Clinical and Laboratory Characteristics and Mortality in Patients with Liver Cirrhosis

Background: To identify independent clinical and laboratory predictors of 28-day mortality in patients with liver cirrhosis. Materials and Methods: A prospective cohort study included 137 patients with liver cirrhosis (decompensated cirrhosis without ACLF, n=72; with ACLF, n=65). Univariate and multivariate Cox regression analysis was used to identify independent predictors of 28-day mortality. Three models were built and compared: a comprehensive model (all significant variables), a basic clinical model (CLIF-C OFs, SpO₂/FiO₂, pneumonia, ACLF stages), and an extended laboratory model (basic model + lactate, ammonia, C-reactive protein). Results: In the univariate analysis, significant predictors of mortality were the severity according to the CLIF-C OFs score, ACLF grades 2 and 3, the presence of pneumonia and urinary tract infection (UTI), elevated levels of lactate, ammonia, C-reactive protein (CRP) and transaminases, as well as decreased SpO₂/FiO₂. In all multivariate models, the following remained independent predictors of an unfavorable outcome: CLIF-C OFs score, ACLF grades 2 and 3, presence of pneumonia, UTI, elevated levels of lactate, ammonia, CRP, and decreased SpO₂/FiO₂. Conclusion: The short-term prognosis in liver cirrhosis is determined by the severity of organ failure, infectious complications, and markers of metabolic stress and inflammation. A comprehensive approach using the CLIF-C OFs score and monitoring lactate, ammonia, and CRP is necessary for risk stratification, which will allow for optimized patient management.