BACKGROUND: Pentraxin-3 (PTX3) and soluble tumor necrosis factor (TNF)-like weak 
inducer of apoptosis (sTWEAK) are new candidate prognostic markers for 
comorbidities and mortality in various inflammatory diseases. Acute 
decompensation of cirrhosis is characterized by acute exacerbation of chronic 
systemic inflammation. Recently, increased circulating PTX3 levels have been 
reported in nonalcoholic steatohepatitis patients and positively correlated with 
disease severity. This study aims to explore serum PTX3/sTWEAK levels and their 
relationship with clinical outcomes in cirrhotic patients with acute 
decompensation.
METHODS: We analyzed serum PTX3/sTWEAK levels in relation to inhospital and 
3-month new clinical events and survivals in cirrhotic patients with acute 
decompensation.
RESULTS: During admission, serum PTX3/sTWEAK levels were significantly higher in 
acute decompensated cirrhotic patients than controls and positively correlated 
with protein-energy wasting (PEW), new infections, long hospital stays, high 
medical costs, and high mortality. During a 3-month follow-up, acute 
decompensated cirrhotic patients with high serum PTX3/sTWEAK levels had more 
episodes of unplanned readmission and high 3-month mortality. On multivariate 
analysis, high PTX3/sTWEAK levels and PEW were independent risk factors for high 
mortality.
CONCLUSION: High serum PTX3/sTWEAK levels and PEW are common in cirrhotic 
patients with acute decompensation. As compared with low serum PTX3 and sTWEAK 
cases, cirrhotic patients with high serum PTX3/sTWEAK levels a have higher 
probability of new severe infections, severe sepsis, septic shock, type 1 
hepatorenal syndrome, in-hospital, and 3-month follow-up mortalities. Therefore, 
high serum PTX3/sTWEAK levels on hospital admission predict disease severity and 
case fatality in cirrhotic patients with acute decompensation.