Shalimar MFS, et al. - In this investigation, researchers identified the correlation between levels of ammonia and hepatic encephalopathy (HE) severity, association with organ dysfunction and short-term mortality using Chronic Liver Failure-Sequential Organ Failure Assessment criteria. Four hundred ninety-eight patients were identified from two institutions as part of prospective observational studies in cirrhotic patients. Findings suggested an association of ammonia level of ≥79.5μmol/L with a higher frequency of organ failures (liver, coagulation, kidney and respiratory). Investigators found that the level of ammonia correlates not only with the severity of HE but also with the failure of other organs and was an independent mortality risk factor. The lack of improvement in ammonia levels was related to a high risk of death, which makes it an important biomarker and a therapeutic objective.