On multivariable analysis, factors associated with in-hospital death (risk ratio—RR, 95% CI) included ACLF (acute-on-chronic liver failure) (1.73, 1.57–1.90), decompensated cirrhosis (1.31, 1.13–1.51), ALBI (albumin–bilirubin) grade 3 versus 2 (1.65, 1.45–1.87), APACHE-III ICU admission diagnosis of sepsis (1.43 vs. upper gastrointestinal bleeding, 1.24–1.66) or liver failure (1.81 vs. upper gastrointestinal bleeding, 1.55–2.12) and older age. The gene discussed is ALB; the disease is Hepatic failure.