CLIF_C_ACLF_guideline v.1
CLIF-C ACLF (Acute-on-Chronic Liver Failure) score is an assessment score used to predict the risk of mortality in acute-on-chronic liver failure patients.
To calculate CLIF-C ACLF score and predict 1, 3, 6 and 12-month mortality.
To be used in patients with decompensated chronic liver disease and a sign of one or more organ system failure. The CLIF-C ACLF score formula is: 10 x [0.33 x CLIF Organ Failure Score + 0.04 x age, years + 0.63 x ln(WBC count, 109 cells/L) - 2]. CLIF Organ Failure Score is the sum of the points of all variables (organs/systems): Bilirubin (<6 mg/dL = 1pt., 6 to <12 mg/dL = 2pt., ≥12 mg/dL = 3pt.), Creatinine (<2 mg/dL = 1pt., 2 to <3.5 mg/dL = 2pt., ≥3.5 mg/dL = 3pt.), West-Haven Grade for Hepatic Encephalopathy (0 = 1pt., 1-2 = 2pt., 3-4 = 3pt.), INR (<2 = 1pt., 2.0 to <2.5 = 2pt., ≥2.5 = 3pt.), MAP (≥70 = 1pt., <70 = 2pt., Any MAP with vasopressors = 3pt.), PaO2/FiO2 ratio (>300 = 1pt., >200 to 300 = 2pt., ≤200 (or if patient intubated for respiratory failure) = 3pt.) or SpO2/FiO2 ratio (>357 = 1pt., >214 to 357 = 2pt., ≤214 (or if patient intubated for respiratory failure) = 3pt.),
Not to be used to predict acute liver failure.
Jalan R, Saliba F, Pavesi M, Amoros A, Moreau R, Ginès P, Levesque E, Durand F, Angeli P, Caraceni P, Hopf C, Alessandria C, Rodriguez E, Solis-Muñoz P, Laleman W, Trebicka J, Zeuzem S, Gustot T, Mookerjee R, Elkrief L, Soriano G, Cordoba J, Morando F, Gerbes A, Agarwal B, Samuel D, Bernardi M, Arroyo V; CANONIC study investigators of the EASL-CLIF Consortium. Development and validation of a prognostic score to predict mortality in patients with acute-on-chronic liver failure. J Hepatol. 2014 Nov;61(5):1038-47. doi: 10.1016/j.jhep.2014.06.012. Epub 2014 Jun 17. PMID: 24950482. Lee M, Lee JH, Oh S, Jang Y, Lee W, Lee HJ, Yoo JJ, Choi WM, Cho YY, Cho Y, Lee DH, Lee YB, Yu SJ, Yi NJ, Lee KW, Kim YJ, Yoon JH, Suh KS, Lee HS. CLIF-SOFA scoring system accurately predicts short-term mortality in acutely decompensated patients with alcoholic cirrhosis: a retrospective analysis. Liver Int. 2015 Jan;35(1):46-57. doi: 10.1111/liv.12683. Epub 2014 Oct 1. PMID: 25203221. Engelmann C, Thomsen KL, Zakeri N, Sheikh M, Agarwal B, Jalan R, Mookerjee RP. Validation of CLIF-C ACLF score to define a threshold for futility of intensive care support for patients with acute-on-chronic liver failure. Crit Care. 2018 Oct 10;22(1):254. doi: 10.1186/s13054-018-2156-0. PMID: 30305132; PMCID: PMC6180662.
OBSERVATION.basic_demographic.v1, OBSERVATION.clif_c_aclf.v0, OBSERVATION.lab_test-full_blood_count.v1
