Zhu ZY, Yan LJ. Prognostic value of dynamic changes in C-reactive protein to albumin ratio in patients with acute-on-chronic liver failure. World J Hepatol 2025; 17(9): 110652 [DOI: 10.4254/wjh.v17.i9.110652]
Corresponding Author of This Article
Li-Juan Yan, Chief Physician, Director, Department of Gastroenterology, Handan Central Hospital, No. 59 Congtai North Road, Congtai District, Handan 056000, Hebei Province, China. ylj456789@126.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Cohort Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Hepatol. Sep 27, 2025; 17(9): 110652 Published online Sep 27, 2025. doi: 10.4254/wjh.v17.i9.110652
Prognostic value of dynamic changes in C-reactive protein to albumin ratio in patients with acute-on-chronic liver failure
Zong-Yi Zhu, Li-Juan Yan
Zong-Yi Zhu, Li-Juan Yan, Department of Gastroenterology, Handan Central Hospital, Handan 056000, Hebei Province, China
Author contributions: Yan LJ designed the research study; Zhu ZY analyzed the data and wrote the manuscript. All authors have read and approve the final manuscript.
Institutional review board statement: The study was reviewed and approved by the Handan Central Hospital Institutional Review Board (Approval number: 2025070).
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could present a potential conflict of interest.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at [ylj456789@126.com]. No additional data are available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Li-Juan Yan, Chief Physician, Director, Department of Gastroenterology, Handan Central Hospital, No. 59 Congtai North Road, Congtai District, Handan 056000, Hebei Province, China. ylj456789@126.com
Received: June 12, 2025 Revised: June 25, 2025 Accepted: August 15, 2025 Published online: September 27, 2025 Processing time: 105 Days and 20.6 Hours
Core Tip
Core Tip: This study demonstrates that dynamic changes in C-reactive protein to albumin ratio (CAR) during the first week after admission provide superior prognostic value compared to baseline measurements in patients with acute-on-chronic liver failure (ACLF). The optimal predictive timepoint was day 7 change from baseline (ΔCAR-7). A novel Chinese Group on Study of Severe Hepatitis B (COSSH)-CAR prognostic model, incorporating ΔCAR-7, baseline Model for End-Stage Liver Disease-Sodium (MELD-Na) score, and hepatic encephalopathy grade, significantly outperformed established scoring systems including Child-Pugh, MELD-Na, and COSSH-ACLF scores. This dynamic biomarker approach offers enhanced risk stratification and may improve clinical decision-making in ACLF management.
