compared with those with AKI stage 1 and final creatinine level < 1.5 mg/dL, we did not observe any difference in 90-day transplant-free survival. Fagundes, et al. evaluated 375 patients admitted due to decompensated cirrhosis and also observed similar probabilities of survival between patients without AKI and patients with AKI and creatinine level ≤ 1.5 mg/dL (88 vs. 84%, respectively; P = 0.52).<a class="elsevierStyleCrossRef" href="#bib0040">8</a> Piano, et al. evaluated 233 patients with ascites and observed that patients with AKI1 and serum creatinine level < 1.5 mg/dL presented lower mortality (P = 0.03) and progression rates (P = 0.01), and better improvement rate (P = 0.025) than patients with AKI1 and creatinine level ≥ 1.5 mg/dL.<a class="elsevierStyleCrossRef" href="#bib0150">30</a> In our study, individuals with AKI stage 1 and final creatinine level ≥ 1.5 mg/dL showed significantly higher transplant-free survival than those without AKI (53.3% vs. 77.6%; P = 0.006). Transplant-free survival rates were also significantly lower in patients with AKI stage 1 and final creatinine ≥ 1.5 mg/dL as compared to those with AKI and final creatinine < 1.5 mg/dL (53.3% vs. 81.8%; P = 0.025), which is similar to that described by Piano.<a class="elsevierStyleCrossRef" href="#bib0150">30</a> Bucsics, et al. evaluated a retrospective cohort where all the individuals were decompensated cirrhotic patients with ascites. The authors demonstrated that renal dysfunction was an important predictor of 30-day mortality, even in patients with AKI 1 and creatinine levels < 1.5 mg/dL.<a class="elsevierStyleCrossRef" href="#bib0100">20</a> In our study, the variable AKI was only independently associated with mortality when using the cutoff level of 1.5 mg/dL.Despite the valuable findings on AKI in cirrhotic patients, we have to address some limitations to this study. The relatively small number of patients with AKI may have influenced the results - especially concerning their classification in subgroups and the regression analysis. In fact, previous studies on the same subject have included a similar number of patients,<a class="elsevierStyleCrossRef" href="#bib0095">19</a>,<a class="elsevierStyleCrossRef" href="#bib0150">30</a> and need external validation on different populations. Additionally, some studies have included heterogeneous population in distinct clinical scenarios (regular ward or intensive care unit),<a class="elsevierStyleCrossRef" href="#bib0040">8</a> while our study prospectively evaluated only patients admitted in the emergency room. Secondly, we do not have data on the evolution of renal dysfunction during hospitalization. Our aim was to evaluate the impact of early AKI during hospitalization. Information on late development of AKI and progression rate of renal dysfunction in patients with early AKI would be of interest. Another important consideration is that in the present study none of the AKI episodes were considered to be related to acute tubular necrosis (ATN) by the hepatology team. In fact all patients who did not respond to volume expansion had a full work up to exclude other causes of AKI including renal ultrasound, urine analysis looking for proteinuria, hematuria, cylindruria. We also usually performed fractional excretion of sodium (FENa) although its performance is very limited in patients with cirrhosis. Even though ATN is a relatively common cause of AKI in studies including patients with cirrhosis, the majority of ATN episodes occur in hospital related AKI, patients in ICU and secondary to nephrotoxic agents such as contrast media and antimicrobials. Our study prospectively included patients evaluated within hours of hospitalization, solely in the emergency room, clinical context where ATN is very uncommon and that probably justifies the results.In conclusion, early AKI was frequent in cirrhotic patients hospitalized for acute decompensation and was associated with 90-day death/liver transplantation only when the final creatinine level was ≥ 1.5 mg/dL. These findings indicate the need of distinct approaches for patients with AKI 1 according to final creatinine level.Financial SupportNo financial support was received for the completion of this study.Conflict of InterestThe authors declare that they have no conflicts of interest.AcknowledgmentsWork presented orally as Free Theme at the XXIII Brazilian Congress of Hepatology." "textoCompletoSecciones" => array:1 [ "secciones" => array:10 [ 0 => array:3 [ "identificador" => "xres1190767" "titulo" => "Abstract" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abs0010" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1110044" "titulo" => "Keywords" ] 2 => array:2 [ "identificador" => "s0005" "titulo" => "Introduction" ] 3 => array:3 [ "identificador" => "s0010" "titulo" => "Material and Methods" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "s0015" "titulo" => "Study Sample" ] 1 => array:2 [ "identificador" => "s0020" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "s0025" "titulo" => "Statistical analyses" ] ] ] 4 => array:3 [ "identificador" => "s0030" "titulo" => "Results" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "s0035" "titulo" => "Characteristics of the sample" ] 1 => array:2 [ "identificador" => "s0040" "titulo" => "Variables associated with AKI" ] 2 => array:2 [ "identificador" => "s0045" "titulo" => "Variables associated with 90-day death or liver transplantation" ] ] ] 5 => array:2 [ "identificador" => "s0050" "titulo" => "Discussion" ] 6 => array:2 [ "identificador" => "s0055" "titulo" => "Financial Support" ] 7 => array:2 [ "identificador" => "s0060" "titulo" => "Conflict of Interest" ] 8 => array:2 [ "identificador" => "s0065" "titulo" => "Acknowledgments" ] 9 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2017-04-27" "fechaAceptado" => "2017-06-26" "PalabrasClave" => array:1 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1110044" "palabras" => array:3 [ 0 => "Acute kidney injury" 1 => "Liver cirrhosis" 2 => "Prognosis" ] ] ] ] "tieneResumen" => true "resumen" => array:1 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "Introduction and aim. New criteria for acute kidney injury (AKI) in cirrhosis have been proposed, but its prognostic significance is unclear. This study aims to evaluate the prognostic significance of the AKI criteria in cirrhotic patients hospitalized for acute decompensation.Material and methods. This is a prospective cohort study. AKI was defined as an increase in creatinine (Cr) levels ≥ 0.3 mg/dL in 48 h or ≥ 50% of the basal value in the last 7d. AKI was divided into stages 1 (elevation: < 2x basal), 2 (2 or 3x), and 3 (> 3x).Results. In this study, 227 patients aged 53.9 ± 11.5 years were included, of whom 37% had AKI (28% AKI1, 5% AKI2, and 4% AKI3). Thirty percent of the patients died or were transplanted within 90 days from causes related to the presence of ascites at hospital admission and higher values of Chronic Liver Failure-Sequential Organ Failure Assessment (CLIF-SOFA) scores, but not to the presence of AKI. In a regression analysis conducted to assess the effect of the final Cr level in patients with AKI, 90-day mortality was associated with ascites, higher CLIF-SOFA score, and AKI with final Cr level ≥ 1.5 mg/dL. The patients with AKI with Cr levels ≥ 1.5 mg/dL showed lower transplant-free survival rates than those without AKI, and those with AKI1 with final Cr level < 1.5 mg/dL.Conclusions. Early AKI was frequent and associated with 90-day mortality or transplantation only when the final Cr level was ≥ 1.5 mg/dL. Distinct approaches are needed for patients with AKI1 according to final Cr." ] ] "multimedia" => array:4 [ 0 => array:7 [ "identificador" => "f0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 551 "Ancho" => 512 "Tamanyo" => 45775 ] ] "descripcion" => array:1 [ "en" => "Ninety-day cumulative survival rate of cirrhotic patients according to the stages of acute kidney injury (AKI). Surviva was significantly lower in the patients with AKI stages 2 and 3 than in those without AKI (P < 0.001, log-rank test). When individuals were compared according to the AKI stage, those with AKI stage 1 had higher survival than those with stage 2 (P = 0.022). No differences were observed between those in stages 2 and 3." ] ] 1 => array:7 [ "identificador" => "f0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 570 "Ancho" => 511 "Tamanyo" => 58269 ] ] "descripcion" => array:1 [ "en" => "Ninety-day cumulative survival rate of the cirrhotic patients according to the stages of acute kidney injury (AKI). Survival was significantly lower in patients with AKI stage 1 and final creatinine level ≥1.5 mg/dL than in those without AKI (P = 0.006, log-rank test). This difference can aso be observed between patients with AKI stage 1 and final creatinine values ≥ or < 1.5 mg/dL (P = 0.025)." ] ] 2 => array:7 [ "identificador" => "t0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">All (η = 227) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Without kidney dysfunction (n = 159) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Acute kidney dysfunction (n = 68) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">P \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Age (years)<a class="elsevierStyleCrossRef" href="#tblfn0010">*</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">53.9 ±11.5 (54.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">53.1 ± 12.1 (53.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">55.2 ± 10.5(55.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.1996t \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Males (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">72.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">75.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">67.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.211q \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Propranolol (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">34.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">34 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">34.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.000q \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Cirrhosis etiology \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Hepatitis C virus \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">38.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">38.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">39.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.902q \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Hepatitis Β virus \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.000f \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Alcohol \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">60.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">61.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">59.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.764q \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Cryptogenic \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.609q \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Ascites at admission (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">48.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">44.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">57.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.057q \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Upper gastrointestinal hemorrhage (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">46.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">51 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">39.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.086q \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Encephalopathy at admission (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">54.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">49 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">64.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.025q \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Bacterial peritonitis (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">17.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.020q \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Infection (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">31.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">26.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">41 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.025q \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Mean arterial pressure \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">83.5 ± 14.9 (83.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">86.3 ± 15.5 (83.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">78.6 ± 12.6(76.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">< 0.001t \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Cardiac frequency \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">81.7 ± 17.4 (80.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">80.6 ± 17.1 (79.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">83.6 ± 17.9(82.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.421m \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Sodium (mEq/L)<a class="elsevierStyleCrossRef" href="#tblfn0010">*</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">135.0 ± 5.6 (135.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">136.0 ± 4.8 (136.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">133.2 ± 6.4(134.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">< 0.001t \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Albumin (mg/dL)<a class="elsevierStyleCrossRef" href="#tblfn0010">*</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.3 ± 0.7 (2.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.3 ± 0.7 (2.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.2 ± 0.6 (2.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.308t \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">International Normalized Ratio<a class="elsevierStyleCrossRef" href="#tblfn0010">*</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.5 ± 0,3 (1,4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1,5 ± 0,3 (1,4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.6 ± 0.4(1.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.054m \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Total bilirubin (mg/dL)<a class="elsevierStyleCrossRef" href="#tblfn0010">*</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3.9 ± 5.6 (2.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3.5 ± 4.2 (2.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.6 ± 7.4 (2.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.663m \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Platelets/mm3<a class="elsevierStyleCrossRef" href="#tblfn0010">*</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">104,070.5 ± 70,837.2 (82,000.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">99720.3 ± 63,900.3 (81,000.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">111,476.2 ± 21,174.7 (93,000.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.483m \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">C-reactive protein (mg/dL)<a class="elsevierStyleCrossRef" href="#tblfn0010">*</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">40.5 ± 60.1 (14.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">32.6 ± 49.6 (10.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">54.2 ± 73.1 (23.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.082m \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Child-Pugh classification \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.498q \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Β \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">48.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">52.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">42.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.150q \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">41.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">36.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">49.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.060q \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Model for End-Stage Liver Disease<a class="elsevierStyleCrossRef" href="#tblfn0010">*</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16.8 ± 6.5 (15.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">15.0 ± 5.2 (14.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">20.2 ± 7.3 (19.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">< 0.001t \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">CLIF-SOFA<a class="elsevierStyleCrossRef" href="#tblfn0010">*</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.7 ± 2.9 (6.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.2 ± 2.9 (6.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7.4 ± 2.7 (8.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.002t \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Acute on chronic liver failure (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">24.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">54.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">< 0.001q \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2031846.png" ] ] ] "notaPie" => array:2 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "†" "nota" => "Acute kidney injury (AKI) I, 2, or 3. q: χ2test. f -.Fisher exact test, t: Student t test, m: Mann-Whitney." ] 1 => array:3 [ "identificador" => "tblfn0010" "etiqueta" => "*" "nota" => "Mean ± standard deviation (median =). CLIF-SOFA: Chronic Liver Failure Consortium-Sequential Organ Failure Assessment." ] ] ] "descripcion" => array:1 [ "en" => "Characteristics of the 227 individuals hospitalized for acute decompensation of hepatic cirrhosis, according to the presence of acute kidney dysfunction<a class="elsevierStyleCrossRef" href="#tblfn0005">†</a>at admission." ] ] 3 => array:7 [ "identificador" => "t0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:3 [ "leyenda" => "P: χ2 test, Fisher exact test, Student t test, and Mann-Whitney U test." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Survival (n = 159) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">90-day mortality (n = 68) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">P \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Age (years) <a class="elsevierStyleCrossRef" href="#tblfn0015">*</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">54.1 ±11.0 (54.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">53.4 ± 12.7 (52.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.189 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Males, (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">77.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">61.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.016 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Propranolol (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">36.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">28.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.234 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Cirrhosis causes (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Hepatitis C virus \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">39 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">38.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.914 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Hepatitis B virus \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3.84.41 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Alcohol \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">62.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">57.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.488 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Cryptogenic \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.61.80.376 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Renal dysfunction at admission (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">30.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">52.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Stage 1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">27 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">29.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.715 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Stage 2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.019 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Stage 3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">< 0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Ascites at admission (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">37.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">76.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">< 0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Upper gastrointestinal hemorrhage (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">49.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">35.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.051 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Encephalopathy (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">47.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">72.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Spontaneous bacterial peritonitis (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.923 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Infection within the first 48 h(%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">21.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">61.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">< 0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Mean arterial pressure \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">84.2 ± 14.7 (83.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">81.8 ± 15.4 (80.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">< 0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Cardiac frequency \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">79.6 ± 17.6 (78.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">86.7 ± 16.1 (87.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.007 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Creatinine (mg/dL)<a class="elsevierStyleCrossRef" href="#tblfn0015">*</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.2 ± 0.8 (1.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.9 ± 1.5(1.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">< 0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Sodium (mEq/L)<a class="elsevierStyleCrossRef" href="#tblfn0015">*</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">135.7 ± 5.1 (136.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">133.4 ± 6.2 (134.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.002 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Albumin (mg/dL)<a class="elsevierStyleCrossRef" href="#tblfn0015">*</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.4 ± 0,7 (2,4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.0 ± 0.5 (1.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">< 0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">International Normalized Ratio<a class="elsevierStyleCrossRef" href="#tblfn0015">*</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.5 ± 0.3 (1.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.7 ± 0.4 (1.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">< 0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Total bilirubin (mg/dL)<a class="elsevierStyleCrossRef" href="#tblfn0015">*</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.7 ± 3.5 (1.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.6 ± 8.0 (3.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">< 0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Platelets/mm3<a class="elsevierStyleCrossRef" href="#tblfn0015">*</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">107,905.7 ± 111,825.7 (82,000.00) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">111,911.8 ± 87,298.4 (87,000) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.255 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Lactate (mEq/L)<a class="elsevierStyleCrossRef" href="#tblfn0015">*</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.9 ± 1.5 (1.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3.8 ± 8.9 (2.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.014 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">C-reactive protein (mg/dL)<a class="elsevierStyleCrossRef" href="#tblfn0015">*</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">31.8 ± 49.4(9.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">60.3 ± 76.0(29.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Child-Pugh classification, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">56.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">29.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">< 0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">29.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">70.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">< 0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Model for End-Stage Liver Disease<a class="elsevierStyleCrossRef" href="#tblfn0015">*</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14.8 ± 5.0 (13.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">21.9 ± 6.9 (21.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">CLIF-SOFA<a class="elsevierStyleCrossRef" href="#tblfn0015">*</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.7 ± 2.2 (6.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8.9 ± 3.0 (9.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">< 0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Acute on chronic liver failure<a class="elsevierStyleCrossRef" href="#tblfn0015">*</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">51.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">< 0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2031847.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0015" "etiqueta" => "*" "nota" => "Mean ± standard deviation (median). 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Emilia T.O. Bansho*,**, Pedro Eduardo S. Silva*,**, Bruno S. Colombo*,**, Leticia M. Wildner***, Maria Luiza Bazzo***, Esther B. Dantas-Corrêa*,**, Leonardo L. Schiavon*,**, Janaína L. Narciso-Schiavon

,**,

Corresponding author

janaina.narciso@uol.com.br

Corresponding author.

* Núcleo de Estudos em Gastroenterologia e Hepatologia, Internal Medicine Department, Federal University of Santa Catarina, Florianopolis, SC, Brazil.

** Professional Master Program in Intensive and Palliative Care, Health Sciences Center, Federal University of Santa Catarina, Florianopolis, SC, Brazil.

*** Department of Clinical Analysis, University Hospital Polydoro Ernani de São Thiago-Federal University of Santa Catarina, Florianopolis, SC, Brazil.

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          "en" => "<p id="sp0005" class="elsevierStyleSimplePara elsevierViewall">Ninety-day cumulative survival rate of cirrhotic patients according to the stages of acute kidney injury &#40;AKI&#41;&#46; Surviva was significantly lower in the patients with AKI stages 2 and 3 than in those without AKI &#40;P &#60; 0&#46;001&#44; log-rank test&#41;&#46; When individuals were compared according to the AKI stage&#44; those with AKI stage 1 had higher survival than those with stage 2 &#40;P &#61; 0&#46;022&#41;&#46; No differences were observed between those in stages 2 and 3&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="s0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0015">Introduction</span><p id="p0005" class="elsevierStylePara elsevierViewall">Renal dysfunction is a frequent and challenging complication of liver cirrhosis&#44; and its definition has been extensively revised&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Twenty years ago&#44; the proposed criteria to establish a significant reduction in glomerular filtration rate in cirrhotic patients&#44; which by that time was defined as hepatorenal syndrome&#44; were&#58;<ul class="elsevierStyleList" id="l0005"><li class="elsevierStyleListItem" id="u0005"><span class="elsevierStyleLabel">&#8226;</span><p id="p0010" class="elsevierStylePara elsevierViewall">Serum creatinine level higher than 1&#46;5 mg&#47;dL or</p></li><li class="elsevierStyleListItem" id="u0010"><span class="elsevierStyleLabel">&#8226;</span><p id="p0015" class="elsevierStylePara elsevierViewall">24-h creatinine depuration of &#60; 40 mL&#47;min&#44; excluding other causes of renal insufficiency&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p></li></ul></p><p id="p0020" class="elsevierStylePara elsevierViewall">Recently&#44; the acute kidney injury &#40;AKI&#41; network staging system was created&#44; which is based on studies that showed that the risk of death and renal substitution therapy increases at each stage<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a>&#44;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> and that AKI is associated with a greater risk of death&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> Therefore&#44; a small increase in serum creatinine level &#40;e&#46;g&#46;&#44; 0&#46;3 mg&#47;dL or 50&#37; higher than the basal&#41; was established to be enough to diagnose AKI&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="p0025" class="elsevierStylePara elsevierViewall">Despite the fact that the concept of AKI has been especially elaborated for patients at intensive care units &#40;ICUs&#41;&#44; this concept has been used for patients admitted for acute decompensation of cirrhosis&#46; This is because&#44; in addition to hepatorenal syndrome&#44; this group of patients may develop renal insufficiency due to a series of other causes&#44; particularly volume depletion&#44; bacterial infections&#44; administration of nephrotoxic drugs&#44; exacerbation of chronic renal diseases&#44; or a combination of factors&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a>&#44;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> Although clinical practice guidelines for AKI clearly states that etiology is important for therapy&#44; it is not required for the diagnosis and staging of AKI&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="p0030" class="elsevierStylePara elsevierViewall">Currently&#44; AKI is classified into three stages according to the magnitude of increase in serum creatinine level as follows&#58; stage 1 &#40;elevation of creatinine level&#58; &#60; 2 times the basal value&#41;&#44; stage 2 &#40;2 or 3 times the basal value&#41;&#44; and stage 3 &#40;3 times the basal value&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Fagundes&#44; <span class="elsevierStyleItalic">et al&#46;</span> proposed the following new classification into 3 groups of risk&#58;<ul class="elsevierStyleList" id="l0010"><li class="elsevierStyleListItem" id="u0015"><span class="elsevierStyleLabel">&#8226;</span><p id="p0035" class="elsevierStylePara elsevierViewall">Patients with stage AKI 1 with a creatinine peak &#8805; 1&#46;5 mg&#47;dL&#46;</p></li><li class="elsevierStyleListItem" id="u0020"><span class="elsevierStyleLabel">&#8226;</span><p id="p0040" class="elsevierStylePara elsevierViewall">Patients with stage 1 with a creatinine peak &#62; 1&#46;5 mg&#47;dL&#44; and</p></li><li class="elsevierStyleListItem" id="u0025"><span class="elsevierStyleLabel">&#8226;</span><p id="p0045" class="elsevierStylePara elsevierViewall">Patients with stage 2 or 3 disease&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a></p></li></ul></p><p id="p0050" class="elsevierStylePara elsevierViewall">In addition&#44; in 2015&#44; the Ascites International Club published the new resolutions for diagnosis and management of AKI in cirrhotic patients&#44; including the cutoff point of 1&#46;5 mg&#47;dL for stage&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a></p><p id="p0055" class="elsevierStylePara elsevierViewall">Considering that the prognostic significance of the new diagnostic criteria for AKI in cirrhosis is still unclear&#44; this study aimed to describe the clinical characteristics of a group of individuals admitted for acute decompensation of the disease&#44; identify the characteristics associated with AKI and 90-day mortality&#44; and finally&#44; determine the prognostic significance of new criteria for AKI in this population&#46;</p></span><span id="s0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0020">Material and Methods</span><span id="s0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0025">Study Sample</span><p id="p0060" class="elsevierStylePara elsevierViewall">From January 2011 to October 2014&#44; a prospective cohort study was performed&#44; which included individuals consecutively admitted to the emergency service of a Brazilian tertiary hospital for acute decompensation of cirrhosis&#46; The following exclusion criteria were used&#58; admission for elective procedures&#44; admissions not related to liver cirrhosis complications&#44; hospitalization for less than 48 h&#44; hepatocellular carcinoma outside Milan criteria&#44; absence of laboratory data&#44; and questionable diagnosis of liver cirrhosis&#46; Repeated hospital admissions were excluded&#44; and the most recent admission was considered for this analysis&#46; All the patients were initially admitted in the emergency unit&#46; The decision to transfer the patient to the ward or ICU was made by the assistant physician according to the severity of acute decompensation&#46; The diagnosis of cirrhosis was established histologically &#40;when available&#41; or based on a combination of clinical&#44; imaging&#44; and laboratory findings in patients with evidence of portal hypertension&#46;</p></span><span id="s0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0030">Methods</span><p id="p0065" class="elsevierStylePara elsevierViewall">Acute liver decompensation was defined as the acute development of hepatic encephalopathy&#44; large-volume ascites&#44; gastrointestinal hemorrhage&#44; bacterial infection&#44; or any combination of these&#46; AKI was defined on the first 48 h of admission as an increase in creatinine level &#8805; 0&#46;3 mg&#47;dL in 48 h or &#8805; 50&#37; of the basal value&#44; presumably occurring in the last 7 days&#46; The last value of serum creatinine within the last 3 months before admission &#40;when available&#41; or the creatinine value at admission was used as baseline creatinine&#46; The final creatinine was that of admission&#44; in case of an available creatinine prior to hospitalization or 48-h creatinine when admission creatinine was considered the baseline creatinine&#46; AKI was divided into stage 1 &#40;elevation of creatinine level&#58; &#60; 2 times the basal&#41;&#44; stage 2 &#40;2 or 3 times&#41;&#44; and stage 3 &#40;&#62; 3 times&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> All patients were evaluated within 24 h after admission and&#44; subsequently&#44; within 48 h after admission by one of the researchers involved in the study&#46; The following clinical variables were collected&#58; age&#44; sex&#44; ethnicity&#44; cirrhosis etiology&#44; current complications of cirrhosis&#44; classification of renal dysfunction at admission&#44; infection within the first 48 h of hospitalization&#44; and regular use of propranolol&#46;</p><p id="p0070" class="elsevierStylePara elsevierViewall">All individuals were subjected to laboratory evaluation at admission and 48 h&#44; and the following were assessed&#58; creatinine&#44; sodium&#44; albumin&#44; international normalized ratio &#40;INR&#41;&#44; total bilirubin level&#44; platelet count&#44; and C-reactive protein &#40;CRP&#41;&#46;</p><p id="p0075" class="elsevierStylePara elsevierViewall">Active alcoholism was defined as an average overall consumption of 21 or more drinks per week for men and 14 or more drinks per week for women during the 4 weeks before enrollment &#40;one standard drink is equal to 12 g absolute alcohol&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> The patients were monitored during hospitalization&#44; and 90-day mortality was assessed through telephone enquiries in case of hospital discharge&#46;</p><p id="p0080" class="elsevierStylePara elsevierViewall">Individuals with suspicion of bacterial infection at hospital admission were subjected to clinical examination in order to confirm this diagnosis and establish the main primary source of infection&#46; The diagnosis of infection was performed according the guidelines established by the Centers for Disease Control&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a> Diagnostic paracentesis was performed in all patients with ascites at admission&#46; Spontaneous bacterial peritonitis &#40;SBP&#41; was diagnosed when the neutrophil count in the ascitic fluid was &#8805; 250 neutrophils&#47;mm<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> in the absence of an intra-abdominal source of infection&#44; regardless of negative culture result&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a> All the patients with SBP received ceftriaxone and intravenous albumin adjusted for weight&#44; in the first and third days after diagnosis&#46;</p><p id="p0085" class="elsevierStylePara elsevierViewall">Hepatic encephalopathy was graded according to the West-Haven criteria&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a> When present&#44; a precipitant factor was investigated and lactulose administration was initiated&#44; with adjusted dosage as needed&#46; All patients with acute variceal bleeding received intravenous octreotide and an antibiotic &#40;oral norfloxacin or intravenous ceftriaxone&#41;&#44; and were subjected to emergency therapeutic endoscopy after stabilization&#46; The severity of liver disease was estimated according to the Child-Pugh classification system<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> and through the model for end-stage liver disease &#40;MELD&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a> calculated based on laboratory tests performed at admission&#46; Acute-on-Chronic Liver Failure &#40;ACLF&#41; and the Chronic Liver Failure-Sequential Organ Failure Assessment &#40;CLIF-SOFA&#41; were defined as proposed by the European Association for the Study of Liver-Chronic Liver Failure &#40;EASL-CLIF&#41; Consortium&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a></p></span><span id="s0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0035">Statistical analyses</span><p id="p0090" class="elsevierStylePara elsevierViewall">Patients were divided into two groups according to the presence or absence of AKI&#46; The groups were compared regarding clinical and laboratory variables&#46;</p><p id="p0095" class="elsevierStylePara elsevierViewall">The normality of the distribution of variables was determined by using the Kolmogorov-Smirnov test&#46; The numerical variables with normal distribution were expressed as mean and standard deviation &#40;SD&#41;&#44; and compared by using the Student t test&#46; The numerical variables with non-normal distributions were expressed as median and compared by using the Mann-Whitney U test&#46; The qualitative variables were represented by frequency &#40;&#37;&#41;&#59; and for its analysis&#44; the &#967;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> and Fisher exact tests were used&#44; as necessary&#46; Bivariate and multivariate analyses were performed to identify the variables associated with AKI and 90-day death or liver transplantation&#46; Multiple logistic regression analysis &#40;forward stepwise regression&#41; was used to investigate the factors independently associated with 90-day death or liver transplantation&#46; Kaplan-Meier curves were constructed after logistic regression analysis as a way of demonstrating the impact of different AKI categories in transplant-free survival&#46; Differences in survival between the groups were compared by using the log-rank test&#46;</p><p id="p0100" class="elsevierStylePara elsevierViewall">Statistical analysis was performed by Statistical Package for the Social Sciences software version 22&#46;0 &#40;IBM SPSS statistics&#44; Chicago&#44; Illinois&#44; EUA&#41;&#46; Results were considered significant when P values &#60; 0&#46;05&#46;</p><p id="p0105" class="elsevierStylePara elsevierViewall">The study protocol is in agreement with the ethical guidelines of the Declaration of Helsinki and was approved by the local ethics research committee&#44; under No&#46; 252&#46;709&#46;</p></span></span><span id="s0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0040">Results</span><span id="s0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0045">Characteristics of the sample</span><p id="p0110" class="elsevierStylePara elsevierViewall">From January 2011 to October 2014&#44; 336 admissions due to acute decompensation of hepatic cirrhosis were registered&#46; When evaluated based only on the most recent hospitalization&#44; 252 patients were considered for inclusion in the study&#46; Twenty-two patients who were hospitalized for less than 48 h were excluded&#46; Another three individuals who did not have laboratory data were excluded&#46; Therefore&#44; 227 patients were eligible for the study&#46;</p><p id="p0115" class="elsevierStylePara elsevierViewall">The mean age was 53&#46;9 &#177; 11&#46;5 years&#44; 72&#46;7&#37; described themselves as Caucasian or White and a male predominance was observed &#40;72&#46;7&#37;&#41;&#46; The mean MELD score was 16&#46;84 &#177; 6&#46;51&#44; 41&#46;3&#37; of the patients were classified as Child-Pugh C and 24&#46;7&#37; presented ACLF &#40;Grade 1 in 18&#46;5&#37;&#44; Grade 2 in 4&#46;4&#37; and Grade 3 in 1&#46;8&#37;&#41;&#46; Active alcoholism was reported by 37&#46;0&#37; of the patients&#46; The main cirrhosis etiologies were alcohol intake &#40;36&#46;1&#37;&#41; and hepatitis C virus &#40;HCV&#41; &#40;15&#46;9&#37;&#41;&#44; whereas 22&#46;9&#37; presented both alcoholism and HCV&#46; Previous cirrhosis decompensation was reported by 62&#46;2&#37; of patients&#46;</p></span><span id="s0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0050">Variables associated with AKI</span><p id="p0120" class="elsevierStylePara elsevierViewall">At admission&#44; AKI was observed in 37&#46;0&#37; of the patients &#40;stages 1&#44; 2&#44; and 3 in 27&#46;8&#37;&#44; 4&#46;8&#37;&#44; and 4&#46;4&#37;&#44; respectively&#41;&#46; Among the individuals who presented with AKI&#44; 85&#46;7&#37; had pre renal insufficiency and 14&#46;3&#37; had hepatorenal syndrome&#46; Patients with HRS type 1 with creatinine &#8805; 1&#46;5 mg&#47;dL receive intravenous albumin for 48 h and&#44; if they do not respond and there is no other obvious cause for renal dysfunction&#44; they receive terlipressin-albumin&#46; Among patients with hepatorenal syndrome type 1 in the first 3 days of hospital admission&#44; none have survived despite medical efforts&#46;</p><p id="p0125" class="elsevierStylePara elsevierViewall">As compared to patients without AKI&#44; the AKI group had greater proportion of individuals with hepatic encephalopathy at admission &#40;64&#46;3&#37; <span class="elsevierStyleItalic">vs&#46;</span> 49&#46;0&#37;&#59; P &#61; 0&#46;025&#41;&#44; SBP &#40;17&#46;9&#37; <span class="elsevierStyleItalic">vs&#46;</span> 7&#46;7&#37;&#59; P &#61; 0&#46;020&#41;&#44; and bacterial infection &#40;41&#46;0&#37; <span class="elsevierStyleItalic">vs&#46;</span> 26&#46;6&#37;&#59; P &#61; 0&#46;025&#41;&#46; Regarding laboratory variables&#44; individuals with AKI showed lower mean sodium levels &#40;133&#46;2 &#177; 6&#46;4 <span class="elsevierStyleItalic">vs&#46;</span> 136&#46;0 &#177; 4&#46;8 mEq&#47;L&#59; P &#60; 0&#46;001&#41;&#46; As expected&#44; patients with AKI showed greater mean MELD score &#40;20&#46;2 &#177; 7&#46;3 <span class="elsevierStyleItalic">vs&#46;</span> 15&#46;0 &#177; 5&#46;2&#59; P &#60; 0&#46;001&#41; and CLIF-SOFA score &#40;7&#46;4&#37; &#177; 2&#46;7 <span class="elsevierStyleItalic">vs&#46;</span> 6&#46;2&#37; &#177; 2&#46;9&#59; P &#61; 0&#46;002&#41;&#44; and higher proportion of individuals with ACLF &#40;54&#46;8&#37; <span class="elsevierStyleItalic">vs&#46;</span> 7&#46;0&#37;&#59; P &#60; 0&#46;001&#41; &#40;<a class="elsevierStyleCrossRef" href="#t0005">Table 1</a>&#41;&#46;</p><elsevierMultimedia ident="t0005"></elsevierMultimedia><p id="p0130" class="elsevierStylePara elsevierViewall">Logistic regression analysis &#40;forward conditional&#41; was performed including the following variables with P &#60; 0&#46;050 in the bivariate analysis&#58; hepatic encephalopathy&#44; infection at admission&#44; mean arterial pressure &#40;MAP&#41;&#44; and sodium levels&#46; The variables intimately associated to renal dysfunction such as creatinine levels&#44; MELD score&#44; CLIF-SOFA score&#44; and ACLF were not included in the multivariate analysis&#46; We identified MAP &#40;odds ratio &#91;OR&#93;&#44; 0&#46;965&#59; 95&#37; confidence interval &#91;CI&#93;&#44; 0&#46;943-0&#46;987&#59; P &#61; 0&#46;002&#41; and sodium levels &#40;OR&#44; 0&#46;920&#59; 95&#37; CI&#44; 0&#46;871-0&#46;971&#59; P &#61; 0&#46;003&#41; as independently associated to AKI&#46;</p></span><span id="s0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0055">Variables associated with 90-day death or liver transplantation</span><p id="p0135" class="elsevierStylePara elsevierViewall">Among the individuals included in the study&#44; 63 &#40;27&#46;7&#37;&#41; died and 5 &#40;2&#46;2&#37;&#41; were transplanted within 90 days after hospitalization&#46; In the bivariate analysis &#40;<a class="elsevierStyleCrossRef" href="#t0010">Table 2</a>&#41;&#44; the 90-day death&#47;liver transplantation was associated with a lower proportion of male patients &#40;61&#46;8&#37; <span class="elsevierStyleItalic">vs&#46;</span> 77&#46;4&#37;&#59; P &#61; 0&#46;016&#41; and a higher proportion of individuals with encephalopathy &#40;72&#46;1&#37; <span class="elsevierStyleItalic">vs&#46;</span> 47&#46;2&#37;&#59; P &#61; 0&#46;001&#41;&#44; ascites &#40;76&#46;5&#37; <span class="elsevierStyleItalic">vs&#46;</span> 37&#46;1&#37;&#59; P &#60; 0&#46;001&#41;&#44; bacterial infections &#40;61&#46;8&#37; <span class="elsevierStyleItalic">vs&#46;</span> 21&#46;9&#37;&#59; P &#60; 0&#46;001&#41;&#44; Child-Pugh class C &#40;70&#46;1&#37; <span class="elsevierStyleItalic">vs&#46;</span> 29&#46;1&#37;&#59; P &#60; 0&#46;001&#41;&#44; ACLF &#40;51&#46;5&#37; <span class="elsevierStyleItalic">vs&#46;</span> 13&#46;2&#37;&#59; P &#60; 0&#46;001&#41;&#44; and AKI &#40;52&#46;9&#37; <span class="elsevierStyleItalic">vs&#46;</span> 30&#46;2&#37;&#59; P &#61; 0&#46;001&#41;&#46; In addition&#44; patients with poor outcome showed greater creatinine values &#40;1&#46;5 mg&#47;dL <span class="elsevierStyleItalic">vs&#46;</span> 1&#46;0 mg&#47;dL&#59; P &#60; 0&#46;001&#41;&#44; INR &#40;1&#46;6 <span class="elsevierStyleItalic">vs&#46;</span> 1&#46;4&#59; P &#60; 0&#46;001&#41;&#44; total bilirubin level &#40;3&#46;4 mg&#47;dL <span class="elsevierStyleItalic">vs&#46;</span> 1&#46;7 mg&#47;dL&#59; P &#60; 0&#46;001&#41;&#44; CRP level &#40;29&#46;7 mg&#47;L <span class="elsevierStyleItalic">vs&#46;</span> 9&#46;5 mg&#47;L&#59; P &#61; 0&#46;001&#41;&#44; lactate level &#40;2&#46;0 <span class="elsevierStyleItalic">vs&#46;</span> 1&#46;6 mEq&#47;L&#59; P &#61; 0&#46;014&#41;&#59; MELD score &#40;21&#46;9 &#177; 6&#46;9 <span class="elsevierStyleItalic">vs&#46;</span> 14&#46;8 &#177; 5&#46;0&#59; P &#60; 0&#46;001&#41;&#44; and CLIF-SOFA score &#40;8&#46;1 &#177; 3&#46;01 <span class="elsevierStyleItalic">vs&#46;</span> 5&#46;7 &#177; 2&#46;2&#59; P &#60; 0&#46;001&#41;&#44; in addition to lower levels of albumin &#40;2&#46;0 &#177; 0&#46;5 g&#47;dL <span class="elsevierStyleItalic">vs&#46;</span> 2&#46;4 &#177; 0&#46;7 g&#47;dL&#59; P &#60; 0&#46;001&#41; and sodium &#40;134&#46;0 mEq&#47;L <span class="elsevierStyleItalic">vs&#46;</span> 136&#46;0 mEq&#47;L&#59; P &#61; 0&#46;002&#41;&#46; When individuals who died or were transplanted within 90 days after admission were compared to those who survived&#44; no differences were observed regarding age&#44; propranolol use&#44; cirrhosis etiology&#44; spontaneous bacterial peritonitis&#44; and platelet count&#46;</p><elsevierMultimedia ident="t0010"></elsevierMultimedia><p id="p0140" class="elsevierStylePara elsevierViewall">The logistic regression analysis included the following variables with P &#60; 0&#46;010 in the bivariate analysis&#58; AKI&#44; ascites&#44; encephalopathy&#44; infection&#44; cardiac frequency&#44; sodium level&#44; albumin level&#44; INR&#44; Child-Pugh class C&#44; MELD score&#44; CLIF-SOFA score&#44; and ACLF&#46; In this analysis&#44; 90-day death&#47;liver transplantation was related to ascites at admission &#40;OR&#44; 4&#46;071&#59; 95&#37; CI&#44; 1&#46;860-8&#46;907&#59; P &#60; 0&#46;001&#41;&#44; and higher values of CLIF-SOFA &#40;OR&#44; 1&#46;652&#59; 95&#37; CI&#44; 1&#46;392-1&#46;961&#59; P &#60; 0&#46;001&#41;&#44; but not to AKI&#46;</p><p id="p0145" class="elsevierStylePara elsevierViewall">A subsequent analysis was performed to evaluate the effect of the final creatinine level in patients with AKI &#40;AKI absent or with final creatinine &#60; 1&#46;5 mg&#47;dL <span class="elsevierStyleItalic">vs&#46;</span> AKI present with final creatinine level &#8805; 1&#46;5 mg&#47;dL&#41;&#46; In the bivariate analysis&#44; 90-day death&#47;liver transplantation was significantly higher among patients with AKI and final creatinine &#8805; 1&#46;5 mg&#47;dL as compared to those with AKI and final creatinine &#60; 1&#46;5 mg&#47;dL &#40;58&#46;8&#37; <span class="elsevierStyleItalic">vs&#46;</span> 21&#46;6&#37;&#59; P &#60; 0&#46;001&#41;&#46;</p><p id="p0150" class="elsevierStylePara elsevierViewall">We also performed a new regression analysis that included AKI with a final creatinine level &#8805; 1&#46;5 mg&#47;dL&#44; and the remaining variables with a P value &#60; 0&#46;10&#46; Ninety-day death&#47;liver transplantation was independently associated with the presence of ascites &#40;OR&#44; 3&#46;768&#59; 95&#37; CI&#44; 1&#46;694-8&#46;379&#59; P &#61; 0&#46;001&#41;&#44; higher CLIF-SOFA score &#40;OR&#44; 1&#46;568&#59; 95&#37; CI&#44; 1&#46;319-1&#46;864&#59; P &#60; 0&#46;001&#41;&#44; and AKI with a final Cr &#8805;1&#46;5 mg&#47;dL &#40;OR&#44; 2&#46;602&#59; 95&#37; CI&#44; 1&#46;133-5&#46;974&#59; P &#61; 0&#46;024&#41;&#46;</p><p id="p0155" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#f0005">Figures 1</a> and <a class="elsevierStyleCrossRef" href="#f0010"><span class="elsevierStyleSup">2</span></a> exhibited the Kaplan-Meier curves for mortality during the follow-up period&#44; according to the presence and stage of AKI&#46; There were no differences in 90-day transplant-free survival probability when patients without AKI were compared to those with AKI stage 1 &#40;77&#46;6&#37; <span class="elsevierStyleItalic">vs&#46;</span> 68&#46;3&#37;&#59; P &#61; 0&#46;147&#41;&#46; Furthermore&#44; we observed a higher transplant-free survival probability among patients without AKI than among those with AKI stage 2 &#40;77&#46;6&#37; <span class="elsevierStyleItalic">vs&#46;</span> 36&#46;4&#37;&#59; P &#60; 0&#46;001&#41; and stage 3 &#40;77&#46;6&#37; <span class="elsevierStyleItalic">vs&#46;</span> 10&#46;0&#37;&#59; P &#60; 0&#46;001&#41;&#46; Individuals with AKI were compared according to stage &#40;dysfunction degree&#41; with a difference in transplant-free survival being observed between individuals in stages 1 and 2 &#40;68&#46;3&#37; <span class="elsevierStyleItalic">vs&#46;</span> 36&#46;4&#37;&#59; P &#61; 0&#46;022&#41;&#44; but not between stages 2 and 3 &#40;36&#46;4&#37; <span class="elsevierStyleItalic">vs&#46;</span> 10&#46;0&#37;&#59; P &#61; 0&#46;124&#41;&#46; When patients with AKI stage 1 and final creatinine &#60; 1&#46;5 mg&#47;dL were compared with those without AKI&#44; no differences were observed in 90-day transplant-free survival &#40;81&#46;8&#37; <span class="elsevierStyleItalic">vs&#46;</span> 76&#46;6&#37;&#59; P &#61; 0&#46;669&#41;&#46; On the other hand&#44; individuals with AKI stage 1 and final creatinine level &#8805; 1&#46;5 mg&#47;dL showed significantly lower transplant-free survival rates than those without AKI &#40;53&#46;3&#37; <span class="elsevierStyleItalic">vs&#46;</span> 77&#46;6&#37;&#59; P &#61; 0&#46;006&#41;&#46; Transplant-free survival rates were also significantly lower in patients with AKI stage 1 and final creatinine &#8805; 1&#46;5 mg&#47;dL as compared to those with AKI and final creatinine &#60; 1&#46;5 mg&#47;dL &#40;53&#46;3&#37; <span class="elsevierStyleItalic">vs&#46;</span> 81&#46;8&#37;&#59; P &#61; 0&#46;025&#41; &#40;<a class="elsevierStyleCrossRef" href="#f0010">Figure 2</a>&#41;&#46;</p><elsevierMultimedia ident="f0005"></elsevierMultimedia><elsevierMultimedia ident="f0010"></elsevierMultimedia></span></span><span id="s0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0060">Discussion</span><p id="p0160" class="elsevierStylePara elsevierViewall">Creatine is a nitrogenous organic acid synthesized in the liver before being stored in muscles where it is phosphorylated as creatinine&#46; Creatinine production varies slightly from day to day and depends on muscle mass&#44; protein intake&#44; sex&#44; age and ethnicity&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a> In cirrhotic patients&#44; serum creatinine may overestimate renal function for several reasons&#44; as hepatic dysfunction may result in a decrease in creatinine synthesis&#44; including protein calorie malnutrition and loss of muscular mass&#44; which are common during cirrhosis&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a>&#44;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a></p><p id="p0165" class="elsevierStylePara elsevierViewall">AKI&#44; according to the International Club of Ascites consensus definition&#44;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> was found in 37&#37; of our patients&#46; The two main causes of AKI were prerenal insufficiency and hepatorenal syndrome&#44; as described in the literature&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a> In previous studies&#44; AKI prevalence ranges from 33&#37; to 60&#37; among individuals with decompensated cirrhosis and varies slightly according to the diagnostic criteria used<a class="elsevierStyleCrossRefs" href="#bib0095"><span class="elsevierStyleSup">19</span></a><span class="elsevierStyleSup">&#8211;</span><a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">22</span></a> and the cause of decompensation&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a> AKI occurred in 11&#37; of patients with UGIH&#44; 34&#37; of patients with SBP&#44; 27&#37; patients with non-SBP bacterial infections&#44; and in 40&#37; to 49&#37; of critically ill cirrhotic patients who required intensive therapy&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">23</span></a>&#44;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">24</span></a></p><p id="p0170" class="elsevierStylePara elsevierViewall">In the multivariate analysis&#44; AKI was independently associated with lower MAP and sodium values&#46; Similarly&#44; Wong&#44; <span class="elsevierStyleItalic">et al&#46;</span> observed lower values of MAP &#40;81 &#177; 16 <span class="elsevierStyleItalic">vs&#46;</span> 85 &#177; 15 mmHg&#59; P &#61; 0&#46;04&#41; and sodium &#40;131 &#177; 7 <span class="elsevierStyleItalic">vs&#46;</span> 134 &#177; 6 mmol&#47;L&#59; P &#61; 002&#41; among individuals who developed AKI than among those without renal dysfunction&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">25</span></a> Ruiz-DelArbol&#44; <span class="elsevierStyleItalic">et al&#46;</span> did not find any association between serum sodium and renal dysfunction&#44; but described a significant reduction in MAP among individuals with AKI&#44; suggesting that hemodynamic instability contributes to the worsening of renal function&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">26</span></a> Therefore&#44; maintaining the effective circulating volume is a strategy to prevent and treat renal dysfunction&#46;</p><p id="p0175" class="elsevierStylePara elsevierViewall">Identifying clinical characteristics in the first 48 h after admission that could predict 90-day mortality is a useful strategy in the management of cirrhotic patients&#44; as it allows early interventions that can influence prognosis&#46; In the present study&#44; the presence of ascites and higher CLIF-SOFA scores&#44; but not AKI&#44; were independently associated with 90-day death&#47;liver transplantation in the initial regression analysis&#46; However&#44; when we took into consideration AKI with higher final creatinine levels&#44; a subsequent regression analysis showed that AKI with a final Cr &#8805; 1&#46;5 mg&#47;dL along with ascites and CLIF-SOFA were independent predictors of 90-day death&#47;liver transplantation&#46;</p><p id="p0180" class="elsevierStylePara elsevierViewall">The CLIF-SOFA score has been recently proposed by the EASL-CLIF consortium<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a> and validated by our group&#46;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">27</span></a> Moreau&#44; <span class="elsevierStyleItalic">et al&#46;</span> described a 51&#46;2&#37; 90-day death&#47;liver transplantation in patients with ACLF and that elevated CLIF-SOFA values would be independently associated with mortality&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a> These findings were very similar to those found in our study&#46; The presence of ascites is regarded as a predictor of renal dysfunction&#44;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">28</span></a> and its association with mortality has been clearly described by Silva&#44; <span class="elsevierStyleItalic">et al&#46;</span>&#44; where the Kaplan-Meier 90-day survival probability was much higher &#40;91&#46;6&#37;&#41; for cirrhotic patients without ascites and ACLF at admission&#44; and only 21&#46;9&#37; for patients with both complications&#46;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">27</span></a></p><p id="p0185" class="elsevierStylePara elsevierViewall">Wong&#44; <span class="elsevierStyleItalic">et al&#46;</span> prospectively evaluated 337 patients with cirrhosis and infection and observed a greater proportion of patients with AKI who died within 30 days &#40;34&#37; <span class="elsevierStyleItalic">vs&#46;</span> 7&#37;&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">22</span></a> Belcher&#44; <span class="elsevierStyleItalic">et al&#46;</span> evaluated 192 cirrhotic patients with renal dysfunction and observed that progression of AKI was associated with mortality &#40;OR&#44; 3&#46;8&#59; 95&#37; CI&#44; 1&#46;3-11&#46;1&#41;&#46; A relevant question would be whether increased serum creatinine level is &#8805; 0&#46;3 mg&#47;dL but &#60; 1&#46;5 mg&#47;dL &#40;AKI 1A&#41; would be associated with higher mortality than that in patients with unchanged serum creatinine or increased serum creatinine level &#60; 0&#46;3 mg&#47;dL&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">29</span></a> The cutoff for creatinine value of 1&#46;5 mg&#47;dL was used in the traditional definition of hepatorenal syndrome&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> Further dividing patients with stage 1 AKI into two groups &#40;1A&#58; creatinine level &#60; 1&#46;5 mg&#47;dL and 1B&#58; creatinine level &#8805; 1&#46;5 mg&#47;dL&#41; is a physiopathological approach&#44; as it combines dynamic reduction in glomerular filtration rate &#40;GFR&#41;&#44; given by the increase in serum creatinine level&#44; associated with a deep reduction in GFR&#44; according to classical definition&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> In our study&#44; when patients without AKI were compared with those with AKI stage 1 and final creatinine level &#60; 1&#46;5 mg&#47;dL&#44; we did not observe any difference in 90-day transplant-free survival&#46; Fagundes&#44; <span class="elsevierStyleItalic">et al&#46;</span> evaluated 375 patients admitted due to decompensated cirrhosis and also observed similar probabilities of survival between patients without AKI and patients with AKI and creatinine level &#8804; 1&#46;5 mg&#47;dL &#40;88 <span class="elsevierStyleItalic">vs&#46;</span> 84&#37;&#44; respectively&#59; P &#61; 0&#46;52&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> Piano&#44; <span class="elsevierStyleItalic">et al&#46;</span> evaluated 233 patients with ascites and observed that patients with AKI1 and serum creatinine level &#60; 1&#46;5 mg&#47;dL presented lower mortality &#40;P &#61; 0&#46;03&#41; and progression rates &#40;P &#61; 0&#46;01&#41;&#44; and better improvement rate &#40;P &#61; 0&#46;025&#41; than patients with AKI1 and creatinine level &#8805; 1&#46;5 mg&#47;dL&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">30</span></a> In our study&#44; individuals with AKI stage 1 and final creatinine level &#8805; 1&#46;5 mg&#47;dL showed significantly higher transplant-free survival than those without AKI &#40;53&#46;3&#37; <span class="elsevierStyleItalic">vs&#46;</span> 77&#46;6&#37;&#59; P &#61; 0&#46;006&#41;&#46; Transplant-free survival rates were also significantly lower in patients with AKI stage 1 and final creatinine &#8805; 1&#46;5 mg&#47;dL as compared to those with AKI and final creatinine &#60; 1&#46;5 mg&#47;dL &#40;53&#46;3&#37; <span class="elsevierStyleItalic">vs&#46;</span> 81&#46;8&#37;&#59; P &#61; 0&#46;025&#41;&#44; which is similar to that described by Piano&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">30</span></a> Bucsics&#44; <span class="elsevierStyleItalic">et al&#46;</span> evaluated a retrospective cohort where all the individuals were decompensated cirrhotic patients with ascites&#46; The authors demonstrated that renal dysfunction was an important predictor of 30-day mortality&#44; even in patients with AKI 1 and creatinine levels &#60; 1&#46;5 mg&#47;dL&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a> In our study&#44; the variable AKI was only independently associated with mortality when using the cutoff level of 1&#46;5 mg&#47;dL&#46;</p><p id="p0190" class="elsevierStylePara elsevierViewall">Despite the valuable findings on AKI in cirrhotic patients&#44; we have to address some limitations to this study&#46; The relatively small number of patients with AKI may have influenced the results - especially concerning their classification in subgroups and the regression analysis&#46; In fact&#44; previous studies on the same subject have included a similar number of patients&#44;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a>&#44;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">30</span></a> and need external validation on different populations&#46; Additionally&#44; some studies have included heterogeneous population in distinct clinical scenarios &#40;regular ward or intensive care unit&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> while our study prospectively evaluated only patients admitted in the emergency room&#46; Secondly&#44; we do not have data on the evolution of renal dysfunction during hospitalization&#46; Our aim was to evaluate the impact of early AKI during hospitalization&#46; Information on late development of AKI and progression rate of renal dysfunction in patients with early AKI would be of interest&#46; Another important consideration is that in the present study none of the AKI episodes were considered to be related to acute tubular necrosis &#40;ATN&#41; by the hepatology team&#46; In fact all patients who did not respond to volume expansion had a full work up to exclude other causes of AKI including renal ultrasound&#44; urine analysis looking for proteinuria&#44; hematuria&#44; cylindruria&#46; We also usually performed fractional excretion of sodium &#40;FENa&#41; although its performance is very limited in patients with cirrhosis&#46; Even though ATN is a relatively common cause of AKI in studies including patients with cirrhosis&#44; the majority of ATN episodes occur in hospital related AKI&#44; patients in ICU and secondary to nephrotoxic agents such as contrast media and antimicrobials&#46; Our study prospectively included patients evaluated within hours of hospitalization&#44; solely in the emergency room&#44; clinical context where ATN is very uncommon and that probably justifies the results&#46;</p><p id="p0195" class="elsevierStylePara elsevierViewall">In conclusion&#44; early AKI was frequent in cirrhotic patients hospitalized for acute decompensation and was associated with 90-day death&#47;liver transplantation only when the final creatinine level was &#8805; 1&#46;5 mg&#47;dL&#46; These findings indicate the need of distinct approaches for patients with AKI 1 according to final creatinine level&#46;</p></span><span id="s0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0065">Financial Support</span><p id="p0200" class="elsevierStylePara elsevierViewall">No financial support was received for the completion of this study&#46;</p></span><span id="s0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0070">Conflict of Interest</span><p id="p0205" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest&#46;</p></span><span id="s0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0075">Acknowledgments</span><p id="p0210" class="elsevierStylePara elsevierViewall">Work presented orally as Free Theme at the XXIII Brazilian Congress of Hepatology&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
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        0 => array:3 [
          "identificador" => "xres1190767"
          "titulo" => "Abstract"
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              "identificador" => "abs0010"
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        1 => array:2 [
          "identificador" => "xpalclavsec1110044"
          "titulo" => "Keywords"
        ]
        2 => array:2 [
          "identificador" => "s0005"
          "titulo" => "Introduction"
        ]
        3 => array:3 [
          "identificador" => "s0010"
          "titulo" => "Material and Methods"
          "secciones" => array:3 [
            0 => array:2 [
              "identificador" => "s0015"
              "titulo" => "Study Sample"
            ]
            1 => array:2 [
              "identificador" => "s0020"
              "titulo" => "Methods"
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            2 => array:2 [
              "identificador" => "s0025"
              "titulo" => "Statistical analyses"
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          ]
        ]
        4 => array:3 [
          "identificador" => "s0030"
          "titulo" => "Results"
          "secciones" => array:3 [
            0 => array:2 [
              "identificador" => "s0035"
              "titulo" => "Characteristics of the sample"
            ]
            1 => array:2 [
              "identificador" => "s0040"
              "titulo" => "Variables associated with AKI"
            ]
            2 => array:2 [
              "identificador" => "s0045"
              "titulo" => "Variables associated with 90-day death or liver transplantation"
            ]
          ]
        ]
        5 => array:2 [
          "identificador" => "s0050"
          "titulo" => "Discussion"
        ]
        6 => array:2 [
          "identificador" => "s0055"
          "titulo" => "Financial Support"
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        7 => array:2 [
          "identificador" => "s0060"
          "titulo" => "Conflict of Interest"
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        8 => array:2 [
          "identificador" => "s0065"
          "titulo" => "Acknowledgments"
        ]
        9 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2017-04-27"
    "fechaAceptado" => "2017-06-26"
    "PalabrasClave" => array:1 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec1110044"
          "palabras" => array:3 [
            0 => "Acute kidney injury"
            1 => "Liver cirrhosis"
            2 => "Prognosis"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:1 [
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abs0010" class="elsevierStyleSection elsevierViewall"><p id="sp0025" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Introduction and aim&#46;</span> New criteria for acute kidney injury &#40;AKI&#41; in cirrhosis have been proposed&#44; but its prognostic significance is unclear&#46; This study aims to evaluate the prognostic significance of the AKI criteria in cirrhotic patients hospitalized for acute decompensation&#46;</p><p id="sp0030" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Material and methods&#46;</span> This is a prospective cohort study&#46; AKI was defined as an increase in creatinine &#40;Cr&#41; levels &#8805; 0&#46;3 mg&#47;dL in 48 h or &#8805; 50&#37; of the basal value in the last 7d&#46; AKI was divided into stages 1 &#40;elevation&#58; &#60; 2x basal&#41;&#44; 2 &#40;2 or 3x&#41;&#44; and 3 &#40;&#62; 3x&#41;&#46;</p><p id="sp0035" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Results</span>&#46; In this study&#44; 227 patients aged 53&#46;9 &#177; 11&#46;5 years were included&#44; of whom 37&#37; had AKI &#40;28&#37; AKI1&#44; 5&#37; AKI2&#44; and 4&#37; AKI3&#41;&#46; Thirty percent of the patients died or were transplanted within 90 days from causes related to the presence of ascites at hospital admission and higher values of Chronic Liver Failure-Sequential Organ Failure Assessment &#40;CLIF-SOFA&#41; scores&#44; but not to the presence of AKI&#46; In a regression analysis conducted to assess the effect of the final Cr level in patients with AKI&#44; 90-day mortality was associated with ascites&#44; higher CLIF-SOFA score&#44; and AKI with final Cr level &#8805; 1&#46;5 mg&#47;dL&#46; The patients with AKI with Cr levels &#8805; 1&#46;5 mg&#47;dL showed lower transplant-free survival rates than those without AKI&#44; and those with AKI1 with final Cr level &#60; 1&#46;5 mg&#47;dL&#46;</p><p id="sp0040" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Conclusions&#46;</span> Early AKI was frequent and associated with 90-day mortality or transplantation only when the final Cr level was &#8805; 1&#46;5 mg&#47;dL&#46; Distinct approaches are needed for patients with AKI1 according to final Cr&#46;</p></span>"
      ]
    ]
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        "identificador" => "f0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
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        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 551
            "Ancho" => 512
            "Tamanyo" => 45775
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        "descripcion" => array:1 [
          "en" => "<p id="sp0005" class="elsevierStyleSimplePara elsevierViewall">Ninety-day cumulative survival rate of cirrhotic patients according to the stages of acute kidney injury &#40;AKI&#41;&#46; Surviva was significantly lower in the patients with AKI stages 2 and 3 than in those without AKI &#40;P &#60; 0&#46;001&#44; log-rank test&#41;&#46; When individuals were compared according to the AKI stage&#44; those with AKI stage 1 had higher survival than those with stage 2 &#40;P &#61; 0&#46;022&#41;&#46; No differences were observed between those in stages 2 and 3&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "f0010"
        "etiqueta" => "Figure 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
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        "descripcion" => array:1 [
          "en" => "<p id="sp0010" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Ninety-day cumulative survival rate of the cirrhotic patients according to the stages of acute kidney injury &#40;AKI&#41;&#46; Survival was significantly lower in patients with AKI stage 1 and final creatinine level</span> &#8805;<span class="elsevierStyleItalic">1&#46;5 mg&#47;dL than in those without AKI &#40;P &#61; 0&#46;006&#44; log-rank test&#41;&#46; This difference can aso be observed between patients with AKI stage 1 and final creatinine values</span> &#8805; <span class="elsevierStyleItalic">or &#60; 1&#46;5 mg&#47;dL &#40;P &#61; 0&#46;025&#41;&#46;</span></p>"
        ]
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      2 => array:7 [
        "identificador" => "t0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">All &#40;&#951; &#61; 227&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Without kidney dysfunction &#40;n &#61; 159&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Acute kidney dysfunction &#40;n &#61; 68&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">P&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Age &#40;years&#41;<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">53&#46;9 &#177;11&#46;5 &#40;54&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">53&#46;1 &#177; 12&#46;1 &#40;53&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">55&#46;2 &#177; 10&#46;5&#40;55&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;1996<span class="elsevierStyleSup">t</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Males &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">72&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">75&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">67&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;211<span class="elsevierStyleSup">q</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Propranolol &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">34&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">34&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">34&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;000<span class="elsevierStyleSup">q</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cirrhosis etiology&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hepatitis C virus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">38&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">38&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">39&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;902<span class="elsevierStyleSup">q</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hepatitis &#914; virus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;000<span class="elsevierStyleSup">f</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Alcohol&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">60&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">61&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">59&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;764<span class="elsevierStyleSup">q</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cryptogenic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;609<span class="elsevierStyleSup">q</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ascites at admission &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">48&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">44&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">57&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;057<span class="elsevierStyleSup">q</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Upper gastrointestinal hemorrhage &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">46&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">51&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">39&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;086<span class="elsevierStyleSup">q</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Encephalopathy at admission &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">54&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">49&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">64&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;025<span class="elsevierStyleSup">q</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Bacterial peritonitis &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;020<span class="elsevierStyleSup">q</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Infection &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">31&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">41&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;025<span class="elsevierStyleSup">q</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Mean arterial pressure&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">83&#46;5 &#177; 14&#46;9 &#40;83&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">86&#46;3 &#177; 15&#46;5 &#40;83&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">78&#46;6 &#177; 12&#46;6&#40;76&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#46;001<span class="elsevierStyleSup">t</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cardiac frequency&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">81&#46;7 &#177; 17&#46;4 &#40;80&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">80&#46;6 &#177; 17&#46;1 &#40;79&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">83&#46;6 &#177; 17&#46;9&#40;82&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;421<span class="elsevierStyleSup">m</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sodium &#40;mEq&#47;L&#41;<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">135&#46;0 &#177; 5&#46;6 &#40;135&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">136&#46;0 &#177; 4&#46;8 &#40;136&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">133&#46;2 &#177; 6&#46;4&#40;134&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#46;001<span class="elsevierStyleSup">t</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Albumin &#40;mg&#47;dL&#41;<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;3 &#177; 0&#46;7 &#40;2&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;3 &#177; 0&#46;7 &#40;2&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;2 &#177; 0&#46;6 &#40;2&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;308<span class="elsevierStyleSup">t</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">International Normalized Ratio<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;5 &#177; 0&#44;3 &#40;1&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;5 &#177; 0&#44;3 &#40;1&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;6 &#177; 0&#46;4&#40;1&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;054<span class="elsevierStyleSup">m</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Total bilirubin &#40;mg&#47;dL&#41;<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46;9 &#177; 5&#46;6 &#40;2&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46;5 &#177; 4&#46;2 &#40;2&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;6 &#177; 7&#46;4 &#40;2&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;663<span class="elsevierStyleSup">m</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Platelets&#47;mm<span class="elsevierStyleSup">3</span><a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">104&#44;070&#46;5 &#177; 70&#44;837&#46;2 &#40;82&#44;000&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">99720&#46;3 &#177; 63&#44;900&#46;3 &#40;81&#44;000&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">111&#44;476&#46;2 &#177; 21&#44;174&#46;7 &#40;93&#44;000&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;483<span class="elsevierStyleSup">m</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">C-reactive protein &#40;mg&#47;dL&#41;<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">40&#46;5 &#177; 60&#46;1 &#40;14&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32&#46;6 &#177; 49&#46;6 &#40;10&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">54&#46;2 &#177; 73&#46;1 &#40;23&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#46;082<span class="elsevierStyleSup">m</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Child-Pugh classification&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">A&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">10&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;498<span class="elsevierStyleSup">q</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#914;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">48&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">52&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">42&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;150<span class="elsevierStyleSup">q</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">C&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">41&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">36&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">49&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;060<span class="elsevierStyleSup">q</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Model for End-Stage Liver Disease<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16&#46;8 &#177; 6&#46;5 &#40;15&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&#46;0 &#177; 5&#46;2 &#40;14&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20&#46;2 &#177; 7&#46;3 &#40;19&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#46;001<span class="elsevierStyleSup">t</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">CLIF-SOFA<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#46;7 &#177; 2&#46;9 &#40;6&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#46;2 &#177; 2&#46;9 &#40;6&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#46;4 &#177; 2&#46;7 &#40;8&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#46;002<span class="elsevierStyleSup">t</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Acute on chronic liver failure &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">24&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">54&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#46;001<span class="elsevierStyleSup">q</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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                  \t\t\t\t\tvoid\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Survival &#40;n &#61; 159&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">90-day mortality &#40;n &#61; 68&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">P&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Age &#40;years&#41; <a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">54&#46;1 &#177;11&#46;0 &#40;54&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">53&#46;4 &#177; 12&#46;7 &#40;52&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;189&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Males&#44; &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">77&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">61&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;016&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Propranolol &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">36&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">28&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;234&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cirrhosis causes &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hepatitis C virus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">39&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">38&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;914&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hepatitis B virus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46;84&#46;41&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Alcohol&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">62&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">57&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;488&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cryptogenic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#46;61&#46;80&#46;376&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Renal dysfunction at admission &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">52&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Stage 1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">29&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;715&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Stage 2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;019&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Stage 3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ascites at admission &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">37&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">76&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Upper gastrointestinal hemorrhage &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">49&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">35&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;051&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Encephalopathy &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">47&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">72&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Spontaneous bacterial peritonitis &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;923&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Infection within the first 48 h&#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">61&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Mean arterial pressure&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">84&#46;2 &#177; 14&#46;7 &#40;83&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">81&#46;8 &#177; 15&#46;4 &#40;80&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cardiac frequency&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">79&#46;6 &#177; 17&#46;6 &#40;78&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">86&#46;7 &#177; 16&#46;1 &#40;87&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;007&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Creatinine &#40;mg&#47;dL&#41;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;2 &#177; 0&#46;8 &#40;1&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;9 &#177; 1&#46;5&#40;1&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sodium &#40;mEq&#47;L&#41;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">135&#46;7 &#177; 5&#46;1 &#40;136&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">133&#46;4 &#177; 6&#46;2 &#40;134&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;002&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Albumin &#40;mg&#47;dL&#41;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;4 &#177; 0&#44;7 &#40;2&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;0 &#177; 0&#46;5 &#40;1&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#46;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;5 &#177; 0&#46;3 &#40;1&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;7 &#177; 0&#46;4 &#40;1&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">107&#44;905&#46;7 &#177; 111&#44;825&#46;7 &#40;82&#44;000&#46;00&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">111&#44;911&#46;8 &#177; 87&#44;298&#46;4 &#40;87&#44;000&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">Lactate &#40;mEq&#47;L&#41;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;9 &#177; 1&#46;5 &#40;1&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">C-reactive protein &#40;mg&#47;dL&#41;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">31&#46;8 &#177; 49&#46;4&#40;9&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">60&#46;3 &#177; 76&#46;0&#40;29&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#46;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">Child-Pugh classification&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">21&#46;9 &#177; 6&#46;9 &#40;21&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">CLIF-SOFA<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Acute on chronic liver failure<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
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                            5 => "Smith W&#46;"
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                        "tituloSerie" => "J Am Soc Nephrol"
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Article information

ISSN: 16652681
Original language: English

DOI:10.5604/01.3001.0011.7390

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Year/Month	Html	Pdf	Total

2024 November	5	1	6
2024 October	44	6	50
2024 September	39	8	47
2024 August	33	4	37
2024 July	30	1	31
2024 June	22	3	25
2024 May	18	3	21
2024 April	40	8	48
2024 March	25	7	32
2024 February	28	6	34
2024 January	34	10	44
2023 December	25	8	33
2023 November	42	7	49
2023 October	54	15	69
2023 September	34	9	43
2023 August	47	10	57
2023 July	38	4	42
2023 June	53	3	56
2023 May	97	3	100
2023 April	84	4	88
2023 March	63	19	82
2023 February	53	7	60
2023 January	34	8	42
2022 December	45	2	47
2022 November	35	10	45
2022 October	36	16	52
2022 September	44	36	80
2022 August	40	10	50
2022 July	44	20	64
2022 June	39	9	48
2022 May	52	7	59
2022 April	46	15	61
2022 March	61	13	74
2022 February	36	7	43
2022 January	41	8	49
2021 December	29	11	40
2021 November	40	9	49
2021 October	42	8	50
2021 September	33	10	43
2021 August	84	13	97
2021 July	23	10	33
2021 June	30	11	41
2021 May	49	14	63
2021 April	124	35	159
2021 March	42	3	45
2021 February	33	12	45
2021 January	39	10	49
2020 December	26	10	36
2020 November	40	14	54
2020 October	18	7	25
2020 September	15	19	34
2020 August	26	7	33
2020 July	17	10	27
2020 June	13	3	16
2020 May	12	8	20
2020 April	14	5	19
2020 March	11	2	13
2020 February	5	8	13
2020 January	11	4	15
2019 December	12	8	20
2019 November	17	7	24
2019 October	14	2	16
2019 September	12	5	17
2019 August	2	2	4
2019 July	14	4	18
2019 June	9	7	16
2019 May	19	8	27

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