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Review
. 2025 May-Jun;59(5):420-432.
doi: 10.1097/MCG.0000000000002143. Epub 2025 Feb 3.

Optimal Management of the Inpatient With Decompensated Cirrhosis

Sandeep Sikerwar  1 , Leah Yao  2 , Yasmine Elfarra  2 , Arun Jesudian  2
Affiliations
Review

Optimal Management of the Inpatient With Decompensated Cirrhosis

Sandeep Sikerwar et al. J Clin Gastroenterol. 2025 May-Jun.

Abstract

Over the past several years, there has been a wealth of new data pertaining to the management of complications of cirrhosis, resulting in several important updates to best practices and consensus guidelines. Despite these advancements and numerous recent targeted quality initiatives, hospitalizations resulting from complications of cirrhosis remain frequent, costly and associated with poor patient outcomes. An emphasis on evidence-based management of hospitalized patients with decompensated cirrhosis has the potential to decrease readmission rates and length of stay while improving overall patient outcomes. Herein, we provide an updated, evidence-based overview of the optimal inpatient management of the most frequently encountered complications associated with cirrhosis.

Keywords: HRS; ascites; cirrhosis; decompensated cirrhosis; hepatic encephalopathy; hepatorenal syndrome; spontaneous bacterial peritonitis; variceal bleeding.

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References

    1. Biggins SW, Angeli P, Garcia-Tsao G, et al. Diagnosis, evaluation, and management of ascites, spontaneous bacterial peritonitis and Hepatorenal Syndrome: 2021 practice guidance by the American Association for the study of liver diseases. Hepatology. 2021;74:1014–1048.
    1. Angeli P, Bernardi M, Villanueva C, et al. EASL clinical practice guidelines for the management of patients with decompensated cirrhosis. J Hepatol. 2018;69:406–460.
    1. Karvellas CJ, Bajaj JS, Kamath PS, et al. AASLD practice guidance on acute-on-chronic liver failure and the management of critically ill patients with cirrhosis. Hepatology. 2023;79:1463–1502.
    1. Abraldes JG, Caraceni P, Ghabril M, et al. Update in the treatment of the complications of cirrhosis. Clin Gastroenterol Hepatol. 2023;21:2100–2109.
    1. Hirode G, Saab S, Wong RJ. Trends in the burden of chronic liver disease among hospitalized US adults. JAMA Network Open. 2020;3:e201997.

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