Publication Name	World Journal of Hepatology
Manuscript ID	113552
Country	Egypt

Category	Gastroenterology & Hepatology
Manuscript Type	Editorial
Article Title	Dynamic inflammation-based prognostication in acute-on-chronic liver failure: The COSSH-CAR model as a step forward in personalized risk stratification
Manuscript Source	Invited Manuscript
All Author List	Noura A A Ebrahim, Thoraya A Farghaly and Soliman M A Soliman
Funding Agency and Grant Number
Corresponding Author	Noura A A Ebrahim, MD, PhD, Department of Oncologic Pathology, National Cancer Institute, Cairo University, Kasr Al Eini Street, Fom El Khalig, Cairo 11796, Al Qāhirah, Egypt. npathologist@gmail.com
Key Words	Acute-on-chronic liver failure; C-reactive protein to albumin ratio; COSSH-CAR; Dynamic biomarkers; Systemic inflammation; Hepatic encephalopathy; Risk stratification
Core Tip	The dynamic shift in the C-reactive protein to albumin ratio during the initial week provides additional prognostic insight into Chinese Group on Study of Severe Hepatitis B-defined acute-on-chronic liver failure, surpassing the predictive capacity of traditional indices such as the model for end-stage liver disease sodium score and hepatic encephalopathy grade. Embedding 7-day variation of CAR within the Chinese Group on Study of Severe Hepatitis B-C-reactive protein to albumin ratio score yields a biologically plausible, practical bedside instrument. Nonetheless, confirmation through robust, multicenter validation is essential before widespread clinical application can be recommended.
Citation	Ebrahim NAA, Farghaly TA, Soliman SMA. Dynamic inflammation-based prognostication in acute-on-chronic liver failure: The COSSH-CAR model as a step forward in personalized risk stratification. World J Hepatol 2025; In press

Received	2025-08-28 15:08
Peer-Review Started	2025-08-29 00:19
First Decision by Editorial Office Director	2025-09-23 08:20
Return for Revision	2025-09-23 08:20
Revised	2025-10-18 19:54
Publication Fee Transferred
Second Decision by Editor	2025-12-08 02:38
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2025-12-08 08:27
Articles in Press	2025-12-08 08:27
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	1948-5182 (online)
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