Shalimar MFS, et al. - Using Chronic Liver Failure-Sequential Organ Failure Assessment criteria, researchers identified the relationship between levels of ammonia and hepatic encephalopathy (HE) severity, association with organ dysfunction and short-term mortality. 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). It was concluded that ammonia levels not only correlate with the severity of HE but also with the failure of other organs and are an independent mortality risk factor. The lack of improvement in ammonia levels is linked to a high risk of death, which makes it an important biomarker and a therapeutic target.