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We read with interest the recent paper by Angeli et al 1 investigating the acute-on-chronic liver failure classification in comparison to the acute kidney injury classification as a prognostic parameter in patients with decompensated cirrhosis. Higher stages of acute-on-chronic liver failure were accompanied with mortality and more frequently bacterial infections were identified in patients with multiorgan failure in this large cohort of patients. It is well known that patients with cirrhosis are at high risk for bacterial infections and bacterial infections are common causes of hepatic decompensations.2 Infectious complications significantly impair patients’ prognosis.2 ,3 However, especially hospital acquired infections are associated with high mortality.3 A common additional challenge is the worldwide …
Contributors OW and BK designed and performed the research, analysed the data and wrote the manuscript. VAK and CB analysed the data and critically revised the manuscript. AP and SZ critically revised the manuscript.
Competing interests None.
Ethics approval Institutional Review Board of the Goethe University Hospital Frankfurt.
Provenance and peer review Not commissioned; internally peer reviewed.