Healthcare & Clinical Calculators
CLIF-C ACLF Score (Acute-on-Chronic Liver Failure 28-Day Mortality)
Calculate Jalan et al.’s (2014) EASL-CLIF Consortium ACLF prognostic score = 10 * (0.33 * CLIF-OF + 0.04 * Age + 0.63 * LN(WBC_10^9_L) - 2) from CLIF-Organ Failure subscore (6–18), age, and leukocyte count.
Outperforming MELD and MELD-Na in Acute-on-Chronic Liver Failure by combining 6-organ failure with systemic inflammation!
In cirrhotic patients hospitalized with Acute-on-Chronic Liver Failure (ACLF), MELD ignores extrahepatic respiratory, circulatory, cerebral, and systemic inflammatory failure! Rajiv Jalan et al. (Journal of Hepatology, 2014 — EASL-CLIF Consortium CANONIC Study) derived and validated the CLIF-C ACLF score (0–100 scale): CLIF-C ACLF = 10 * (0.33 * CLIF-OF + 0.04 * Age_years + 0.63 * LN(WBC_10^9/L) - 2), where CLIF-OF (6 to 18 points) sums 1-to-3 subscores across liver, kidney, brain, coagulation, circulation, and lungs!
Evaluate a 56-year-old ACLF Grade 2 patient with CLIF-OF = 11 and white blood cell count WBC = 14.5 × 10^9/L: CLIF-C ACLF = 10 * (3.63 + 2.24 + 1.6847 - 2) = 55.5 (high 28-day transplant-free mortality risk; whereas stabilization to CLIF-OF = 8 and WBC = 8.2 × 10^9/L lowers the score to 42.1, whereas persistent Day 3–7 scores >= 64–70 signal potential ICU futility without urgent transplant)!
| Clinical Trajectory (Age = 56 y) | CLIF-OF (6–18) | WBC (× 10^9/L) | CLIF-C ACLF Score & Prognosis |
|---|---|---|---|
| Stabilized Early ACLF-1 | 8 | 8.2 | 42.1 (Lower Risk < 45 — Medical Stabilization) |
| Active Multi-Organ ACLF-2 | 11 | 14.5 | 55.5 (High 28-Day Mortality — Urgent Transplant Eval) |
| Refractory ACLF-3 (>= 65 Threshold) | 16 | 22.0 | 74.7 (Critical >= 65 — Assess Day 3–7 ICU Futility) |
CLIF-C ACLF Prognostic Score (EASL-CLIF Equation)
Evaluates 10 * (0.33 * B2 + 0.04 * B3 + 0.63 * LN(B4) - 2) across CLIF-OF total B2 (6–18), patient age B3 (years), and WBC count B4 (× 10^9/L).
=IF(OR(B2 < 6, B2 > 18, B3 <= 0, B4 <= 0), "Invalid CLIF-C ACLF Inputs", ROUND(10 * (0.33 * B2 + 0.04 * B3 + 0.63 * LN(B4) - 2), 1))CLIF-C ACLF Risk & Transplant-Urgency Stratification
Classifies CLIF-C ACLF into Lower Risk (< 45), High Risk (45 to < 65), and Critical / Potential ICU Futility Review (>= 65).
=IF(OR(B2 < 6, B2 > 18, B3 <= 0, B4 <= 0), "Invalid CLIF-C ACLF Inputs", IF(10 * (0.33 * B2 + 0.04 * B3 + 0.63 * LN(B4) - 2) >= 65, "Critical Mortality Risk (CLIF-C ACLF >= 65)", IF(10 * (0.33 * B2 + 0.04 * B3 + 0.63 * LN(B4) - 2) >= 45, "High 28-Day Mortality Risk (45–64.9 — Urgent Transplant Eval)", "Lower ACLF Mortality Tier (< 45)")))Try the example
Use the original values or change them to test your understanding.