NACSELD Acute-on-Chronic Liver Failure

NACSELD-ACLF (O'Leary 2018): a count of extrahepatic organ failures (circulatory, brain, renal, respiratory); ≥ 2 defines acute-on-chronic liver failure with sharply lower 30-day survival.

Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.

Example

Circulatory failure
Yes
Brain failure
No
Renal failure
Yes
Respiratory failure
No

Result: NACSELD-ACLF: 2 organ failure(s) — ACLF (>= 2), 30-day survival ~59%.

The tool opens with these values already filled in. Replace them with your own.

What the result means

0-1
Not ACLF; 30-day survival ~93% at 0 failures.
>= 2
ACLF; 30-day survival ~59% (>= 2) to ~19% (4). Circulatory, brain, renal, respiratory failure. A prognostic count, not a treatment order.

What you enter

  • Circulatory failure (shock)
  • Brain failure (grade III–IV encephalopathy)
  • Renal failure (dialysis)
  • Respiratory failure (mechanical ventilation)
How this is calculated

O’Leary JG, Reddy KR, Garcia-Tsao G, et al. NACSELD acute-on-chronic liver failure (NACSELD-ACLF) score predicts 30-day survival in hospitalized patients with cirrhosis. Hepatology. 2018;67(6):2367-2374. Read the source ↗

A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.

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Built by Clay Good. Source on GitHub.