COVID-19
Regístrese
metricas
covid
Annals of Hepatology
Buscar en
Annals of Hepatology
Toda la web
Inicio Annals of Hepatology Renal and brain failure predict mortality of patients with acute-on-chronic live...
Journal Information
Back to article

Statistics

Follow this link to access the full text of the article

Original article
Renal and brain failure predict mortality of patients with acute-on-chronic liver failure admitted to the intensive care unit
Osvely Méndez-Guerreroa, Daniel A. Calle-Rodasa, Eduardo Cervantes-Alvareza,c, Elisa Alatorre-Arenasa, Juanita Pérez-Escobara, Nalu Navarro-Alvareza,b,d,
,1, Aldo Torrea,
,1
a Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Department of Gastroenterology, Mexico City, Mexico
b Universidad Panamericana School of Medicine, Campus México, Mexico City, Mexico
c PECEM, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
d Department of Surgery, University of Colorado Anschutz Medical Campus, Denver, CO, United States
Read
2316
Times
was read the article
407
Total PDF
1909
Total HTML
Share statistics
 array:24 [
  "pii" => "S166526812030185X"
  "issn" => "16652681"
  "doi" => "10.1016/j.aohep.2020.09.014"
  "estado" => "S300"
  "fechaPublicacion" => "2021-05-01"
  "aid" => "270"
  "copyright" => "Fundación Clínica Médica Sur, A.C."
  "copyrightAnyo" => "2020"
  "documento" => "article"
  "crossmark" => 1
  "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
  "subdocumento" => "fla"
  "cita" => "Ann Hepatol. 2021;22C:"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:1 [
    "total" => 0
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S1665268120301873"
    "issn" => "16652681"
    "doi" => "10.1016/j.aohep.2020.09.016"
    "estado" => "S300"
    "fechaPublicacion" => "2021-05-01"
    "aid" => "272"
    "copyright" => "Fundación Clínica Médica Sur, A.C."
    "documento" => "article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "fla"
    "cita" => "Ann Hepatol. 2021;22C:"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>"
      "titulo" => "Unexpected findings of hepatitis B and delta infection in northeastern Brazil&#58; A public health alert"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => "en"
      "contieneResumen" => array:1 [
        "en" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Jomar Diogo Costa Nunes, Diego Luz Felipe da Silva, Lena Maria Barros Fonseca, Ilana Mirian Almeida Felipe, Beatriz Rossetti Ferreira, Rodrigo de Carvalho Santana, Ana de Lourdes Candolo Martinelli, Ant&#244;nio Augusto Moura da Silva, Jo&#227;o Renato Rebello Pinho, Michele Soares Gomes Gouv&#234;a, Max Diego Cruz Santos, Thais Feres Moreira Lima, Ingrid de Campos Albuquerque, Marinilde Teles Souza, Maria Jos&#233;lia Diniz Moraes, Arlene de Jesus Mendes Caldas, Let&#237;cia Alana Barros Souza, Camila Maria Pinheiro de Mello e Silva, Adalgisa de Souza Paiva Ferreira"
          "autores" => array:19 [
            0 => array:2 [
              "nombre" => "Jomar Diogo Costa"
              "apellidos" => "Nunes"
            ]
            1 => array:2 [
              "nombre" => "Diego Luz Felipe da"
              "apellidos" => "Silva"
            ]
            2 => array:2 [
              "nombre" => "Lena Maria Barros"
              "apellidos" => "Fonseca"
            ]
            3 => array:2 [
              "nombre" => "Ilana Mirian Almeida"
              "apellidos" => "Felipe"
            ]
            4 => array:2 [
              "nombre" => "Beatriz Rossetti"
              "apellidos" => "Ferreira"
            ]
            5 => array:2 [
              "nombre" => "Rodrigo de Carvalho"
              "apellidos" => "Santana"
            ]
            6 => array:2 [
              "nombre" => "Ana de Lourdes Candolo"
              "apellidos" => "Martinelli"
            ]
            7 => array:2 [
              "nombre" => "Ant&#244;nio Augusto Moura da"
              "apellidos" => "Silva"
            ]
            8 => array:2 [
              "nombre" => "Jo&#227;o Renato Rebello"
              "apellidos" => "Pinho"
            ]
            9 => array:2 [
              "nombre" => "Michele Soares Gomes"
              "apellidos" => "Gouv&#234;a"
            ]
            10 => array:2 [
              "nombre" => "Max Diego Cruz"
              "apellidos" => "Santos"
            ]
            11 => array:2 [
              "nombre" => "Thais Feres Moreira"
              "apellidos" => "Lima"
            ]
            12 => array:2 [
              "nombre" => "Ingrid de Campos"
              "apellidos" => "Albuquerque"
            ]
            13 => array:2 [
              "nombre" => "Marinilde Teles"
              "apellidos" => "Souza"
            ]
            14 => array:2 [
              "nombre" => "Maria Jos&#233;lia Diniz"
              "apellidos" => "Moraes"
            ]
            15 => array:2 [
              "nombre" => "Arlene de Jesus Mendes"
              "apellidos" => "Caldas"
            ]
            16 => array:2 [
              "nombre" => "Let&#237;cia Alana Barros"
              "apellidos" => "Souza"
            ]
            17 => array:2 [
              "nombre" => "Camila Maria Pinheiro de Mello e"
              "apellidos" => "Silva"
            ]
            18 => array:2 [
              "nombre" => "Adalgisa de Souza Paiva"
              "apellidos" => "Ferreira"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1665268120301873?idApp=UINPBA00004N"
    "url" => "/16652681/000000220000000C/v3_202107300613/S1665268120301873/v3_202107300613/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S1665268120301848"
    "issn" => "16652681"
    "doi" => "10.1016/j.aohep.2020.09.013"
    "estado" => "S300"
    "fechaPublicacion" => "2021-05-01"
    "aid" => "269"
    "copyright" => "Fundaci&#243;n Cl&#237;nica M&#233;dica Sur&#44; A&#46;C&#46;"
    "documento" => "article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "fla"
    "cita" => "Ann Hepatol. 2021;22C:"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>"
      "titulo" => "Long noncoding RNA LINC01189 is associated with HCV-hepatocellular carcinoma and regulates cancer cell proliferation and chemoresistance through hsa-miR-155-5p"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => "en"
      "contieneResumen" => array:1 [
        "en" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:8 [
          "identificador" => "fig0020"
          "etiqueta" => "Fig&#46; 4"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr4.jpeg"
              "Alto" => 3260
              "Ancho" => 2326
              "Tamanyo" => 320838
            ]
          ]
          "detalles" => array:1 [
            0 => array:3 [
              "identificador" => "at0020"
              "detalle" => "Fig&#46; "
              "rol" => "short"
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">LINC01189 attaches to hsa-miR-155-5p&#46; <span class="elsevierStyleBold">&#40;A&#41;</span> Two DNA sequences on wild-type LINC01189 3&#8217;-UTR were predicted to attach to hsa-miR-155-5p&#46; The binding sites were then point-mutated&#46; <span class="elsevierStyleBold">&#40;B&#41;</span> The wild type and mutant LINC01189 3&#8217;-UTRs were used to generate two luciferase reporter vectors&#44; WT&#95;1189 and MU&#95;1189&#46; Then&#44; hsa-miR-155-5p mimics &#40;mimics&#95;miR155&#41; or a non-specific miRNA mimics &#40;mimics&#95;NS&#41; were co-transfected with WT&#95;1189 or MU&#95;1189 in human HEK293T cells&#46; And a dual-luciferase activity assay was conducted 48<span class="elsevierStyleHsp" style=""></span>h later&#46; <span class="elsevierStyleBold">&#40;C&#41;</span> In pc&#95;1189- or pc&#95;NS- transfected Huh7 and Hep3B cells&#44; qRT-PCR was performed to compare hsa-miR-155-5p expressions levels &#40;&#42; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Ying Yao, Fang Shu, Fang Wang, Xiaoqiang Wang, Zhengshe Guo, Haili Wang, Lu Li, Haigang Lv"
          "autores" => array:8 [
            0 => array:2 [
              "nombre" => "Ying"
              "apellidos" => "Yao"
            ]
            1 => array:2 [
              "nombre" => "Fang"
              "apellidos" => "Shu"
            ]
            2 => array:2 [
              "nombre" => "Fang"
              "apellidos" => "Wang"
            ]
            3 => array:2 [
              "nombre" => "Xiaoqiang"
              "apellidos" => "Wang"
            ]
            4 => array:2 [
              "nombre" => "Zhengshe"
              "apellidos" => "Guo"
            ]
            5 => array:2 [
              "nombre" => "Haili"
              "apellidos" => "Wang"
            ]
            6 => array:2 [
              "nombre" => "Lu"
              "apellidos" => "Li"
            ]
            7 => array:2 [
              "nombre" => "Haigang"
              "apellidos" => "Lv"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1665268120301848?idApp=UINPBA00004N"
    "url" => "/16652681/000000220000000C/v3_202107300613/S1665268120301848/v3_202107300613/en/main.assets"
  ]
  "en" => array:20 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>"
    "titulo" => "Renal and brain failure predict mortality of patients with acute-on-chronic liver failure admitted to the intensive care unit"
    "tieneTextoCompleto" => true
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Osvely M&#233;ndez-Guerrero, Daniel A&#46; Calle-Rodas, Eduardo Cervantes-Alvarez, Elisa Alatorre-Arenas, Juanita P&#233;rez-Escobar, Nalu Navarro-Alvarez, Aldo Torre"
        "autores" => array:7 [
          0 => array:3 [
            "nombre" => "Osvely"
            "apellidos" => "M&#233;ndez-Guerrero"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "Daniel A&#46;"
            "apellidos" => "Calle-Rodas"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "Eduardo"
            "apellidos" => "Cervantes-Alvarez"
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "Elisa"
            "apellidos" => "Alatorre-Arenas"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "Juanita"
            "apellidos" => "P&#233;rez-Escobar"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          5 => array:4 [
            "nombre" => "Nalu"
            "apellidos" => "Navarro-Alvarez"
            "email" => array:1 [
              0 => "nalu.navarroa@incmnsz.mx"
            ]
            "referencia" => array:5 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
              2 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">d</span>"
                "identificador" => "aff0020"
              ]
              3 => array:2 [
                "etiqueta" => "&#42;"
                "identificador" => "cor0005"
              ]
              4 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">1</span>"
                "identificador" => "fn0005"
              ]
            ]
          ]
          6 => array:4 [
            "nombre" => "Aldo"
            "apellidos" => "Torre"
            "email" => array:1 [
              0 => "detoal@yahoo.com"
            ]
            "referencia" => array:3 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "&#42;"
                "identificador" => "cor0005"
              ]
              2 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">1</span>"
                "identificador" => "fn0005"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:4 [
          0 => array:3 [
            "entidad" => "Instituto Nacional de Ciencias M&#233;dicas y Nutrici&#243;n Salvador Zubir&#225;n&#44; Department of Gastroenterology&#44; Mexico City&#44; Mexico"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Universidad Panamericana School of Medicine&#44; Campus M&#233;xico&#44; Mexico City&#44; Mexico"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
          2 => array:3 [
            "entidad" => "PECEM&#44; Facultad de Medicina&#44; Universidad Nacional Aut&#243;noma de M&#233;xico&#44; Mexico City&#44; Mexico"
            "etiqueta" => "c"
            "identificador" => "aff0015"
          ]
          3 => array:3 [
            "entidad" => "Department of Surgery&#44; University of Colorado Anschutz Medical Campus&#44; Denver&#44; CO&#44; United States"
            "etiqueta" => "d"
            "identificador" => "aff0020"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding authors&#46;"
          ]
        ]
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:8 [
        "identificador" => "fig0020"
        "etiqueta" => "Fig&#46; 4"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr4.jpeg"
            "Alto" => 1785
            "Ancho" => 3175
            "Tamanyo" => 303687
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0020"
            "detalle" => "Fig&#46; "
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Kaplan&#8211;Meier survival curve in patients based on the type of organ failure&#46; Patients with the following organ failures &#40;A&#41; brain failure &#40;B&#41; circulatory failure &#40;C&#41; liver failure &#40;D&#41; renal failure and &#40;E&#41; coagulation failure&#44; have lower survival &#40;log rank&#44; p&#58;0&#46;001&#41; - &#40;log rank&#44; p&#58;0&#46;02&#41; compared to those without any of these organs&#46; &#40;F&#41; No differences were found between patients with lung failure and those without &#40;log rank&#44; p&#58;0&#46;415&#41;&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleLabel">1</span><span class="elsevierStyleSectionTitle" id="sect0035">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Acute on chronic liver failure &#40;ACLF&#41; is a clinical syndrome manifesting as an acute insult on an already compromised liver with a chronic disease that is associated with organ failure and high short-term mortality &#91;<a class="elsevierStyleCrossRef" href="#bib0005">1</a>&#93;&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Multiple organ dysfunction is a common cause of morbidity and mortality in intensive care units &#40;ICUs&#41; &#91;<a class="elsevierStyleCrossRef" href="#bib0010">2</a>&#93; and in patients with ACLF &#91;<a class="elsevierStyleCrossRef" href="#bib0015">3</a>&#93;&#46; It is known that bacterial infections which are the most common precipitant in ACLF patients&#44; are associated with a bad prognosis &#91;<a class="elsevierStyleCrossRef" href="#bib0005">1</a>&#44;<a class="elsevierStyleCrossRef" href="#bib0020">4</a>&#93;&#44; and with the development of organ failure&#40;s&#41; &#91;<a class="elsevierStyleCrossRefs" href="#bib0025">5&#8211;7</a>&#93;&#46; ACLF events are classified based on the number of organ failure &#40;s&#41; &#40;OFs&#41;&#44; grade 1 &#40;less severe&#41; to grade 3 &#40;most severe&#41; and it is universally known that short-term survival worsens with increasing ACLF grades &#91;<a class="elsevierStyleCrossRef" href="#bib0005">1</a>&#44;<a class="elsevierStyleCrossRef" href="#bib0040">8</a>&#93;&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Moreover&#44; not only the number of organs involved but the type of organ affected&#44; has an impact on mortality &#91;<a class="elsevierStyleCrossRef" href="#bib0045">9</a>&#44;<a class="elsevierStyleCrossRef" href="#bib0050">10</a>&#93;&#46; Hepatic encephalopathy &#40;HE&#41; grade 3&#8211;4 has been associated with high mortality in ACLF patients in the United States &#91;<a class="elsevierStyleCrossRef" href="#bib0045">9</a>&#93;&#44; while in Europe&#44; renal failure in ACLF patients has a high short-term mortality &#91;<a class="elsevierStyleCrossRef" href="#bib0055">11</a>&#93;&#46; Renal failure has also been demonstrated to be a negative predictor of ACLF resolution &#91;<a class="elsevierStyleCrossRef" href="#bib0060">12</a>&#93;&#46; Whereas liver failure within the CLIF-C ACLF score&#44; has been proven to independently predict a severe course &#91;<a class="elsevierStyleCrossRef" href="#bib0065">13</a>&#93;&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">While most of the information we currently have regarding ACLF comes from the European&#44; American and Asian cohorts&#44; information on ACLF and predictors of mortality on Latin American population are completely lacking &#91;<a class="elsevierStyleCrossRef" href="#bib0005">1</a>&#44;<a class="elsevierStyleCrossRef" href="#bib0070">14</a>&#44;<a class="elsevierStyleCrossRef" href="#bib0075">15</a>&#93;&#46; Here we present our 6-year single-center experience of patients admitted to the ICU that fulfill the criteria for ACLF&#44; and describe the clinical factors and type of organ failures that are independent predictors of 28 and 90-day mortality&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleLabel">2</span><span class="elsevierStyleSectionTitle" id="sect0040">Methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleLabel">2&#46;1</span><span class="elsevierStyleSectionTitle" id="sect0045">Patients</span><p id="par0025" class="elsevierStylePara elsevierViewall">Patients with cirrhosis that were admitted to the intensive care unit &#40;ICU&#41; due to a decompensation event between 2012 to 2018 and fulfilled criteria for ACLF diagnosis within the first 6 days of hospitalization were included&#46; The diagnosis of liver cirrhosis was based on histological&#44; clinical signs of hepatic decompensation &#40;HE&#44; variceal bleeding&#44; jaundice&#44; ascites and&#47;or hepatorenal syndrome&#41; ultrasonography&#44; and&#47;or endoscopic findings&#46; Liver disease severity was assessed using the following scores&#58; Child-pugh&#44; Model for End-Stage liver disease &#40;MELD&#41; &#91;<a class="elsevierStyleCrossRef" href="#bib0080">16</a>&#44;<a class="elsevierStyleCrossRef" href="#bib0085">17</a>&#93;&#46; We excluded patients younger than 18 years old&#44; pregnant&#44; and patients diagnosed with hepatocellular carcinoma&#44; as well as those who received a liver transplant during the 90-day follow-up after the diagnosis of ACLF&#46; The present study was approved by the ethics committee and was performed according to the ethical guidelines of the 1975 Declaration of Helsinki&#46; The requirement for obtaining informed consent from patients was waived because of the retrospective nature of the study&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleLabel">2&#46;2</span><span class="elsevierStyleSectionTitle" id="sect0050">ACLF and organ failure definitions</span><p id="par0030" class="elsevierStylePara elsevierViewall">ACLF was diagnosed according to the EASL-CLIF Consortium criteria &#91;<a class="elsevierStyleCrossRef" href="#bib0005">1</a>&#93;&#46; Grading of ACLF was performed according to the CANONIC study &#91;<a class="elsevierStyleCrossRef" href="#bib0005">1</a>&#93; with the following classification&#58; ACLF 1&#58; patients with renal failure &#40;creatinine &#8805;2&#46;0&#8239;mg&#47;dl&#41; or a non-renal organ failure plus renal dysfunction &#40;creatinine between 1&#46;5&#8211;1&#46;9&#8239;mg&#47;dl&#41; and&#47;or HE grade I&#8211;II&#46; ACLF 2&#58; Patients with 2 organ failures&#59; ACLF 3&#58; Patients with 3 or more organ failures&#46; Organ Failure&#40;s&#41; were defined as follows&#58; Liver &#40;serum bilirubin &#8805;12&#46;0&#8239;mg&#47;dl&#41;&#44; renal &#40;creatinine &#8805;2&#8239;mg&#47;dl or renal replacement&#41;&#44; brain &#40;HE III&#8211;IV grade&#41;&#44; coagulation &#40;INR&#8239;&#8805;&#8239;2&#46;5&#41;&#44; circulatory &#40;vasopressor use for circulatory failure indication&#41; and lung &#40;SpO2&#47;FiO2&#8239;&#8804;&#8239;214 or mechanical Ventilation for lung failure&#41;&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleLabel">2&#46;3</span><span class="elsevierStyleSectionTitle" id="sect0055">Infections</span><p id="par0035" class="elsevierStylePara elsevierViewall">The following diagnostic criteria for infection were used&#58; suggestive findings on chest radiographs was diagnostic of pneumonia &#91;<a class="elsevierStyleCrossRef" href="#bib0090">18</a>&#93;&#44; Spontaneous Bacterial Peritonitis &#40;SBP&#41; was based on an increased number of polymorphonuclear neutrophils in ascitic fluid &#40;&#62;250&#47;mm<span class="elsevierStyleSup">3</span>&#41; &#91;<a class="elsevierStyleCrossRef" href="#bib0095">19</a>&#93; &#59;more than 15 white blood cells in urine per high power field with either positive urine gram stain or culture was diagnostic of urinary tract infection &#91;<a class="elsevierStyleCrossRef" href="#bib0100">20</a>&#93;&#59; and acute cholangitis was suspected clinically by the Charcot triad &#40;pain&#44; fever&#44; jaundice&#41; and confirmed by means of biliary tract dilatation or obstruction &#91;<a class="elsevierStyleCrossRef" href="#bib0105">21</a>&#93;&#46; Nosocomial infections were those diagnosed after 48&#8239;h of admission&#44; and community acquired &#40;CA&#41; within 48&#8239;h of admission&#46; Diagnosis of other infections were made according to conventional criteria &#91;<a class="elsevierStyleCrossRef" href="#bib0110">22</a>&#93;&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleLabel">2&#46;4</span><span class="elsevierStyleSectionTitle" id="sect0060">Data collection</span><p id="par0040" class="elsevierStylePara elsevierViewall">The following data were collected from the charts&#58; patient demographics including age&#44; sex&#44; cirrhosis etiology&#44; ascites according to the International Club of Ascites &#91;<a class="elsevierStyleCrossRef" href="#bib0115">23</a>&#93;&#44; HE according to the West-Haven criteria &#91;<a class="elsevierStyleCrossRef" href="#bib0120">24</a>&#93;&#44; vital signs&#44; biochemical profile including complete blood count &#40;CBC&#41;&#44; liver function tests&#44; use of vasopressors&#44; need for renal replacement therapy&#44; mechanical ventilation and precipitating factors &#40;Infection&#44; GI bleeding&#44; HE&#44; Alcohol&#41; affecting ACLF development and mortality&#46; Patients were followed for up to 90-days&#46; If patients were discharged before 90-days&#44; the follow-up was performed by reviewing the medical records&#44; contacting the patient&#44; a close relative or legal representative&#44; or in person during a scheduled follow-up appointment&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleLabel">2&#46;5</span><span class="elsevierStyleSectionTitle" id="sect0065">Statistical analysis</span><p id="par0045" class="elsevierStylePara elsevierViewall">All results were expressed as mean&#8239;&#177;&#8239;standard deviation &#40;SD&#41; or median and interquartile range &#40;percentile 25 to percentile 75&#41; according to the normal distribution of the data&#46; The quantitative variable distribution was performed using asymmetry values&#44; kurtosis&#44; and Kolmogorov&#8211;Smirnov test&#46; Categorical variables were reported in frequencies and percentages and compared using Pearson&#8217;s Chi-squared test&#46; The comparison among ACLF grades was performed using ANOVA when the continuous variables were normally distributed or a non-parametric test &#40;Kruskal&#8211;Wallis&#41; for those variables with asymmetric distribution&#46; We constructed a Cox regression analysis to evaluate the possible predictors&#47;associations with ACLF mortality&#46; We used a stepwise approach and included only clinically meaningful variables in the final model to understand what factors were independently associated with 28 and 90-day mortality&#46; Collinearity between explanatory variables was tested using the Variance Inflation Factor&#44; highly correlated variables were excluded from the analysis to prevent issues with multicollinearity&#46; Survival curves were done using a Kaplan&#8211;Meier plot and were compared with the log-rank test&#46; All analyses were performed using SPSS &#40;Statistical Package for the Social Sciences&#41; version 22 and GraphPad Prism version 8 software&#46; A p-value of &#60;0&#46;05 was considered statistically significant&#46;</p></span></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleLabel">3</span><span class="elsevierStyleSectionTitle" id="sect0070">Results</span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleLabel">3&#46;1</span><span class="elsevierStyleSectionTitle" id="sect0075">General demographics</span><p id="par0050" class="elsevierStylePara elsevierViewall">From 2012&#8211;2018 a total of 938 cirrhotic patients were seen in the emergency department and admitted to the ICU due to a decompensation event&#46; Of those 938 patients&#44; 599 had decompensated cirrhosis &#40;DC&#41;&#44; 263 developed ACLF and 76 patients were excluded for the following reasons &#40;57 had hepatocellular carcinoma&#44; 13 had extra-hepatic cancer &#40;colon&#44; stomach&#44; pancreas&#41; and 6 had HIV infection&#41;&#46; From the 263 patients fulfilling ACLF inclusion criteria&#44; 115 were excluded &#40;92 had incomplete data and 23 received liver transplantation during the 90 days following the diagnosis of ACLF&#41;&#46; Thus&#44; a total of 148 patients were included in this study&#44; with the majority fulfilling ACLF criteria either at the time of admission or during the first 6 days of admission to the ICU &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0055" class="elsevierStylePara elsevierViewall">The median age for our cohort was 54 years old &#40;interquartile range 41&#8211;63 years&#41;&#46; Sex frequency was very similar&#44; with females constituting 55&#37; &#40;n&#8239;&#61;&#8239;81&#41; of the population&#46; The underlying causes of cirrhosis were virus 29&#46;8&#37; &#40;n&#8239;&#61;&#8239;44&#41;&#44; cryptogenic 17&#46;6&#37; &#40;n&#8239;&#61;&#8239;26&#41;&#44; alcohol 13&#46;5&#37; &#40;n&#8239;&#61;&#8239;20&#41;&#44; Autoimmune Hepatitis &#40;AIH&#41; 11&#46;5&#37; &#40;n&#8239;&#61;&#8239;17&#41;&#44; Primary Biliary Cirrhosis &#40;PBC&#41; 8&#46;1&#37; &#40;n&#8239;&#61;&#8239;12&#41;&#44; and non-alcoholic fatty liver disease &#40;NAFLD&#41; 7&#46;4&#37; &#40;n&#8239;&#61;&#8239;11&#41;&#46; Based on the liver disease severity scores&#44; the majority of the patients were severely ill&#44; had MELD score &#62;15 &#40;69&#46;6&#37;&#59; n&#8239;&#61;&#8239;103&#41;&#44; 68&#46;2&#37; &#40;n&#8239;&#61;&#8239;101&#41; had Child-Pugh C&#44; 28&#46;4 &#37; &#40;n&#8239;&#61;&#8239;42&#41; had Child-Pugh B and only 3&#46;4&#37; &#40;n&#8239;&#61;&#8239;5&#41; had Child-Pugh A&#46; In addition&#44; more than half of the patients 55&#37; &#40;n&#8239;&#61;&#8239;82&#41; had ACLF grade 3&#44; 28&#37; &#40;n&#8239;&#61;&#8239;41&#41; grade 2&#44; and only 17&#37; &#40;n&#8239;&#61;&#8239;25&#41; grade 1 &#40;Supplementary Table S1&#41;&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">The most common precipitating events were infection 58&#46;1&#37; &#40;n&#8239;&#61;&#8239;86&#41;&#44; GI bleeding 8&#46;1&#37; &#40;n&#8239;&#61;&#8239;12&#41;&#44; Hepatic Encephalopathy &#40;HE&#41; 2&#46;7&#37; &#40;n&#8239;&#61;&#8239;4&#41; and alcohol 2&#46;7&#37; &#40;n&#8239;&#61;&#8239;4&#41;&#46; Interestingly in 28&#46;4&#37; &#40;n&#8239;&#61;&#8239;42&#41; of the patients&#44; the precipitant was unknown &#40;Supplementary Table S1&#41;&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleLabel">3&#46;2</span><span class="elsevierStyleSectionTitle" id="sect0080">Clinical and biochemical characteristics and organ failure prevalence based on ACLF grading</span><p id="par0065" class="elsevierStylePara elsevierViewall">Patients were further classified into ACLF grade&#44; and clinical and biochemical characteristics were analyzed &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46; There were no statistical differences in age&#44; sex or etiology among the different ACLF grades &#40;p&#8239;&#61;&#8239;0&#46;535&#41;&#44; &#40;p&#8239;&#61;&#8239;0&#46;982&#41;&#44; &#40;p&#8239;&#61;&#8239;0&#46;332&#41; respectively&#46; However&#44; we found a significant difference among them in the presence of HE &#40;p&#8239;&#61;&#8239;0&#46;001&#41;&#44; bilirubin &#40;p&#8239;&#61;&#8239;0&#46;002&#41;&#44; creatinine &#40;p&#8239;&#61;&#8239;0&#46;001&#41;&#44; INR &#40;p&#8239;&#61;&#8239;0&#46;007&#41;&#44; leukocytes &#40;p&#8239;&#61;&#8239;0&#46;024&#41;&#44; Child-Pugh score &#40;p&#8239;&#61;&#8239;0&#46;017&#41; vasopressor use &#40;P&#8239;&#61;&#8239;0&#46;001&#41; and SpO2&#47;FiO2&#8239;&#8804;&#8239;214 &#40;p&#8239;&#61;&#8239;0&#46;042&#41;&#46; The majority of patients with ACLF grade 3 accounted for these differences&#44; with 68&#46;3&#37; &#40;n&#8239;&#61;&#8239;56&#41; presenting with HE grades III&#8211;IV&#44; a median of serum bilirubin of 19&#46;1&#8239;mg&#47;dl&#44; creatinine of 2&#46;41&#8239;mg&#47;dl&#44; INR of 2&#46;1&#8239;mg&#47;dl and total leukocyte count of 12&#46;7&#8239;&#215;&#8239;10<span class="elsevierStyleSup">9</span>&#47;l&#46; Sixty four percent &#40;n&#8239;&#61;&#8239;53&#41; of patients with ACLF-3 presented with severe circulatory failure with a MAP&#8239;&#8804;&#8239;70 &#40;mmHg&#41;&#44; and almost all of these patients&#44; 97&#46;6&#37; &#40;n&#8239;&#61;&#8239;80&#41; required vasopressors&#46; Likewise&#44; mechanical ventilation was required in more than half of ACLF-3 patients 59&#46;69&#37; &#40;n&#8239;&#61;&#8239;49&#41;&#44; of which in 46&#46;34&#37; &#40;n&#8239;&#61;&#8239;38&#41; was indicated by HE&#46; As we expected&#44; the ACLF and CLIF-C OF scores were significantly different among groups with a proportional increase according to the degree of ACLF severity &#40;p&#8239;&#61;&#8239;0&#46;001&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">The most prevalent OF was the circulation with 83&#46;1&#37; &#40;n&#8239;&#61;&#8239;123&#41; of the total cases&#44; followed by renal 52&#46;7&#37; &#40;n&#8239;&#61;&#8239;78&#41;&#44; brain 50&#46;7&#37; &#40;n&#8239;&#61;&#8239;75&#41;&#44; liver 46&#46;6&#37; &#40;n&#8239;&#61;&#8239;69&#41;&#44; coagulation 24&#46;3&#37; &#40;n&#8239;&#61;&#8239;36&#41; and lung failure 13&#46;5&#37; &#40;n&#8239;&#61;&#8239;20&#41;&#44; of cases respectively &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">When patients were divided according to ACLF severity&#44; it was interesting to note that in ACLF 1 there was no lung failure&#46; Meanwhile&#44; the failures that occurred most frequently in grade 3 ACLF were the circulatory 97&#46;6&#37; &#40;n&#8239;&#61;&#8239;80&#41; and renal failure 82&#46;9&#37; &#40;n&#8239;&#61;&#8239;68&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleLabel">3&#46;3</span><span class="elsevierStyleSectionTitle" id="sect0085">Survival and mortality according to ACLF grading</span><p id="par0080" class="elsevierStylePara elsevierViewall">The global 90-day survival for patients with ACLF was 18&#37; &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>-A&#41; and the median overall survival was 19 days 95&#37; CI &#40;11&#46;96&#8211;26&#46;03&#41;&#46; When survival was analyzed according to ACLF severity&#44; we found that the higher the ACLF grade&#44; the lower the survival &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>-B&#41;&#46; Survival for patients with ACLF-3 was extremely low 10&#37;&#44; while survival for grades 2 and 1&#44; was 22&#37; and 45&#37; respectively&#46; Likewise&#44; the median survival in grade 3 was 6 days&#44; 95&#37; CI &#40;3&#46;3&#8211;8&#46;6&#41;&#44; grade 2 was 28 days&#44; 95&#37; CI &#40;22&#46;7&#8211;33&#46;29&#41; and grade 1 was 90 days 95&#37; CI &#40;82&#46;3&#8211;97&#46;65&#41;&#46; There was a statistical difference in the survival curves between ACLF grades &#40;p&#8239;&#61;&#8239;0&#46;001&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>-B&#41;&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">When mortality was analyzed globally&#44; it was clear that most of the patients died within the first 7 days 35&#46;8&#37; &#40;n&#8239;&#61;&#8239;53&#41;&#59; 29&#46;7&#37; &#40;n&#8239;&#61;&#8239;44&#41; of patients died by 28 days and 18&#46;2&#37; &#40;n&#8239;&#61;&#8239;27&#41; by 90 days&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">According to the ACLF grade&#44; as expected&#44; ACLF grade 3 patients had higher mortality within the first 7 days &#91;59&#46;2&#37; &#40;n&#8239;&#61;&#8239;45&#41;&#93;&#44; compared to grade 2 &#91;17&#46;1&#37; &#40;n&#8239;&#61;&#8239;6&#41;&#93; and grade 1 &#91;15&#46;4&#37; &#40;n&#8239;&#61;&#8239;2&#41;&#93;&#46; The same applied for 28 and 90 days with 31&#46;6&#37; &#40;n&#8239;&#61;&#8239;24&#41; and 9&#46;2&#37; &#40;n&#8239;&#61;&#8239;7&#41; of cases respectively &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>-C&#41;&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">We next evaluated which organ failure was associated with lower survival&#46; When comparing patients with and without each of the different organ failures&#44; it was clear that having brain&#44; circulatory&#44; liver&#44; renal or coagulation failure was associated with lower survival &#40;P&#8239;&#60;&#8239;0&#46;05&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0020">Fig&#46; 4</a>-A&#8211;E&#41;&#46; The median survival was lower in patients with the presence of any of the specified organ failure than in those without &#40;12 days&#44; 95&#37; CI &#40;4&#46;50&#8211;19&#46;49&#41; vs 27 days&#44; 95&#37; CI &#40;19&#46;74&#8211;34&#46;25&#41; brain&#41;&#44; &#40;14 days&#44; 95&#37; CI &#40;4&#46;80&#8211;23&#46;19&#41; vs 45 days&#44; 95&#37; CI &#40;2&#46;61&#8211;87&#46;38&#41; circulatory&#41; &#40;11 days&#44; 95&#37; CI &#40;0&#46;9&#8211;23&#46;44&#41; vs 26 days&#44; 95&#37; CI &#40;17&#46;29&#8211;34&#46;71&#41; liver&#41;&#44; &#40;6 days&#44; 95&#37; CI &#40;4&#46;07&#8211;7&#46;92&#41; vs 45 days&#44; 95&#37; CI &#40;28&#46;23&#8211;61&#46;77&#41; renal&#41; &#40;6 days 95&#37; CI &#40;2&#46;08&#8211;9&#46;92&#41; vs 25 days&#44; 95&#37; CI &#40;18&#46;76&#8211;31&#46;23&#41; coagulation&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0020">Fig&#46; 4</a>A&#8211;E&#41; respectively&#46; Lung failure was associated with the lowest median survival&#44; however&#44; there was no significant difference between patients with and without the failure &#40;2&#46;23 days&#44; 95&#37; CI &#40;1&#8211;8&#46;38&#41; vs 20 days&#44; 95&#37; CI &#40;12&#46;52&#8211;27&#46;47&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0020">Fig&#46; 4</a>-F&#41;&#46;</p><elsevierMultimedia ident="fig0020"></elsevierMultimedia></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleLabel">3&#46;4</span><span class="elsevierStyleSectionTitle" id="sect0090">Factors associated with increased 28 and 90-day mortality</span><p id="par0100" class="elsevierStylePara elsevierViewall">We first divided patients between those who died &#40;n&#8239;&#61;&#8239;124&#41; and those who survived &#40;n&#8239;&#61;&#8239;24&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46; No significant differences were found in age&#44; however the majority of patients who died were female &#40;52&#46;4&#37; vs 47&#46;6&#37;&#41;&#46; As expected&#44; patients that died&#44; had a significantly higher CLIF-C OF &#91;13 &#40;12&#8211;15&#41; vs 11 &#40;10&#8211;12&#41; p&#8239;&#61;&#8239;0&#46;001&#93;&#44; and ACLF scores &#40;61&#46;45&#8239;&#177;&#8239;10&#46;36 vs 50&#46;08&#8239;&#177;&#8239;7&#46;52&#41; p&#8239;&#61;&#8239;0&#46;001&#44; when compared to those who survived&#46; The majority of the patients that died had ACLF grade 3 &#91;76 &#40;61&#46;3&#37;&#41; vs 6 &#40;25&#37;&#41;&#44; p&#8239;&#61;&#8239;0&#46;001&#93; and a significantly greater proportion of circulatory failure &#91;108 &#40;87&#46;1&#37;&#41; vs 15 &#40;62&#46;5&#37;&#41;&#44; p&#8239;&#61;&#8239;0&#46;007&#93;&#44; renal failure &#91;74 &#40;59&#46;7&#37;&#41; vs 4 &#40;16&#46;7&#37;&#41;&#44; p&#8239;&#61;&#8239;0&#46;001&#93; and brain failure &#91;70 &#40;56&#46;5&#37;&#41; vs 5 &#40;20&#46;8&#37;&#41;&#44; p&#8239;&#61;&#8239;0&#46;002&#93;&#46; No significant differences were observed in coagulation failure &#91;33 &#40;26&#46;6&#37;&#41; vs 3 &#40;12&#46;5&#37;&#41;&#44; p&#8239;&#61;&#8239;0&#46;195&#93;&#44; liver failure &#91;60 &#40;48&#46;4&#37;&#41; vs 9 &#40;37&#46;5&#37;&#41;&#44; p&#8239;&#61;&#8239;0&#46;377&#93; and lung failure &#91;16 &#40;12&#46;9&#37;&#41; vs 4 &#40;16&#46;7&#37;&#41;&#44; p&#8239;&#61;&#8239;0&#46;744&#93; between patients that died and those who survived&#46; While no difference in infection was observed between dead and surviving patients &#91;&#40;74 &#40;59&#46;7&#37;&#41; vs 12 &#40;50&#37;&#41;&#44; p&#8239;&#61;&#8239;0&#46;498&#93;&#44; leukocyte count was significantly higher in patients that died compared to those who survived &#91;12&#46;5&#8239;&#215;&#8239;10<span class="elsevierStyleSup">9</span>&#47;L &#40;7&#46;7&#8211;16&#46;8&#41; vs 9&#46;1&#8239;&#215;&#8239;10<span class="elsevierStyleSup">9</span>&#47;L &#40;4&#46;4&#8211;14&#46;9&#41;&#44; p&#8239;&#61;&#8239;0&#46;073&#93; &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0105" class="elsevierStylePara elsevierViewall">Based on these data&#44; we next performed a bivariate analysis to determine the clinical parameters associated with 90 day-mortality &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46; We found that male sex HR 1&#46;42 &#40;1&#46;02&#8211;2&#46;03&#41; p&#8239;&#61;&#8239;0&#46;049 and leukocyte count HR 1&#46;03 &#40;1&#46;01&#8211;1&#46;06&#41; p&#8239;&#61;&#8239;0&#46;005&#44; were associated with high 90-day mortality&#46; Likewise&#44; ACLF HR 1&#46;05 &#40;1&#46;03&#8211;1&#46;07&#41; p&#8239;&#61;&#8239;0&#46;001 and CLIF-C OF HR 1&#46;32 &#40;1&#46;21&#8211;1&#46;44&#41; p&#8239;&#61;&#8239;0&#46;001 scores&#44; ACLF 3 HR 4&#46;25 &#40;2&#46;34&#8211;7&#46;71&#41; p&#8239;&#61;&#8239;0&#46;001&#44; ACLF 2 HR 2&#46;04 &#40;1&#46;07&#8211;3&#46;87&#41; P&#8239;&#61;&#8239;0&#46;029 as well as the presence of all organ failures&#58; liver HR 1&#46;58 &#40;1&#46;11&#8211;2&#46;26&#41; p&#8239;&#61;&#8239;0&#46;011&#44; renal HR 2&#46;91 &#40;2&#46;01&#8211;4&#46;22&#41; p&#8239;&#61;&#8239;0&#46;001&#44; brain HR 1&#46;67 &#40;1&#46;17&#8211;2&#46;39&#41; p&#8239;&#61;&#8239;0&#46;005&#44; coagulation HR 1&#46;73 &#40;1&#46;16&#8211;2&#46;58&#41; p&#8239;&#61;&#8239;0&#46;007 and circulatory HR 1&#46;81 &#40;1&#46;07&#8211;3&#46;07&#41; p&#8239;&#61;&#8239;0&#46;026 were all associated with high 90-day mortality&#46; We next performed a multivariate regression analysis using Cox proportional hazard ratio&#44; to determine which factors were independently associated with 28 and 90-day mortality&#46; Results are shown in Table 4&#46; Based on this model&#44; we determined that male sex&#44; brain and renal organ failures were independent predictors of 28 and 90-day mortality in patients with ACLF &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46; Of the three factors mentioned above&#44; renal failure &#40;HR 3&#46;26 95&#37; CI &#40;2&#46;13&#8211;4&#46;99&#41;&#44; p&#8239;&#60;&#8239;0&#46;001&#44; proved superior compared to male sex &#40;HR 1&#46;62 95&#37; CI &#40;1&#46;10&#8211;2&#46;40&#41;&#44; p&#8239;&#61;&#8239;0&#46;015 and brain failure &#40;HR 1&#46;37 95&#37; CI &#40;1&#46;09&#8211;2&#46;04&#41;&#44; p&#8239;&#61;&#8239;0&#46;049&#41; in predicting 28 day mortality&#46; Meanwhile&#44; the same variables were also independent predictors of 90-day mortality&#59; with renal failure &#40;HR 3&#46;06 95&#37; CI &#40;2&#46;08&#8211;4&#46;51&#41;&#44; p&#8239;&#60;&#8239;0&#46;001 still being superior compared to male sex &#40;HR 1&#46;78 95&#37; CI &#40;1&#46;23&#8211;2&#46;56&#41;&#44; p&#8239;&#60;&#8239;0&#46;002&#41; and brain failure &#40;HR 1&#46;43 95&#37; CI &#40;1&#46;03&#8211;2&#46;07&#41;&#44; p&#8239;&#61;&#8239;0&#46;05 in predicting 90-day mortality &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46;</p></span></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleLabel">4</span><span class="elsevierStyleSectionTitle" id="sect0095">Discussion</span><p id="par0110" class="elsevierStylePara elsevierViewall">To our knowledge&#44; this is the first study to report an independent cohort with detailed analysis of ACLF syndrome in the Mexican population&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">In Latin America&#44; only 2 studies have described ACLF patients&#46; The first one was a prospective Brazilian cohort of 192 patients with decompensated cirrhosis&#44; 24&#37; of those developing ACLF &#91;<a class="elsevierStyleCrossRef" href="#bib0125">25</a>&#93;&#46; The second one was performed in Argentina &#91;<a class="elsevierStyleCrossRef" href="#bib0130">26</a>&#93;&#44; where 29&#37; of patients admitted for AD were diagnosed with ACLF&#46; When compared with the CANONIC study&#44; despite race differences&#44; it seems that the overall prevalence in Latin America remains pretty much within the range of 20&#8211;30&#37;&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">However&#44; there seems to be a difference in the mortality rate&#44; which vary significantly between races&#46; For instance&#44; mortality rate in Europe according to the CANONIC&#44; is 33&#37; and 51&#37; at 28-days and 90 days &#91;<a class="elsevierStyleCrossRef" href="#bib0005">1</a>&#93;&#44; while in Asia is 41&#37; and 63&#37; &#91;<a class="elsevierStyleCrossRef" href="#bib0135">27</a>&#93; respectively&#46; On the other hand&#44; in the American continent we have data from the USA indicating that ACLF mortality ranges from 26&#37; to 40&#37; at day 28 and day 90 &#91;<a class="elsevierStyleCrossRef" href="#bib0140">28</a>&#93;&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Based on the gathered information&#44; it is clear that our ACLF population differs significantly from Europeans&#44; Asians and Americans&#46; ACLF in the Mexican population is a well-defined entity characterized by an extremely high 28-day &#40;70&#46;3&#37;&#41; and 90-day &#40;81&#46;8&#37;&#41; mortality which doubles the one generally observed in other cohorts&#46; In addition&#44; our population comprises patients usually presenting with a more severe disease state as determined by their higher MELD and ACLF-scores prompting their ICU admission&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">When comparing the etiology of the underlying chronic disease with those reported in the CANONIC study&#44; we observed that we have the same 2 most prevalent causes &#40;HCV and alcohol&#41;&#44; with the main difference being that in the European population&#44; alcohol &#40;60&#46;3&#37;&#41; was almost 6 times higher than HCV &#40;13&#37;&#41;&#46; In our population&#44; HCV &#40;29&#46;8&#37;&#41; doubled the alcohol proportion &#40;13&#46;5&#37;&#41;&#44; possibly because HCV in Mexico is the most common cause of cirrhosis &#91;<a class="elsevierStyleCrossRef" href="#bib0145">29</a>&#93;&#46; Another likely contributing factor is that the hospital where our study was conducted is a reference center for treating HCV infection&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">However&#44; while prevalence according to ACLF degree in studies conducted in Latin America &#91;<a class="elsevierStyleCrossRef" href="#bib0125">25</a>&#44;<a class="elsevierStyleCrossRef" href="#bib0130">26</a>&#93; matches that of the CANONIC &#91;<a class="elsevierStyleCrossRef" href="#bib0005">1</a>&#93;&#44; with ACLF grade 1 being the most prevalent group&#44; we found very different results&#46; Most of our patients presented with more advanced cirrhosis stage &#40;Child-Pugh C 68&#46;2&#37;&#41; and had more organ failure&#40;s&#41; with a great majority presenting with ACLF grade 3&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">The precipitating factors described in the literature vary widely depending on the geographical area&#46; In the region of Asia and the Pacific&#44; on which the guidelines of Asian Pacific Association for the Study of the Liver &#40;APASL&#41; are based&#44; the main ACLF precipitant is HBV&#46; In European countries&#44; these viral etiologies are replaced mostly by non-viral insults&#44; such as bacterial infections &#91;<a class="elsevierStyleCrossRef" href="#bib0075">15</a>&#93; similarly to what was reported in Latin America &#40;Brazil and Argentina&#41; and what we found in our population&#46; Despite that&#44; our population&#8217;s mortality is still extremely high&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">We found a significant association between high 90-day mortality and several clinical factors including leukocyte count&#44; as well as ACLF and CLIF-C OF scores and ACLF grade 3&#46; Those factors were increased in patients that died&#44; compared to those that survived&#44; indicating the critically ill population that this cohort comprises&#46; In addition&#44; having any of the 6 organ failures recognized by the CANONIC for the definition of ACLF was also associated with a higher 90-day mortality&#46; Of all those&#44; lung failure was the only organ not associated with 90-day mortality &#40;p&#8239;&#61;&#8239;0&#46;428&#44; HR 1&#46;23&#44; 95&#37; CI&#58; 0&#46;73&#8211;2&#46;09&#46; Whereas renal&#44; brain&#44; coagulation and circulatory failure were all associated with a HR between 2&#46;91 and 1&#46;58 of 90-day mortality&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">Indeed&#44; the most affected organ in our cohort was the circulatory system &#40;83&#46;1&#37;&#41; even among the different grades of ACLF &#40;48&#37; in ACLF 1&#44; 75&#46;6&#37; in ACLF 2&#44; and 97&#46;6&#37; in ACLF 3&#41;&#46; In comparison&#44; in the CANONIC study&#44; the kidney was the most affected organ &#40;55&#46;8&#37;&#41; followed by the liver &#40;43&#46;6&#37;&#41;&#59; while in North America the brain &#40;55&#46;7&#37;&#41; was the most frequent one&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">The multivariate analysis leads us to identify that 3 specific factors were independently associated with 28 and 90-day mortality&#46; The first one is male sex &#40;p&#8239;&#61;&#8239;0&#46;015&#44; HR 1&#46;62&#44; 95&#37; CI&#58; 1&#46;10&#8211;2&#46;40&#41; and &#40;p&#8239;&#61;&#8239;0&#46;002&#44; HR 1&#46;78&#44; 95&#37; CI&#58; 1&#46;23&#8211;2&#46;56&#41; for 28 and 90 days respectively&#44; which we attribute to the fact that females seek earlier medical attention and are more compliant to medical treatment&#46; Additionally&#44; all those with alcoholic etiology &#40;87&#37;&#44; n&#8239;&#61;&#8239;20&#41; are men of whom 94&#46;4&#37; &#40;n&#8239;&#61;&#8239;17&#41; died&#46; Although the sample size is too small to take into account the type of etiology as a prognostic factor&#44; a trend in this variable was also found&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">The other two factors that independently predicted 28 and 90-day mortality were renal and brain failure &#40;p&#8239;&#61;&#8239;0&#46;001&#44; HR 3&#46;26&#44; 95&#37; CI&#58; 2&#46;13&#8211;4&#46;99&#41; and &#40;p&#8239;&#61;&#8239;0&#46;049&#44; HR 1&#46;37&#44; 95&#37; CI&#58; 1&#46;09&#8211;2&#46;04&#41; for 28 and &#40;p&#8239;&#61;&#8239;0&#46;001&#44; HR 3&#46;06&#44; 95&#37; CI&#58; 2&#46;08&#8211;4&#46;51&#41; and &#40;p&#8239;&#61;&#8239;0&#46;05&#44; HR 1&#46;43&#44; 95&#37; CI&#58; 1&#46;03&#8211;2&#46;07&#41; for 90 day respectively&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">Recently&#44; Sawhney et al&#46;&#44; demonstrated that ACLF survival&#44; diminishes in relation to the presence of HE &#40;ACLF with HE 35&#47;53&#44; &#91;66&#37;&#93;&#59; ACLF without HE&#44; 16&#47;48 &#91;33&#37;&#93;&#59; p&#8239;&#61;&#8239;0&#44;002&#41; and the grade of HE&#44; grade 0&#8211;1&#44; 16&#47;48 &#91;33&#37;&#93;&#59; grade 2&#44; 19&#47;32 &#91;59&#37;&#93;&#59; grade 3&#8211;4&#44; 16&#47;21 &#91;76&#37;&#93;&#59; p&#8239;&#61;&#8239;0&#46;002&#41; &#91;<a class="elsevierStyleCrossRef" href="#bib0030">6</a>&#93;&#46; Similar results were shown by Cordoba et al&#46;&#44; and an additional association with increased systemic inflammatory response in ACLF patients with HE was found&#44; as assessed by elevated C reactive protein levels &#40;ACLF without HE&#44; 27 &#40;12&#8211;49&#8239;mg&#47;dl&#41;&#59; ACLF with HE&#44; 32 &#40;16&#8211;60&#8239;mg&#47;dl&#41;&#59; p&#8239;&#60;&#8239;0&#46;0001&#41; &#91;<a class="elsevierStyleCrossRef" href="#bib0150">30</a>&#93;&#46; These findings support the ones in our study&#44; where patient prognosis is negatively affected by the presence of brain failure as determined by the presence of grade III&#47;IV HE&#46; In addition&#44; our results also indicate that patients that died have a more severe systemic inflammatory response compared to those who survived as indicated by higher leukocyte count p&#8239;&#61;&#8239;0&#46;073&#44; 12&#46;5&#8239;&#215;&#8239;10<span class="elsevierStyleSup">9</span>&#47;l &#40;7&#46;7&#8211;16&#46;8&#41; vs 9&#46;1&#8239;&#215;&#8239;10<span class="elsevierStyleSup">9</span>&#47;l &#40;4&#46;4&#8211;14&#46;9&#41; despite no significant differences in the presence of infection p&#8239;&#61;&#8239;0&#46;498&#44; 74 &#40;59&#46;7&#37;&#41; vs 12 &#40;50&#37;&#41;&#46; Renal failure as demonstrated in the CANONIC has also been associated with a worse mortality and with a severe systemic inflammatory response &#91;<a class="elsevierStyleCrossRef" href="#bib0005">1</a>&#93;&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">The relation between the three independent predictors of mortality &#40;male sex&#44; brain and renal failure&#41; with the systemic inflammatory response observed in patients that died&#44; deserve further attention since it could have implications in the physiopathology of ACLF&#46;</p><p id="par0175" class="elsevierStylePara elsevierViewall">Limitations to our study include its retrospective nature and the fact that we only describe patients treated in a single third-level center&#44; where there is a larger number of patients with this condition&#46; Therefore&#44; it is not possible to generalize the prevalence nationwide&#46;</p><p id="par0180" class="elsevierStylePara elsevierViewall">This study provides a comprehensive analysis of the clinical characteristics of the ACLF syndrome in Mexico&#44; which due to its high mortality rate is considered an important area of &#8203;&#8203;research&#46; We have identified three important independent prognostic factors associated with higher 28 and 90-day mortality&#44; which could allow us to prioritize ACLF patients for general supportive care&#44; disease-specific therapy&#44; management of complications and&#44; if needed&#44; a timely referral for liver transplantation&#46; Additional studies are needed to understand its pathophysiology and to develop novel diagnostic markers and therapeutic options for ACLF patients&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall">In conclusion&#44; ACLF patients admitted to the ICU have a very high short-term mortality&#44; especially when patients are male and present with brain and renal failure&#46;AbbreviationsACLFAcute on chronic liver failureHEHepatic encephalopathyICUIntensive care unitCLIF-C OFChronic Liver Failure - Organ FailureOFOrgan failureCBCComplete blood countSDStandard deviationSPSSStatistical Package for the Social SciencesAIHAutoimmune HepatitisPBCPrimary Biliary CholangitisNAFLDNon-alcoholic fatty liver diseaseMELDModel for End-stage Liver DiseaseMAPmean arterial pressureEASL-CLIFEuropean Association for the Study of the Liver &#8211; Chronic Liver FailureHCVHepatitis C virusAPASLAsian Pacific Association for the Study of the LiverICUIntensive care unit</p><p id="par0190" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleDefList"><span class="elsevierStyleSectionTitle" id="sect0100">Abbreviations</span><span class="elsevierStyleDefTerm">ACLF</span><span class="elsevierStyleDefDescription"><p id="par0195" class="elsevierStylePara elsevierViewall">Acute on chronic liver failure</p></span><span class="elsevierStyleDefTerm">HE</span><span class="elsevierStyleDefDescription"><p id="par0200" class="elsevierStylePara elsevierViewall">Hepatic encephalopathy</p></span><span class="elsevierStyleDefTerm">ICU</span><span class="elsevierStyleDefDescription"><p id="par0205" class="elsevierStylePara elsevierViewall">Intensive care unit</p></span><span class="elsevierStyleDefTerm">CLIF-C OF</span><span class="elsevierStyleDefDescription"><p id="par0210" class="elsevierStylePara elsevierViewall">Chronic Liver Failure - Organ Failure</p></span><span class="elsevierStyleDefTerm">OF</span><span class="elsevierStyleDefDescription"><p id="par0215" class="elsevierStylePara elsevierViewall">Organ failure</p></span><span class="elsevierStyleDefTerm">CBC</span><span class="elsevierStyleDefDescription"><p id="par0220" class="elsevierStylePara elsevierViewall">Complete blood count</p></span><span class="elsevierStyleDefTerm">SD</span><span class="elsevierStyleDefDescription"><p id="par0225" class="elsevierStylePara elsevierViewall">Standard deviation</p></span><span class="elsevierStyleDefTerm">SPSS</span><span class="elsevierStyleDefDescription"><p id="par0230" class="elsevierStylePara elsevierViewall">Statistical Package for the Social Sciences</p></span><span class="elsevierStyleDefTerm">AIH</span><span class="elsevierStyleDefDescription"><p id="par0235" class="elsevierStylePara elsevierViewall">Autoimmune Hepatitis</p></span><span class="elsevierStyleDefTerm">PBC</span><span class="elsevierStyleDefDescription"><p id="par0240" class="elsevierStylePara elsevierViewall">Primary Biliary Cholangitis</p></span><span class="elsevierStyleDefTerm">NAFLD</span><span class="elsevierStyleDefDescription"><p id="par0245" class="elsevierStylePara elsevierViewall">Non-alcoholic fatty liver disease</p></span><span class="elsevierStyleDefTerm">MELD</span><span class="elsevierStyleDefDescription"><p id="par0250" class="elsevierStylePara elsevierViewall">Model for End-stage Liver Disease</p></span><span class="elsevierStyleDefTerm">MAP</span><span class="elsevierStyleDefDescription"><p id="par0255" class="elsevierStylePara elsevierViewall">mean arterial pressure</p></span><span class="elsevierStyleDefTerm">EASL-CLIF</span><span class="elsevierStyleDefDescription"><p id="par0260" class="elsevierStylePara elsevierViewall">European Association for the Study of the Liver &#8211; Chronic Liver Failure</p></span><span class="elsevierStyleDefTerm">HCV</span><span class="elsevierStyleDefDescription"><p id="par0265" class="elsevierStylePara elsevierViewall">Hepatitis C virus</p></span><span class="elsevierStyleDefTerm">APASL</span><span class="elsevierStyleDefDescription"><p id="par0270" class="elsevierStylePara elsevierViewall">Asian Pacific Association for the Study of the Liver</p></span><span class="elsevierStyleDefTerm">ICU</span><span class="elsevierStyleDefDescription"><p id="par0275" class="elsevierStylePara elsevierViewall">Intensive care unit</p></span></span></p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Conflict of interest</span><p id="par0280" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Author contributions</span><p id="par0285" class="elsevierStylePara elsevierViewall">OMG&#58; study concept and design&#44; acquisition of data&#44; analysis and interpretation of data&#44; drafting of the manuscript&#44; statistical analysis&#46;</p><p id="par0290" class="elsevierStylePara elsevierViewall">DACR&#44; EC&#44; EAA&#44; JPE&#58; acquisition of data and drafting of the manuscript&#44; administrative&#44; technical and material support</p><p id="par0295" class="elsevierStylePara elsevierViewall">NNA&#44; AT&#58; Study concept and design&#44; drafting of the manuscript&#44; critical revision of the manuscript and study supervision</p></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Funding</span><p id="par0300" class="elsevierStylePara elsevierViewall">This research did not receive any specific grant from funding agencies in the public&#44; commercial&#44; or not-for-profit sectors&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:11 [
        0 => array:3 [
          "identificador" => "xres1555538"
          "titulo" => "Abstract"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "abst0005"
              "titulo" => "Introduction and Objectives"
            ]
            1 => array:2 [
              "identificador" => "abst0010"
              "titulo" => "Patients and methods"
            ]
            2 => array:2 [
              "identificador" => "abst0015"
              "titulo" => "Results"
            ]
            3 => array:2 [
              "identificador" => "abst0020"
              "titulo" => "Conclusions"
            ]
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec1404006"
          "titulo" => "Keywords"
        ]
        2 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introduction"
        ]
        3 => array:3 [
          "identificador" => "sec0010"
          "titulo" => "Methods"
          "secciones" => array:5 [
            0 => array:2 [
              "identificador" => "sec0015"
              "titulo" => "Patients"
            ]
            1 => array:2 [
              "identificador" => "sec0020"
              "titulo" => "ACLF and organ failure definitions"
            ]
            2 => array:2 [
              "identificador" => "sec0025"
              "titulo" => "Infections"
            ]
            3 => array:2 [
              "identificador" => "sec0030"
              "titulo" => "Data collection"
            ]
            4 => array:2 [
              "identificador" => "sec0035"
              "titulo" => "Statistical analysis"
            ]
          ]
        ]
        4 => array:3 [
          "identificador" => "sec0040"
          "titulo" => "Results"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "sec0045"
              "titulo" => "General demographics"
            ]
            1 => array:2 [
              "identificador" => "sec0050"
              "titulo" => "Clinical and biochemical characteristics and organ failure prevalence based on ACLF grading"
            ]
            2 => array:2 [
              "identificador" => "sec0055"
              "titulo" => "Survival and mortality according to ACLF grading"
            ]
            3 => array:2 [
              "identificador" => "sec0060"
              "titulo" => "Factors associated with increased 28 and 90-day mortality"
            ]
          ]
        ]
        5 => array:2 [
          "identificador" => "sec0065"
          "titulo" => "Discussion"
        ]
        6 => array:2 [
          "identificador" => "sec0070"
          "titulo" => "Conflict of interest"
        ]
        7 => array:2 [
          "identificador" => "sec0075"
          "titulo" => "Author contributions"
        ]
        8 => array:2 [
          "identificador" => "sec0080"
          "titulo" => "Funding"
        ]
        9 => array:2 [
          "identificador" => "xack548179"
          "titulo" => "Acknowledgments"
        ]
        10 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2020-08-10"
    "fechaAceptado" => "2020-09-21"
    "PalabrasClave" => array:1 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec1404006"
          "palabras" => array:5 [
            0 => "ACLF"
            1 => "Mortality predictors"
            2 => "Brain failure"
            3 => "Renal failure"
            4 => "Mexico"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:1 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction and Objectives</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Acute on Chronic Liver Failure &#40;ACLF&#41; is characterized by organ failure and high 28-day mortality&#46; Identifying clinical predictors associated with early mortality could have implications for the treatment of patients with ACLF&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Patients and methods</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Patients diagnosed with chronic liver failure that developed ACLF based on the EASL-CLIF Consortium definition admitted to the Intensive care unit of a tertiary hospital between 2012&#8211;2018 were included&#46; Bivariate and multivariate Cox regression analyses were performed to identify factors associated with mortality&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">148 patients &#40;55&#37; female&#41; were diagnosed with ACLF of which 55&#37; &#40;n&#8239;&#61;&#8239;82&#41; had ACLF grade 3&#44; 28&#37; &#40;n&#8239;&#61;&#8239;41&#41; grade 2 and 17&#37; &#40;n&#8239;&#61;&#8239;25&#41; grade 1&#46; The median age was 54 years &#40;41-63&#41;&#46; Hepatitis C virus &#40;HCV&#41; was the most frequent etiology in 29&#46;8&#37; &#40;n&#8239;&#61;&#8239;44&#41; of the patients with bacterial infection being the most predominant precipitant factor in 58&#46;1&#37; &#40;n&#8239;&#61;&#8239;86&#41;&#46; Ninety-day global cumulative survival was only 18&#37;&#46; When divided by grade&#44; mortality reached to 10&#37; in ACLF 3&#46; Moreover&#44; in the multivariate Cox regression analysis&#44; renal failure &#40;HR 3&#46;26&#44; 95&#37; CI &#40;2&#46;13&#8211;4&#46;99&#41;&#44; brain failure &#40;HR 1&#46;37&#44; 95&#37; CI 1&#46;09&#8211;2&#46;04&#41; and male sex &#40;HR 1&#46;62&#44; 95&#37; CI 1&#46;10&#8211;2&#46;40&#41; were independent predictors of 28- and 90-day mortality&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">ACLF is a frequent syndrome among chronic liver disease patients&#46; Brain and renal failure are significantly associated with higher mortality and are independent predictors of 28 and 90-day mortality&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Introduction and Objectives"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Patients and methods"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Results"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Conclusions"
          ]
        ]
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:3 [
        "etiqueta" => "1"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Contributed equally&#46;</p>"
        "identificador" => "fn0005"
      ]
    ]
    "apendice" => array:1 [
      0 => array:1 [
        "seccion" => array:1 [
          0 => array:4 [
            "apendice" => "<p id="par0315" class="elsevierStylePara elsevierViewall">The following are Supplementary data to this article&#58;<elsevierMultimedia ident="upi0005"></elsevierMultimedia></p>"
            "etiqueta" => "Appendix A"
            "titulo" => "Supplementary data"
            "identificador" => "sec0090"
          ]
        ]
      ]
    ]
    "multimedia" => array:8 [
      0 => array:8 [
        "identificador" => "fig0005"
        "etiqueta" => "Fig&#46; 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1364
            "Ancho" => 1508
            "Tamanyo" => 185669
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0005"
            "detalle" => "Fig&#46; "
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Study inclusion flowchart&#46; From 2012 to 2018&#44; 938 patients with liver cirrhosis were admitted to the emergency department for some decompensation event &#40;variceal bleeding&#44; infection&#44; hepatic encephalopathy&#44; among others&#41; of which 148 patients diagnosed with ACLF were analyzed&#46;</p>"
        ]
      ]
      1 => array:8 [
        "identificador" => "fig0010"
        "etiqueta" => "Fig&#46; 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 970
            "Ancho" => 1508
            "Tamanyo" => 97290
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0010"
            "detalle" => "Fig&#46; "
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Frequency of organ failures based on ACLF grading&#46; Circulatory&#44; renal and brain failure were the most prevalent organ failures&#46; According to the ACLF grade&#44; circulatory failure was the most prevalent in all ACLF grades&#46; Lung failure was not present in grade 1 and renal failure was more prevalent in grade 3 compared to grade 2 and 1&#46;</p>"
        ]
      ]
      2 => array:8 [
        "identificador" => "fig0015"
        "etiqueta" => "Fig&#46; 3"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr3.jpeg"
            "Alto" => 2077
            "Ancho" => 2508
            "Tamanyo" => 242733
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0015"
            "detalle" => "Fig&#46; "
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Survival and mortality in patiens with ACLF&#46; &#40;A&#41; Graphic representation of cumulative survival during the 90-day follow up&#46; After 90 days&#44; only 18&#37; of the cohort was still alive&#46; &#40;B&#41; Survival was greater in patients with grade 1 and decreased as the degree of ACLF increases &#40;log rank&#44; p&#58;0&#46;001&#41;&#46; Green line&#58; Grade 1&#44; blue line&#58; Grade 2&#44; and red line&#58; Grade 3&#46; &#40;C&#41; Percentage of 7&#44; 28- and 90-day mortality based on ACLF grading&#46;</p>"
        ]
      ]
      3 => array:8 [
        "identificador" => "fig0020"
        "etiqueta" => "Fig&#46; 4"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr4.jpeg"
            "Alto" => 1785
            "Ancho" => 3175
            "Tamanyo" => 303687
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0020"
            "detalle" => "Fig&#46; "
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Kaplan&#8211;Meier survival curve in patients based on the type of organ failure&#46; Patients with the following organ failures &#40;A&#41; brain failure &#40;B&#41; circulatory failure &#40;C&#41; liver failure &#40;D&#41; renal failure and &#40;E&#41; coagulation failure&#44; have lower survival &#40;log rank&#44; p&#58;0&#46;001&#41; - &#40;log rank&#44; p&#58;0&#46;02&#41; compared to those without any of these organs&#46; &#40;F&#41; No differences were found between patients with lung failure and those without &#40;log rank&#44; p&#58;0&#46;415&#41;&#46;</p>"
        ]
      ]
      4 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0025"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">The data are presented in frequency &#40;n&#46;&#41; and percentage &#40;&#37;&#41;&#44; median and interquartile range&#44; mean and standard deviation &#40;SD&#41;&#40;&#177;&#41;&#46; <span class="elsevierStyleItalic">Abbreviations</span>&#46; ACLF &#40;Acute on chronic liver failure&#41;&#44; AIH &#40;Autoimmune Hepatitis&#41;&#44; PBC &#40;Primary Biliary Cholangitis&#41;&#44; NAFLD &#40;non-alcoholic fatty liver disease&#41;&#44; MELD &#40;Model for End-stage Liver Disease&#41;&#44; CLIF-C OF&#40;Chronic Liver Failure -Organ Failure&#41;&#44; Mg &#40;milligram&#41;&#44; HE &#40;Hepatic encephalopathy&#41;&#44; dl &#40;deciliter&#41; mmol&#47;l &#40;milliosmoles&#47;liter&#41;&#44; MAP &#40;Mean arterial pressure&#41;&#44; SpO2 &#40;Oxygen saturation&#41;&#44; FiO2 &#40;Fractional inspired oxygen&#41;&#46;</p>"
          "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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Characteristics&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">Grade 1<span class="elsevierStyleItalic">n&#8239;&#61;&#8239;25</span>&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">Grade 2<span class="elsevierStyleItalic">n&#8239;&#61;&#8239;41</span>&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"><span class="elsevierStyleItalic">Grade 3</span><span class="elsevierStyleItalic">n&#8239;&#61;&#8239;82</span>&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-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Age &#40;years&#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">57 &#40;47&#8211;59&#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">56 &#40;47&#8211;64&#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">50&#46;5 &#40;40&#8211;63&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;535&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Female sex &#8211; <span class="elsevierStyleItalic">n&#46;&#40;&#37;&#41;</span>&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">14 &#40;56&#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">22 &#40;53&#46;7&#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">45 &#40;54&#46;9&#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">0&#46;982&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Etiology &#8211; n&#46; &#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">&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">&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">&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">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic"><span class="elsevierStyleHsp" style=""></span>Viral</span>&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 &#40;28&#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">16 &#40;39&#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 &#40;25&#46;6&#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  " rowspan="8" align="left" valign="middle">0&#46;332</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic"><span class="elsevierStyleHsp" style=""></span>Alcohol</span>&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">5 &#40;20&#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">4 &#40;9&#46;8&#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 &#40;13&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic"><span class="elsevierStyleHsp" style=""></span>AIH</span>&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 &#40;8&#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">4 &#40;9&#46;8&#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 &#40;13&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic"><span class="elsevierStyleHsp" style=""></span>PBC</span>&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 &#40;8&#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">1 &#40;2&#46;4&#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">9 &#40;11&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic"><span class="elsevierStyleHsp" style=""></span>NASH</span>&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 &#40;12&#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">4 &#40;9&#46;8&#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">4 &#40;4&#46;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic"><span class="elsevierStyleHsp" style=""></span>Cryptogenic</span>&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 &#40;8&#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">7 &#40;17&#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">17 &#40;20&#46;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic"><span class="elsevierStyleHsp" style=""></span>Overlap syndrome</span>&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 &#40;4&#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">2 &#40;5&#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">3 &#40;3&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic"><span class="elsevierStyleHsp" style=""></span>Others</span>&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 &#40;12&#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">3 &#40;7&#46;3&#37;&#124;&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 &#40;7&#46;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Child-Pugh &#8211; n&#46; &#40;&#37;&#41;</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic"><span class="elsevierStyleHsp" style=""></span>A</span>&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 &#40;12&#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">0 &#40;0&#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">2 &#40;2&#46;4&#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  " rowspan="3" align="left" valign="middle">0&#46;017</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic"><span class="elsevierStyleHsp" style=""></span>B</span>&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 &#40;8&#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">13 &#40;31&#46;7&#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">27 &#40;32&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic"><span class="elsevierStyleHsp" style=""></span>C</span>&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 &#40;80&#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">28 &#40;68&#46;3&#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">53 &#40;64&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">MELD score&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">&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">&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">&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">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic"><span class="elsevierStyleHsp" style=""></span>&#8804;15</span>&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">5 &#40;20&#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">14 &#40;34&#46;1&#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">26 &#40;31&#46;7&#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  " rowspan="2" align="left" valign="middle">0&#46;459</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic"><span class="elsevierStyleHsp" style=""></span>&#62;15</span>&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 &#40;80&#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">27 65&#46;9&#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">56 &#40;68&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">CLIF-C OF&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 &#40;10&#8211;11&#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">12 &#40;11&#8211;13&#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&#40;13&#8211;16&#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;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ACLF score&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&#8239;&#177;&#8239;6&#46;64&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;8&#8239;&#177;&#8239;9&#46;69&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;7&#8239;&#177;&#8239;9&#46;15&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-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HE &#8211; <span class="elsevierStyleItalic">n&#46; &#40;&#37;&#41;</span>&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">&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">&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">&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">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic"><span class="elsevierStyleHsp" style=""></span>No HE</span>&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 &#40;16&#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">8 &#40;19&#46;5&#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">4 &#40;4&#46;9&#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  " rowspan="3" align="left" valign="middle">0&#46;001</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic"><span class="elsevierStyleHsp" style=""></span>I&#8211;II</span>&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">18 &#40;72&#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">18 &#40;43&#46;9&#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">22 &#40;26&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic"><span class="elsevierStyleHsp" style=""></span>III&#8211;IV</span>&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 &#40;12&#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">15 &#40;36&#46;6&#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">56 &#40;68&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ascites &#8211; <span class="elsevierStyleItalic">n&#46;&#40;&#37;&#41;</span>&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 &#40;84&#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 &#40;75&#46;6&#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">66 &#40;80&#46;5&#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">0&#46;694&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Serum bilirubin &#40;mg&#47;dl&#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;5 &#40;3&#46;7&#8211;10&#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">9&#46;2 &#40;6&#46;4&#8211;17&#46;8&#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">19&#46;1 &#40;6&#46;2&#8211;34&#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-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Serum creatinine &#40;mg&#47;dl&#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;29 &#40;0&#46;93&#8211;1&#46;75&#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;49&#40;1&#46;1&#8211;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">2&#46;41 &#40;2&#46;1&#8211;3&#46;8&#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;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">INR&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;7&#40;1&#46;6&#8211;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">1&#46;7&#40;1&#46;5&#8211;2&#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">2&#46;1 &#40;1&#46;6&#8211;2&#46;8&#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-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sodium &#40;mmol&#47;l&#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 &#40;132&#8211;137&#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 &#40;131&#8211;138&#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">134 &#40;131&#8211;138&#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;838&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Leukocytes &#40;&#215;10<span class="elsevierStyleSup">9</span>&#47;l&#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">10&#46;3 &#40;4&#46;3&#8211;13&#46;8&#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;6 &#40;4&#46;8&#8211;16&#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">12&#46;7 &#40;8&#46;6&#8211;16&#46;8&#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;024&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Renal replacement&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 &#40;0&#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">2 &#40;4&#46;9&#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">6 &#40;7&#46;3&#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">0&#46;427&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">MAP&#8239;&#8804;&#8239;70 &#40;mmHg&#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">14 &#40;56&#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">20 &#40;48&#46;8&#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">53 &#40;64&#46;6&#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">0&#46;229&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Vasopressor use&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">12 &#40;48&#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 &#40;75&#46;6&#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">80 &#40;97&#46;6&#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">0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">SpO2&#47;FiO2&#8239;&#8804;&#8239;214&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 &#40;0&#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">5 &#40;12&#46;2&#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">15 &#40;18&#46;3&#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">0&#46;042&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Mechanical Ventilation&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">&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">&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">&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">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic"><span class="elsevierStyleHsp" style=""></span>HE</span>&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 &#40;8&#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">4 &#40;9&#46;7&#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">38 &#40;46&#46;34&#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  " rowspan="3" align="left" valign="middle">0&#46;081</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic"><span class="elsevierStyleHsp" style=""></span>Respiratory failure</span>&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 &#40;0&#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">6 &#40;14&#46;6&#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">3 &#40;3&#46;65&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic"><span class="elsevierStyleHsp" style=""></span>Both</span>&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 &#40;4&#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">1 &#40;1&#46;9&#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">8&#40;9&#46;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2666352.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Population baseline characteristics based on ACLF grading &#40;n&#8239;&#61;&#8239;148&#41;&#46;</p>"
        ]
      ]
      5 => array:8 [
        "identificador" => "tbl0010"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0030"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">The data are presented in frequency &#40;n&#46;&#41; and percentage &#40;&#37;&#41;&#44; median and interquartile range &#40;P25&#8211;P75&#41;&#44; mean and standard deviation &#40;SD&#41; &#40;&#177;&#41;&#46; Bivariate analysis by means of U Mann&#8211;Whitney test&#44; T-student and chi square test&#46; <span class="elsevierStyleItalic">Abbreviations</span>&#46; CLIF-C OF &#40;Chronic Liver Failure - Organ Failure&#41; ACLF &#40;Acute on chronic liver failure&#41;&#46;</p>"
          "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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Characteristics&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">Died<span class="elsevierStyleItalic">n&#8239;&#61;&#8239;124</span>&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">Survived<span class="elsevierStyleItalic">n&#8239;&#61;&#8239;24</span>&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"><span class="elsevierStyleItalic">p</span>&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-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Age &#40;years&#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 &#40;44&#8211;64&#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 &#40;39&#8211;58&#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;089&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Male sex &#8211; <span class="elsevierStyleItalic">n&#46;&#40;&#37;&#41;</span>&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 &#40;47&#46;6&#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">8 &#40;33&#46;3&#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">0&#46;199&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">CLIF-C OF&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">13 &#40;12&#8211;15&#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 &#40;10&#8211;12&#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;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ACLF score&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;45&#8239;&#177;&#8239;10&#46;36&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">50&#46;08&#8239;&#177;&#8239;7&#46;52&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-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">ACLF Grade</span>&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">&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">&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">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Grade 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">13 &#40;10&#46;5&#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">12 &#40;50&#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  " rowspan="3" align="left" valign="middle">0&#46;001</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Grade 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">35 &#40;28&#46;2&#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">6 &#40;25&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Grade 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">76 &#40;61&#46;3&#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">6 &#40;25&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Organ failures</span>&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">&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">&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">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Liver&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 &#40;48&#46;4&#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">9 &#40;37&#46;5&#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">0&#46;377&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Renal&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">74 &#40;59&#46;7&#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">4 &#40;16&#46;7&#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">0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Brain&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">70 &#40;56&#46;5&#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">5 &#40;20&#46;8&#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">0&#46;002&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Coagulation&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">33 &#40;26&#46;6&#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">3 &#40;12&#46;5&#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">0&#46;195&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Circulatory&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">108 &#40;87&#46;1&#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">15 &#40;62&#46;5&#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">0&#46;007&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Lung&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 &#40;12&#46;9&#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">4 &#40;16&#46;7&#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">0&#46;744&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sodium &#40;mmol&#47;l&#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">135&#8239;&#177;&#8239;6&#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">134&#8239;&#177;&#8239;4&#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;613&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Leukocytes &#40;&#215;10<span class="elsevierStyleSup">9</span>&#47;l&#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">12&#46;5 &#40;7&#46;7&#8211;16&#46;8&#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">9&#46;1 &#40;4&#46;4&#8211;14&#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">0&#46;073&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Infection&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">74 &#40;59&#46;7&#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">12 &#40;50&#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">0&#46;498&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2666351.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">General characteristics based on outcome&#46;</p>"
        ]
      ]
      6 => array:8 [
        "identificador" => "tbl0015"
        "etiqueta" => "Table 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0035"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Bivariate and multivariate analysis using Cox proportional risks&#46; <span class="elsevierStyleItalic">Abbreviations</span>&#46; HR &#40;Hazard ratio&#41;&#44; CI &#40;Confidence interval&#41;&#44; ACLF &#40;Acute on chronic liver failure&#41;&#44; CLIF-OF &#40;Chronic Liver Failure - Organ Failure&#41;&#46;</p>"
          "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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Parameters&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">Bivariate analysis&#44;Crude HR &#40;95&#37; CI&#41;&#40;90 days mortality&#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 Value&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">Multivariate analysis&#44; HR &#40;95&#37; CI&#41;&#42;P value of the model&#40;28-day mortality&#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">pValue&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">Multivariate analysis&#44; HR &#40;95&#37; CI&#41;&#42;P value of the model&#40;90-day mortality&#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">pValue&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-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="7" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">General characteristics</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Age &#40;years&#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;0 &#40;0&#46;99&#8211;1&#46;01&#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;543&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  " rowspan="4" align="left" valign="middle">1&#46;62 &#40;1&#46;10&#8211;2&#46;40&#41; &#42;0&#46;001</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="4" align="left" valign="middle">0&#46;015</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="4" align="left" valign="middle">1&#46;78 &#40;1&#46;23&#8211;2&#46;56&#41;&#42;0&#46;001</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="4" align="left" valign="middle">0&#46;002</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Male sex&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;42 &#40;1&#46;02&#8211;2&#46;03&#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;049&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Leukocytes&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;03 &#40;1&#46;01&#8211;1&#46;06&#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;005&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Infection&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;18 &#40;0&#46;83&#8211;1&#46;70&#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;344&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="7" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">ACLF characteristics</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ACLF Score&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;05 &#40;1&#46;03&#8211;1&#46;07&#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;001&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">&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">&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">&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">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">CLIF-C OF&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;32 &#40;1&#46;21&#8211;1&#46;44&#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;001&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">&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">&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">&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">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ACLF Grade&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">&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">&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">&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">&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">&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">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Grade 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 &#40;reference&#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;210&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">&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">&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">&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">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Grade 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;04 &#40;1&#46;07&#8211;3&#46;87&#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;029&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">&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">&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">&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">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Grade 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">4&#46;25 &#40;2&#46;34&#8211;7&#46;71&#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;001&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">&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">&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">&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">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="7" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Organ failures</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Liver&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;58 &#40;1&#46;11&#8211;2&#46;26&#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;011&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">&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">&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">&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">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Renal&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;91 &#40;2&#46;01&#8211;4&#46;22&#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;001&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;26 &#40;2&#46;13&#8211;4&#46;99&#41;&#42;0&#46;001&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><td class="td" title="\n
                  \t\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;06 &#40;2&#46;08&#8211;4&#46;51&#41;&#42;0&#46;001&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-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Brain&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;67 &#40;1&#46;17&#8211;2&#46;39&#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;005&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;37 &#40;1&#46;09&#8211;2&#46;04&#41;&#42;0&#46;001&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;049&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;43 &#40;1&#46;03&#8211;2&#46;07&#41;&#42;0&#46;001&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;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Coagulation&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;73 &#40;1&#46;16&#8211;2&#46;58&#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><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" 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="left" 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="left" 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="left" 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-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Circulatory&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;81 &#40;1&#46;07&#8211;3&#46;07&#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;026&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">&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">&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">&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">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Lung&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;23 &#40;0&#46;73&#8211;2&#46;09&#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;428&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">&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">&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">&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">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2666350.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Clinical predictors of 28 and 90 day mortality&#46; Bivariate and multivariate Cox regression analysis&#46;</p>"
        ]
      ]
      7 => array:5 [
        "identificador" => "upi0005"
        "tipo" => "MULTIMEDIAECOMPONENTE"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "Ecomponente" => array:2 [
          "fichero" => "mmc1.docx"
          "ficheroTamanyo" => 15860
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:30 [
            0 => array:3 [
              "identificador" => "bib0005"
              "etiqueta" => "&#91;1&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Acute-on-chronic liver failure is a distinct syndrome that develops in patients with acute decompensation of cirrhosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46; Moreau"
                            1 => "R&#46; Jalan"
                            2 => "P&#46; Gines"
                            3 => "M&#46; Pavesi"
                            4 => "P&#46; Angeli"
                            5 => "J&#46; Cordoba"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1053/j.gastro.2013.02.042"
                      "Revista" => array:7 [
                        "tituloSerie" => "Gastroenterology"
                        "fecha" => "2013"
                        "volumen" => "144"
                        "numero" => "7"
                        "paginaInicial" => "1426"
                        "paginaFinal" => "1437"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23474284"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0010"
              "etiqueta" => "&#91;2&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Describing organ dysfunction in the intensive care unit&#58; a cohort study of 20&#44;000 patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Soo"
                            1 => "D&#46;J&#46; Zuege"
                            2 => "G&#46;H&#46; Fick"
                            3 => "D&#46;J&#46; Niven"
                            4 => "L&#46;R&#46; Berthiaume"
                            5 => "H&#46;T&#46; Stelfox"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/s13054-019-2459-9"
                      "Revista" => array:6 [
                        "tituloSerie" => "Crit Care"
                        "fecha" => "2019"
                        "volumen" => "23"
                        "numero" => "1"
                        "paginaInicial" => "186"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31122276"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "&#91;3&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Role of predisposition&#44; injury&#44; response and organ failure in the prognosis of patients with acute-on-chronic liver failure&#58; a prospective cohort study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "R&#46; Jalan"
                            1 => "V&#46; Stadlbauer"
                            2 => "S&#46; Sen"
                            3 => "L&#46; Cheshire"
                            4 => "Y&#46;M&#46; Chang"
                            5 => "R&#46;P&#46; Mookerjee"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/cc11882"
                      "Revista" => array:6 [
                        "tituloSerie" => "Crit Care"
                        "fecha" => "2012"
                        "volumen" => "16"
                        "numero" => "6"
                        "paginaInicial" => "R227"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23186071"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0020"
              "etiqueta" => "&#91;4&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "NACSELD acute-on-chronic liver failure &#40;NACSELD-ACLF&#41; score predicts 30-day survival in hospitalized patients with cirrhosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;G&#46; O&#8217;Leary"
                            1 => "K&#46;R&#46; Reddy"
                            2 => "G&#46; Garcia-Tsao"
                            3 => "S&#46;W&#46; Biggins"
                            4 => "F&#46; Wong"
                            5 => "M&#46;B&#46; Fallon"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/hep.29773"
                      "Revista" => array:6 [
                        "tituloSerie" => "Hepatology"
                        "fecha" => "2018"
                        "volumen" => "67"
                        "paginaInicial" => "2367"
                        "paginaFinal" => "2374"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29315693"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "&#91;5&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Infection and systemic inflammation&#44; not ammonia&#44; are associated with grade 3&#47;4 hepatic encephalopathy&#44; but not mortality in cirrhosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "D&#46;L&#46; Shawcross"
                            1 => "Y&#46; Sharifi"
                            2 => "J&#46;B&#46; Canavan"
                            3 => "A&#46;D&#46; Yeoman"
                            4 => "R&#46;D&#46; Abeles"
                            5 => "N&#46;J&#46; Taylor"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jhep.2010.07.045"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Hepatol"
                        "fecha" => "2011"
                        "volumen" => "54"
                        "paginaInicial" => "640"
                        "paginaFinal" => "649"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21163546"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "&#91;6&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Role of ammonia&#44; inflammation&#44; and cerebral oxygenation in brain dysfunction of acute-on-chronic liver failure patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "R&#46; Sawhney"
                            1 => "P&#46; Holland-Fischer"
                            2 => "M&#46; Rosselli"
                            3 => "R&#46;P&#46; Mookerjee"
                            4 => "B&#46; Agarwal"
                            5 => "R&#46; Jalan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Liver Transplant"
                        "fecha" => "2016"
                        "volumen" => "22"
                        "paginaInicial" => "732"
                        "paginaFinal" => "742"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "&#91;7&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Bacterial DNA translocation is associated with systemic circulatory abnormalities and intrahepatic endothelial dysfunction in patients with cirrhosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "P&#46; Bellot"
                            1 => "J&#46;C&#46; Garc&#237;a-Pag&#225;n"
                            2 => "R&#46; Franc&#233;s"
                            3 => "J&#46;G&#46; Abraldes"
                            4 => "M&#46; Navasa"
                            5 => "M&#46; P&#233;rez-Mateo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/hep.23918"
                      "Revista" => array:6 [
                        "tituloSerie" => "Hepatology"
                        "fecha" => "2010"
                        "volumen" => "52"
                        "paginaInicial" => "2044"
                        "paginaFinal" => "2052"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20979050"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "&#91;8&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Predictive factors for 28-day mortality in acute-on-chronic liver failure patients admitted to the intensive care unit"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46;P&#46;C&#46; da Silva Boteon"
                            1 => "A&#46; Chauhan"
                            2 => "Y&#46;L&#46; Boteon"
                            3 => "S&#46; Tillakaratne"
                            4 => "B&#46; Gunson"
                            5 => "A&#46;M&#46; Elsharkawy"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.dld.2019.04.008"
                      "Revista" => array:6 [
                        "tituloSerie" => "Dig Liver Dis"
                        "fecha" => "2019"
                        "volumen" => "51"
                        "paginaInicial" => "1416"
                        "paginaFinal" => "1422"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31064706"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "&#91;9&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Hepatic encephalopathy is associated with mortality in patients with cirrhosis independent of other extrahepatic organ failures"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;S&#46; Bajaj"
                            1 => "J&#46;G&#46; O&#8217;Leary"
                            2 => "P&#46; Tandon"
                            3 => "F&#46; Wong"
                            4 => "G&#46; Garcia-Tsao"
                            5 => "P&#46;S&#46; Kamath"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.cgh.2016.09.157"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Gastroenterol Hepatol"
                        "fecha" => "2017"
                        "volumen" => "15"
                        "paginaInicial" => "565"
                        "paginaFinal" => "574&#46;e4"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27720916"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "&#91;10&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Coagulation failure is associated with bleeding events and clinical outcome during systemic inflammatory response and sepsis in acute-on-chronic liver failure&#58; an observational cohort study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Premkumar"
                            1 => "P&#46; Saxena"
                            2 => "D&#46; Rangegowda"
                            3 => "S&#46; Baweja"
                            4 => "R&#46; Mirza"
                            5 => "P&#46; Jain"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/liv.14034"
                      "Revista" => array:6 [
                        "tituloSerie" => "Liver Int"
                        "fecha" => "2019"
                        "volumen" => "39"
                        "paginaInicial" => "694"
                        "paginaFinal" => "704"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30589495"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "&#91;11&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Acute-on-chronic liver failure is a distinct syndrome that develops in patients with acute decompensation of cirrhosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46; Moreau"
                            1 => "R&#46; Jalan"
                            2 => "P&#46; Gines"
                            3 => "M&#46; Pavesi"
                            4 => "P&#46; Angeli"
                            5 => "J&#46; Cordoba"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1053/j.gastro.2013.02.042"
                      "Revista" => array:6 [
                        "tituloSerie" => "Gastroenterology"
                        "fecha" => "2013"
                        "volumen" => "144"
                        "paginaInicial" => "1426"
                        "paginaFinal" => "1437&#46;e9"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23474284"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "&#91;12&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Outcome of critically ill cirrhotic patients admitted to the ICU&#58; the role of ACLF"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "A&#46; Ferrarese"
                            1 => "P&#46; Feltracco"
                            2 => "S&#46; Barbieri"
                            3 => "U&#46; Cillo"
                            4 => "P&#46; Burra"
                            5 => "M&#46; Senzolo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jhep.2018.09.015"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Hepatol"
                        "fecha" => "2019"
                        "volumen" => "70"
                        "paginaInicial" => "801"
                        "paginaFinal" => "803"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30685127"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "&#91;13&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical course of acute-on-chronic liver failure syndrome and effects on prognosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "T&#46; Gustot"
                            1 => "J&#46; Fernandez"
                            2 => "E&#46; Garcia"
                            3 => "F&#46; Morando"
                            4 => "P&#46; Caraceni"
                            5 => "C&#46; Alessandria"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/hep.27849"
                      "Revista" => array:6 [
                        "tituloSerie" => "Hepatology"
                        "fecha" => "2015"
                        "volumen" => "62"
                        "paginaInicial" => "243"
                        "paginaFinal" => "252"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25877702"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "&#91;14&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Survival in infection-related acute-on-chronic liver failure is defined by extrahepatic organ failures"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;S&#46; Bajaj"
                            1 => "J&#46;G&#46; O&#8217;Leary"
                            2 => "K&#46;R&#46; Reddy"
                            3 => "F&#46; Wong"
                            4 => "S&#46;W&#46; Biggins"
                            5 => "H&#46; Patton"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/hep.27077"
                      "Revista" => array:6 [
                        "tituloSerie" => "Hepatology"
                        "fecha" => "2014"
                        "volumen" => "60"
                        "paginaInicial" => "250"
                        "paginaFinal" => "256"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24677131"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "&#91;15&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Defining acute-on-chronic liver failure&#58; East&#44; West or Middle ground&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "H&#46; Singh"
                            1 => "C&#46;G&#46; Pai"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.4254/wjh.v7.i25.2571"
                      "Revista" => array:6 [
                        "tituloSerie" => "World J Hepatol"
                        "fecha" => "2015"
                        "volumen" => "7"
                        "paginaInicial" => "2571"
                        "paginaFinal" => "2577"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26557949"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "&#91;16&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "MELD vs Child-Pugh and creatinine-modified Child-Pugh score for predicting survival in patients with decompensated cirrhosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "G&#46;V&#46; Papatheodoridis"
                            1 => "E&#46; Cholongitas"
                            2 => "E&#46; Dimitriadou"
                            3 => "G&#46; Touloumi"
                            4 => "V&#46; Sevastianos"
                            5 => "A&#46;J&#46; Archimandritis"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3748/wjg.v11.i20.3099"
                      "Revista" => array:6 [
                        "tituloSerie" => "World J Gastroenterol"
                        "fecha" => "2005"
                        "volumen" => "11"
                        "paginaInicial" => "3099"
                        "paginaFinal" => "3104"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15918197"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "&#91;17&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Child-Pugh versus MELD score for predicting the in-hospital mortality of acute upper gastrointestinal bleeding in liver cirrhosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "Y&#46; Peng"
                            1 => "X&#46; Qi"
                            2 => "J&#46; Dai"
                            3 => "H&#46; Li"
                            4 => "X&#46; Guo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Clin Exp Med"
                        "fecha" => "2015"
                        "volumen" => "8"
                        "paginaInicial" => "751"
                        "paginaFinal" => "757"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25785053"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "&#91;18&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Community-acquired pneumonia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "J&#46; Franco"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Radiol Technol"
                        "fecha" => "2017"
                        "volumen" => "88"
                        "paginaInicial" => "621"
                        "paginaFinal" => "636"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28900048"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "&#91;19&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Spontaneous bacterial peritonitis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "B&#46; Velkey"
                            1 => "E&#46; Vit&#225;lis"
                            2 => "Z&#46; Vit&#225;lis"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1556/650.2017.30637"
                      "Revista" => array:6 [
                        "tituloSerie" => "Orv Hetil"
                        "fecha" => "2017"
                        "volumen" => "158"
                        "paginaInicial" => "50"
                        "paginaFinal" => "57"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28088889"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "&#91;20&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Evaluation and management of urinary tract infection in the emergency department"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "S&#46;B&#46; Dubbs"
                            1 => "S&#46;K&#46; Sommerkamp"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Emerg Med Clin North Am"
                        "fecha" => "2019"
                        "volumen" => "37"
                        "paginaInicial" => "707"
                        "paginaFinal" => "723"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0105"
              "etiqueta" => "&#91;21&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Acute cholangitis&#58; diagnosis and management"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46; Sokal"
                            1 => "A&#46; Sauvanet"
                            2 => "B&#46; Fantin"
                            3 => "V&#46; de Lastours"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jviscsurg.2019.05.007"
                      "Revista" => array:7 [
                        "tituloSerie" => "J Visc Surg"
                        "fecha" => "2019"
                        "volumen" => "156"
                        "numero" => "6"
                        "paginaInicial" => "515"
                        "paginaFinal" => "525"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31248783"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0110"
              "etiqueta" => "&#91;22&#93;"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Mandell&#44; Douglas and Bennett&#180;s&#46; Principles and Practice of Infectious Diseases&#46; Chapter 75&#58; Sepsis&#44; severe sepsis and septic shock&#59; page&#58; 915-935&#46; 8th edition&#46;"
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0115"
              "etiqueta" => "&#91;23&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Gu&#237;as cl&#237;nicas de diagn&#243;stico y tratamiento de la ascitis Fisiopatolog&#237;a y diagn&#243;stico de la ascitis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "T&#46; Aldo"
                            1 => "P&#46; Mauricio"
                            2 => "D&#46;A&#46; Su&#225;rez"
                            3 => "J&#46;C&#46; Rom&#225;n"
                            4 => "D&#46; Violante"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Gastroenterol Mex"
                        "fecha" => "2009"
                        "volumen" => "74"
                        "paginaInicial" => "387"
                        "paginaFinal" => "391"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20423775"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0120"
              "etiqueta" => "&#91;24&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pathogenesis&#44; diagnosis&#44; and treatment of hepatic encephalopathy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "D&#46;K&#46; Atluri"
                            1 => "R&#46; Prakash"
                            2 => "K&#46;D&#46; Mullen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0973-6883(11)60126-6"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Exp Hepatol"
                        "fecha" => "2011"
                        "volumen" => "1"
                        "paginaInicial" => "77"
                        "paginaFinal" => "86"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25755319"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0125"
              "etiqueta" => "&#91;25&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Single-centre validation of the EASL-CLIF consortium definition of acute- on-chronic liver failure and CLIF-SOFA for prediction of mortality in cirrhosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46;F&#46; Ronsoni"
                            1 => "M&#46;L&#46; Bazzo"
                            2 => "L&#46; Narciso-schiavon"
                            3 => "L&#46;L&#46; Schiavon"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Liver Int"
                        "fecha" => "2014"
                        "paginaInicial" => "1"
                        "paginaFinal" => "8"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib0130"
              "etiqueta" => "&#91;26&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevalence and risk factors of acute-on-chronic liver failure in a single center from Argentina"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "C&#46; Dominguez"
                            1 => "E&#46; Romero"
                            2 => "J&#46; Graciano"
                            3 => "J&#46;L&#46; Fernandez"
                            4 => "L&#46; Viola"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.4254/wjh.v8.i34.1529"
                      "Revista" => array:6 [
                        "tituloSerie" => "World J Hepatol"
                        "fecha" => "2016"
                        "volumen" => "8"
                        "paginaInicial" => "1529"
                        "paginaFinal" => "1534"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28008344"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib0135"
              "etiqueta" => "&#91;27&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Differential characteristics and prognosis of patients with hepatitis B virus-related acute-on-chronic liver failure defined by European Association for the Study of the Liver - Chronic Liver Failure criteria"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46; Wu"
                            1 => "Y&#46;-Y&#46; Li"
                            2 => "J&#46;-H&#46; Hu"
                            3 => "L&#46; Jia"
                            4 => "M&#46; Shi"
                            5 => "F&#46;-P&#46; Meng"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/hepr.12909"
                      "Revista" => array:6 [
                        "tituloSerie" => "Hepatol Res"
                        "fecha" => "2018"
                        "volumen" => "48"
                        "paginaInicial" => "153"
                        "paginaFinal" => "164"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28456135"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib0140"
              "etiqueta" => "&#91;28&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevalence and short-term mortality of acute-on-chronic liver failure&#58; a national cohort study from the USA"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46; Hernaez"
                            1 => "J&#46;R&#46; Kramer"
                            2 => "Y&#46; Liu"
                            3 => "A&#46; Tansel"
                            4 => "Y&#46; Natarajan"
                            5 => "K&#46;B&#46; Hussain"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jhep.2018.12.018"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Hepatol"
                        "fecha" => "2019"
                        "volumen" => "70"
                        "paginaInicial" => "639"
                        "paginaFinal" => "647"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30590100"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib0145"
              "etiqueta" => "&#91;29&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Trends in liver disease prevalence in Mexico from 2005 to 2050 through mortality data"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "N&#46; M&#233;ndez-S&#225;nchez"
                            1 => "A&#46;R&#46; Villa"
                            2 => "N&#46;C&#46; Ch&#225;vez-Tapia"
                            3 => "G&#46; Ponciano-Rodriguez"
                            4 => "P&#46; Almeda-Vald&#233;s"
                            5 => "D&#46; Gonz&#225;lez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Ann Hepatol Off J Mex Assoc Hepatol"
                        "fecha" => "2005"
                        "volumen" => "4"
                        "paginaInicial" => "52"
                        "paginaFinal" => "55"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib0150"
              "etiqueta" => "&#91;30&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Characteristics&#44; risk factors&#44; and mortality of cirrhotic patients hospitalized for hepatic encephalopathy with and without acute-on-chronic liver failure &#40;ACLF&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46; Cordoba"
                            1 => "M&#46; Ventura-Cots"
                            2 => "M&#46; Sim&#243;n-Talero"
                            3 => "&#192; Amor&#243;s"
                            4 => "M&#46; Pavesi"
                            5 => "H&#46; Vilstrup"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jhep.2013.10.004"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Hepatol"
                        "fecha" => "2014"
                        "volumen" => "60"
                        "paginaInicial" => "275"
                        "paginaFinal" => "281"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24128414"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
    "agradecimientos" => array:1 [
      0 => array:4 [
        "identificador" => "xack548179"
        "titulo" => "Acknowledgments"
        "texto" => "<p id="par0305" class="elsevierStylePara elsevierViewall">The authors thanks National Autonomous University of Mexico&#46; Master&#8217;s and Doctoral Program in Medical&#44; Dental and Health Sciences and National Council of Science and Technology &#40;CONACyT&#41; for the support provided&#46;</p>"
        "vista" => "all"
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/16652681/000000220000000C/v3_202107300613/S166526812030185X/v3_202107300613/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "78265"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Original Articles"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/16652681/000000220000000C/v3_202107300613/S166526812030185X/v3_202107300613/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S166526812030185X?idApp=UINPBA00004N"
]
Article information
ISSN: 16652681
Original language: English
DOI:10.1016/j.aohep.2020.09.014
The statistics are updated each day
Year/Month Html Pdf Total
2024 November 2 0 2
2024 October 30 3 33
2024 September 48 3 51
2024 August 35 5 40
2024 July 40 8 48
2024 June 33 1 34
2024 May 18 2 20
2024 April 25 8 33
2024 March 73 8 81
2024 February 76 7 83
2024 January 47 7 54
2023 December 39 9 48
2023 November 39 7 46
2023 October 76 8 84
2023 September 63 5 68
2023 August 46 6 52
2023 July 42 5 47
2023 June 35 2 37
2023 May 75 5 80
2023 April 68 2 70
2023 March 78 3 81
2023 February 35 8 43
2023 January 33 5 38
2022 December 37 8 45
2022 November 27 13 40
2022 October 34 9 43
2022 September 59 24 83
2022 August 39 24 63
2022 July 45 8 53
2022 June 24 10 34
2022 May 23 7 30
2022 April 51 7 58
2022 March 65 6 71
2022 February 49 7 56
2022 January 63 11 74
2021 December 46 9 55
2021 November 41 8 49
2021 October 27 14 41
2021 September 28 13 41
2021 August 19 10 29
2021 July 14 20 34
2021 June 17 13 30
2021 May 26 14 40
2021 April 40 20 60
2021 March 22 9 31
2021 February 25 10 35
2021 January 12 3 15
2020 December 11 4 15
2020 November 7 7 14
2020 October 2 2 4
Show all

Follow this link to access the full text of the article

Subscribe to our newsletter

Publish in
Annals of Hepatology
Affiliated societies

 

es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos