Proxy reports on the EQ-5D-5L in residential aged care facilities: a validation study.

Cirrhosis is a major cause of morbidity and mortality worldwide and is associated with frequent hospitalizations and substantial healthcare utilization [–]. Patients with cirrhosis are particularly vulnerable to acute decompensation and multi-organ dysfunction, which contribute significantly to adverse clinical outcomes [, ]. Among hospitalized patients, complications such as infection, hemodynamic instability, and renal dysfunction are common and often portend poor prognosis [, ]. Acute kidney injury (AKI) is one of the most frequent and clinically significant complications in patients with cirrhosis. The development of AKI reflects complex pathophysiologic processes, including systemic vasodilation, reduced effective arterial blood volume, and activation of neurohormonal pathways, and may manifest as hepatorenal syndrome or intrinsic renal injury [–]. Prior studies have consistently demonstrated that AKI in cirrhosis is associated with increased mortality; however, the magnitude of this association varies across clinical settings and patient populations, and the relationship between AKI severity and outcomes remains incompletely characterized. Despite existing evidence, several important gaps remain. Many prior studies have been limited to single-center cohorts or specific clinical settings, such as intensive care units, which may not reflect broader patient populations [, ]. National-level data quantifying the impact of AKI severity on mortality and healthcare utilization are limited. In addition, the extent to which the association between AKI and mortality varies across key patient subgroups, including those with chronic kidney disease (CKD) and differing age profiles, is not well defined. Furthermore, the economic burden associated with AKI in cirrhosis has not been fully characterized in contemporary, nationally representative datasets.