Healthcare & Clinical Calculators
CLIF-C AD Score: Acute Decompensation of Cirrhosis (Non-ACLF 90-Day Risk)
Calculate Rajiv Jalan et al.’s (2015) EASL-CLIF Acute Decompensation score = 10 * (0.03*Age + 0.66*LN(Cr) + 1.71*LN(INR) + 0.88*LN(WBC) - 0.05*Na + 8) for hospitalized cirrhotic patients without ACLF.
Stratifying hospitalized cirrhosis WITHOUT organ failure—catching the >= 60 high-mortality group early!
Most cirrhotic patients admitted for ascites, GI hemorrhage, or overt encephalopathy do NOT initially meet Acute-on-Chronic Liver Failure (ACLF) organ-failure criteria—yet a subset deteriorates rapidly within 90 days! Rajiv Jalan et al. (Journal of Hepatology, 2015 — EASL-CLIF Consortium) derived the CLIF-C AD score (0–100 scale) specifically for non-ACLF Acute Decompensation: CLIF-C AD = 10 * (0.03 * Age_years + 0.66 * LN(Creatinine_mg_dL) + 1.71 * LN(INR) + 0.88 * LN(WBC_10^9_L) - 0.05 * Sodium_mmol_L + 8), outperforming MELD, MELD-Na, and Child-Pugh for 3-month and 1-year mortality!
EASL guidelines separate low-risk ward discharge candidates (CLIF-C AD <= 45, < 2% 90-day mortality) from high-risk close-monitoring/ACLF-progression patients (CLIF-C AD >= 60, ~30% 90-day mortality): a 62-year-old patient with Cr = 1.4 mg/dL, INR = 1.6, WBC = 9.8 × 10^9/L, and Na = 132 mmol/L scores 62.9 (>= 60 High Risk), vs. 45.0 when Cr = 0.9, INR = 1.1, WBC = 5.5, and Na = 139!
| Hospitalized Non-ACLF Cirrhosis Profile (Age = 62) | CLIF-C AD Score | EASL 90-Day Prognostic Tier |
|---|---|---|
| Cr 0.9, INR 1.1, WBC 5.5, Na 139 | 45.0 (<= 45) | Low 90-Day Mortality Risk (<= 45 — < 2% Mortality) |
| Cr 1.4, INR 1.6, WBC 9.8, Na 132 | 62.9 (>= 60) | High 90-Day Mortality Risk (>= 60 — ~30% Mortality) |
| Zero/Negative Lab Input | "Invalid CLIF-C AD Inputs" | Logarithm Domain Guard |
CLIF-C AD Continuous Prognostic Score (EASL-CLIF Equation)
Evaluates 10 * (0.03*B2 + 0.66*LN(B3) + 1.71*LN(B4) + 0.88*LN(B5) - 0.05*B6 + 8) across Age B2 (years), Creatinine B3 (mg/dL), INR B4, WBC B5 (× 10^9/L), and Sodium B6 (mmol/L).
=IF(OR(B2 <= 0, B3 <= 0, B4 <= 0, B5 <= 0, B6 <= 0), "Invalid CLIF-C AD Inputs", ROUND(10 * (0.03 * B2 + 0.66 * LN(B3) + 1.71 * LN(B4) + 0.88 * LN(B5) - 0.05 * B6 + 8), 1))EASL-CLIF 90-Day Mortality Risk Tier (<= 45, 45.1–59.9, >= 60)
Stratifies CLIF-C AD into Low Risk (<= 45), Intermediate Risk (45.1–59.9), and High Risk (>= 60).
=IF(OR(B2 <= 0, B3 <= 0, B4 <= 0, B5 <= 0, B6 <= 0), "Invalid CLIF-C AD Inputs", IF(ROUND(10 * (0.03 * B2 + 0.66 * LN(B3) + 1.71 * LN(B4) + 0.88 * LN(B5) - 0.05 * B6 + 8), 1) >= 60, "High 90-Day Mortality Risk (>= 60 — ~30% Mortality)", IF(ROUND(10 * (0.03 * B2 + 0.66 * LN(B3) + 1.71 * LN(B4) + 0.88 * LN(B5) - 0.05 * B6 + 8), 1) <= 45, "Low 90-Day Mortality Risk (<= 45 — < 2% Mortality)", "Intermediate 90-Day Risk (45.1–59.9)")))Try the example
Use the original values or change them to test your understanding.