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Introduction Decompensated cirrhosis is a major cause of morbidity and mortality in working aged people. Whilst this is predominately driven by steatotic liver disease in the United Kingdom, there is heterogeneity in symptom burden as well as disease trajectory and experience across the population. The use of patient reported outcomes (PROs) may improve our understanding of these aspects of disease for patients with decompensated cirrhosis as well as define subgroups of patients who may require specific interventions or may have different prognoses. The aim of this scoping review was to define the use of PROs in patients with decompensated cirrhosis.Methods A scoping review was undertaken utilising Ovid MEDLINE and EMBASE databases for studies including PROs undertaken in patients with decompensated cirrhosis from January 2020 – March 2025. Studies were included if they included any patients with decompensated cirrhosis as per Baveno criteria or if they had a Child-Turcotte-Pugh class of B/C. PROs were defined as the patients’ own assessment of their health status including symptoms, reports of daily functioning, quality of life and satisfaction with their health care. This study was conducted in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist.Results 67 studies were included in the final analysis ( figure 1). Of the 40,112 patients in these studies, 6,553 fulfilled criteria for decompensation. Ascites was the most reported decompensation symptom across the cohort (48.2%). 38 different PRO tools were utilised across the different studies with the SF-36 (and it’s variants) used most frequently (43.3% of studies). 13 studies included only patients with decompensated cirrhosis and were utilised to define decompensated cirrhosis specific PROs. 12 individual domains were highlighted across the PRO tools including; general health, physical functioning, pain, vitality/energy, abdominal symptoms, breathing symptoms, gastrointestinal symptoms, cognition, social functioning, emotional status, sleep and self-management. Of these, there were most questions about emotional status (87), followed by physical functioning (74) and general health (68). 14 studies compared patient PRO results across the spectrum of compensation/decompensation. Increasing decompensation was associated with worse PRO outcomes across multiple domains.Abstract P77 Figure 1Conclusions There is a need to better define PRO relevant to patients with decompensated cirrhosis. This may lead to targeted clinical trial design for interventions in the future.