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Hepatic hydrothorax (HH) remains a difficult-to-treat complication of cirrhosis. To define the mortality, length of stay (LOS), and risk of ACLF in patients admitted with HH. We utilized the North American Consortium for the Study of End-stage Liver Disease, a prospective cohort of 2868 non-electively hospitalized patients with cirrhosis from 14 tertiary care hepatology centers in North America. A total of 121 patients who required an inpatient thoracentesis (HH group) were compared to 736 patients with refractory ascites without HH, and t