Serum bile acids as marker for acute decompensation and acute‐on‐chronic liver failure in patients with non‐cholestatic cirrhosis

Background & Aims Retention of bile acids (BAs) plays a central role in hepatic damage and disturbed BA signalling in liver disease. However, there is lack of data regarding the association of BAs with clinical complications, acute decompensation (AD) and acute‐on‐chronic liver failure (ACLF). Thus, we aimed to evaluate the impact of circulating serum BAs for complications in patients with cirrhosis. Methods One hundred and forty‐three patients with cirrhosis were included in this prospective cohort‐type observational study. Total serum BAs and individual BA composition were assessed in all patients on admission via high‐performance liquid chromatography. Clinical complications with respect to AD, ACLF and 1‐year transplant‐free survival were recorded. Results Total BAs and individual serum BAs were significantly higher in patients with bacterial infection, AD and ACLF (P