Abstract: Objective The aim of this study was to analyze the change trends of discharge mode of hospitalized patients with liver failure over the last ten years. Methods The clinical materials of patients with liver failure, including acute liver failure (ALF), subacute liver failure (SALF), and acute-on-chronic liver failure (ACLF) and chronic liver failure (CLF), admitted to Beijing You'an Hospital between 2012 and 2021 was retrospectively collected, and analyzed. Results A total of 8512 patients with liver failure were hospitalized, of them, 5789 patients were enrolled as 2723 patients were ruled out based on exlusion criteria, with the mean age of (50.31 ± 13.49) year old, 28.7% of female, and mean hospital stay of 19.46 ± 15.19 days; the ACLF accounted for 47.3%, CLF for 42.0%, SALF for 7.9% and ALF for 2.9%; in terms of the way of discharging, the ordered accounted for 57.6%, non-ordered for 27.5%, and dead for 15.0%; the in-hospital mortality of ALF, CLF, ACLF and SALF were 52.2%, 14.2%,13.7% and 11.4%; the longitudinal analysis showed that in ALF patients, the percentage of doctor's order for discharge did not significantly changed, with in-hospital mortality fluctuating between 31.2% and 70.0%; in SALF, the percentage of discharge by medical advice increased from 55.6% to 70.8% year by year, and the in-hospital mortality decreased from 25.9% to 8.3% (P<0.001); in patients with ACLF, the proportion of discharge by medical orders increased from 47.9% to 59.7% (z=1.9677, P=0.049); in CLF patients, the proportion of patients discharged by medical order also increased from 55.8% to 75.2% (P<0.05), while the in-hospital mortality rate showed a downward trend from 20.9% to 9.3% (P<0.05) year by year. Conclusion The prognosis of patients with liver failure in our hospital has improved greatly over the past ten years, especially the discharging way by medical advice in patients with SALF, ACLF and CLF has increased year by year, but the in-hospital mortality of patients with ALF is still at a high level, so new diagnosis and treatment strategies need to be further explored.

Key words: Acute liver failure, Subacute liver failure, Acute-on-chronic liver failure, Chronic liver failure, Outcome, Trend