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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 26, 2025; 13(30): 109212
Published online Oct 26, 2025. doi: 10.12998/wjcc.v13.i30.109212
Published online Oct 26, 2025. doi: 10.12998/wjcc.v13.i30.109212
Body mass index and its association with clinical outcomes in acute liver failure
Arunkumar Krishnan, Saleh A Alqahtani, Ahyoung Kim, Amanda Su, Ahmet Gurakar, James P Hamilton, Tinsay A Woreta, Division of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States
Arunkumar Krishnan, Department of Supportive Oncology, Atrium Health Levine Cancer, Charlotte, NC 28204, United States
Arunkumar Krishnan, Department of Medicine, Wake Forest University School of Medicine, Winston Salem, NC 28204, United States
Sameer Khan, Julia Gips, Dhananjay Vaidya, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States
Saleh A Alqahtani, Liver Transplant Center, King Faisal Specialist Hospital and Research Center, Riyadh 12713, Saudi Arabia
Yi-Si Liu, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21287, United States
Author contributions: Krishnan A performed the interpretation of data; Krishnan A and Khan S performed writing the original draft; Krishnan A, Khan S, Hamilton JP, Gurakar A, and Woreta TA revised the manuscript for important intellectual content; Krishnan A and Woreta TA conceptualized, designed, and drafted the methodology of the research; Krishnan A, Gips J, Kim A, and Su A performed data collection; Vaidya D and Liu YS performed the formal analysis; Woreta TA supervised the project; all authors reviewed, revised, and approved the final version of the article, including the authorship list.
Institutional review board statement: The study protocol was approved by the Institutional Review Board of the Johns Hopkins University School of Medicine, No. 00250968.
Informed consent statement: Informed consent was waived for a retrospective review of patient charts.
Conflict-of-interest statement: All the Authors have no conflict of interest related to the manuscript.
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: 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: Tinsay A Woreta, MD, Assistant Professor, Division of Gastroentero
Received: May 6, 2025
Revised: May 25, 2025
Accepted: August 12, 2025
Published online: October 26, 2025
Processing time: 161 Days and 20.9 Hours
Revised: May 25, 2025
Accepted: August 12, 2025
Published online: October 26, 2025
Processing time: 161 Days and 20.9 Hours
Core Tip
Core Tip: The most common causes of acute liver failure (ALF) were acetaminophen toxicity, drug-related hepatitis, and other etiologies. Patients who underwent liver transplantation (LT) or died were older, had a higher body mass index (BMI), and were more likely to have higher-grade hepatic encephalopathy and cerebral edema. They also had higher levels of lactate and phosphate. Overweight and obese patients with ALF had a higher risk of mortality or the need for LT than normal-weight patients. Factors such as increasing age, other etiologies of ALF, higher BMI, and abnormal laboratory values were associated with an increased risk of poor outcomes in ALF patients.