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Management of acute decompensated cirrhosis

Lookup NU author(s): Dr Dina Mansour

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This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Abstract

© 2025. Acute decompensated cirrhosis (AD) refers to the development of ascites, encephalopathy, gastrointestinal haemorrhage, or any combination of these disorders in a patient with known or previously undiagnosed advanced chronic liver disease. It carries a significant mortality, particularly if associated with organ failure (acute on chronic liver failure (ACLF)). Admissions with AD have increased by 50% over the last decade, and liver-related deaths have increased by 64% in the last 20 years. UK-wide reports and audits, including by the National Confidential Enquiry into Patient Outcome and Death, have revealed unwarranted variation in care and outcomes for patients with AD. This article summarises the management of patients admitted with AD, including the British Society of Gastroenterology (BSG) / British Association for the Study of the Liver (BASL) / Society of Acute Medicine (SAM) decompensated cirrhosis care bundle, developed for completion in the first 6 h of admission to standardise care for these complex patients.


Publication metadata

Author(s): Mansour D

Publication type: Review

Publication status: Published

Journal: Clinical Medicine

Year: 2025

Volume: 25

Issue: 6

Print publication date: 02/12/2025

Online publication date: 20/11/2025

Acceptance date: 12/11/2025

ISSN (print): 1470-2118

ISSN (electronic): 1473-4893

Publisher: Elsevier B.V.

URL: https://doi.org/10.1016/j.clinme.2025.100534

DOI: 10.1016/j.clinme.2025.100534


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