Garg et al reported a number of risk factors associated with mortality in patients with acute-on-chronic liver failure (ACLF). The authors are from GB Pant Hospital in New Dehli, India.


Patient selection: acute-on-chronic liver failure


Predictors of mortality:

(1) hepatic encephalopathy

(2) elevated INR (> 2.2) otherwise unexplained

(3) low serum sodium

(4) high total serum bilirubin (>21.7 mg/dL)


Causes of death include:

(1) multi-organ failure

(2) upper gastrointestinal hemorrhage

(3) progressive hepatic failure


Up to two thirds of patients died within 90 days if a liver transplant cannot be provded.


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