Publication Name	World Journal of Hepatology
Manuscript ID	110652
Country	China

Category	Gastroenterology & Hepatology
Manuscript Type	Retrospective Cohort Study
Article Title	Prognostic value of dynamic changes in C-reactive protein to albumin ratio in patients with acute-on-chronic liver failure
Manuscript Source	Unsolicited Manuscript
All Author List	Zong-Yi Zhu and Li-Juan Yan
Funding Agency and Grant Number
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
Key Words	Acute-on-chronic liver failure; C-reactive protein to albumin ratio; Inflammation; Prognosis; Chinese Group on Study of Severe Hepatitis B criteria; Mortality
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.
Citation	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; In press

Received	2025-06-12 09:12
Peer-Review Started	2025-06-12 09:12
To Make the First Decision
Return for Revision	2025-06-17 12:33
Revised	2025-06-25 15:05
Second Decision	2025-08-15 02:54
Accepted by Journal Editor-in-Chief
Accepted by Executive Editor-in-Chief	2025-08-15 08:27
Articles in Press	2025-08-15 08:27
Publication Fee Transferred	2025-07-02 10:50
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	1948-5182 (online)
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