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World J Hepatol. Apr 27, 2026; 18(4): 117905
Published online Apr 27, 2026. doi: 10.4254/wjh.v18.i4.117905
Published online Apr 27, 2026. doi: 10.4254/wjh.v18.i4.117905
Glucocorticoid therapy in acute liver failure: Survival outcomes, predictors, and a response prediction model
Yu-Lan He, Qing-Hua Meng, Interventional Therapy Center for Oncology, Beijing YouAn Hospital, Capital Medical University, Beijing 100069, China
Xue-Hong Yin, Surgical Intensive Care Unit, Beijing Shijitan Hospital, Capital Medical University, Beijing 100069, China
Xiao-Tong Xu, The Second Department of Hepatology, Beijing YouAn Hospital, Capital Medical University, Beijing 100069, China
Juan Li, Department of Clinical Oncology, Beijing YouAn Hospital, Capital Medical University, Beijing 100069, China
Co-first authors: Yu-Lan He and Xue-Hong Yin.
Author contributions: Meng QH was responsible for research conception and design; He YL was responsible for data collection and follow-up; Xu XT and Yin XH were responsible for data analysis; He YL and Xu XT were responsible for drafting the manuscript; Li J and Meng QH were responsible for reviewing and revising the manuscript; He YL and Yin XH have made crucial and indispensable contributions towards the completion of the project and thus qualified as the co-first authors of the paper.
Institutional review board statement: This study/project was approved by the Ethics Committee of Beijing YouAn Hospital, Capital Medical University (No. LL-2024-139-K).
Informed consent statement: The informed consent form was waived by the ethics committee.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
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: The authors confirm that the data supporting the findings of this study are available within the article and its Supplementary materials.
Corresponding author: Qing-Hua Meng, Professor, Interventional Therapy Center for Oncology, Beijing YouAn Hospital, Capital Medical University, No. 8 Xitou Tiao, Fengtai District, Beijing 100069, China. meng_qh0805@ccmu.edu.cn
Received: December 22, 2025
Revised: January 27, 2026
Accepted: March 23, 2026
Published online: April 27, 2026
Processing time: 123 Days and 17.7 Hours
Revised: January 27, 2026
Accepted: March 23, 2026
Published online: April 27, 2026
Processing time: 123 Days and 17.7 Hours
Core Tip
Core Tip: This retrospective cohort study of 179 acute liver failure patients demonstrates that glucocorticoid (GC) therapy significantly improves 28-day survival (58.3% vs 30.5%, P < 0.001). An early increase in prothrombin activity ≥ 4.5% by day 3, alongside baseline model for end-stage liver disease score < 28.5 and blood ammonia < 135.5 μg/dL, forms a highly accurate predictive model for GC response (95.2% accuracy). This model provides a practical tool to select patients most likely to benefit from GC treatment.