ArticleHepatology international2017
Liver failure determines the outcome in patients of acute-on-chronic liver failure (ACLF): comparison of APASL ACLF research consortium (AARC) and CLIF-SOFA models.
Article in Hepatology international, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 131 papers, 3 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
131 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- [Guidelines for the diagnosis and treatment of acute-on-chronic liver failure (2025 version)].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2025Guideline
- [Guidelines for diagnosis and treatment of liver failure (2024 version)].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2025Guideline
- Pooled it
- A prognostic score for patients with acute-on-chronic liver failure treated with plasma exchange-centered artificial liver support system.Scientific reports · 2021Trial
- Models for acute on chronic liver failure development and mortality in a veterans affairs cohort.Hepatology international · 2020Trial
- Value of Liver Regeneration in Predicting Short-Term Prognosis for Patients with Hepatitis B-Related Acute-on-Chronic Liver Failure.BioMed research international · 2020Trial
- Treatment with carvedilol improves survival of patients with acute-on-chronic liver failure: a randomized controlled trial.Hepatology international · 2019Trial
- Machine learning-based risk factors for acute-on-chronic liver failure in alcohol-associated liver disease.Annals of medicine · 2026Observational
- Predicting 90-day mortality in patients with HBV-ACLF: A comparison of machine learning models and logistic regression.Medicine · 2026Article
- Liver Failure versus Organ Failure in Acute-on-Chronic Liver Failure: Sequence and Consequence.Gut and liver · 2026Article
- Comparative Prognostic Performance of Pretransplant AARC, CLIF-C ACLF, and MELD-Na Scores for 90-Day Mortality After Liver Transplantation in Patients With EASL-CLIF Acute-on-Chronic Liver Failure.Annals of transplantation · 2026Observational
- Acute-On-Chronic Liver Failure With Discordant Severity Assessments Following Binge Drinking: A Case Report.Journal of general and family medicine · 2026Article
- Beyond a Single Snapshot: Inflammatory Markers in Acute-on-chronic Liver Failure.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2026Article
- Rethinking ACLF prognosis: Can machine learning outperform conventional scores?: Editorial on "Predictive machine learning model in intensive care unit patients with acute-on-chronic liver failure and two or more organ failures".Clinical and molecular hepatology · 2026Article
- Severe hepatitis B flare and liver failure: current assessment and management.Clinical and molecular hepatology · 2026Review
- Association between the blood urea nitrogen to albumin ratio and all-cause mortality in critically ill patients with liver cirrhosis.BMC gastroenterology · 2026Article
- A Systemic Inflammation Response Index (SIRI)-based nomogram for predicting the prognosis of hepatitis B virus-related acute-on-chronic liver failure: a retrospective cohort study.BMC gastroenterology · 2026Article
- Acute-on-chronic liver failure and immune dysregulation: Systemic inflammation and immunoparesis paradox.Hepatology communications · 2026Review
- Estimating the ideal pretransplant waiting time for living donor liver transplantation in acute-on-chronic liver failure: a retrospective study.Clinical transplantation and research · 2026Article
- A novel nomogram based on inflammatory indexes for predicting short-term prognosis in acute-on-chronic liver failure: a comparison with classical models.European journal of medical research · 2026Article
71 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
42 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
aimsAcute-on-chronic liver failure (ACLF) is a progressive disease associated with rapid clinical worsening and high mortality. Early prediction of mortality and intervention can improve patient outcomes. We aimed to develop a dynamic prognostic model and compare it with the existing models.
methodsA total of 1402 ACLF patients, enrolled in the APASL-ACLF Research Consortium (AARC) with 90-day follow-up, were analyzed. An ACLF score was developed in a derivation cohort (n = 480) and was validated (n = 922).
resultsThe overall survival of ACLF patients at 28 days was 51.7%, with a median of 26.3 days. Five baseline variables, total bilirubin, creatinine, serum lactate, INR and hepatic encephalopathy, were found to be independent predictors of mortality, with AUROC in derivation and validation cohorts being 0.80 and 0.78, respectively. AARC-ACLF score (range 5-15) was found to be superior to MELD and CLIF SOFA scores in predicting mortality with an AUROC of 0.80. The point scores were categorized into grades of liver failure (Gr I: 5-7; II: 8-10; and III: 11-15 points) with 28-day cumulative mortalities of 12.7, 44.5 and 85.9%, respectively. The mortality risk could be dynamically calculated as, with each unit increase in AARC-ACLF score above 10, the risk increased by 20%. A score of ≥11 at baseline or persisting in the first week was often seen among nonsurvivors (p = 0.001).
conclusionsThe AARC-ACLF score is easy to use, dynamic and reliable, and superior to the existing prediction models. It can reliably predict the need for interventions, such as liver transplant, within the first week.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.