CLIF-C ACLF Calculator
This tool estimates CLIF-C ACLF score using age, white blood cell count, and the six-organ CLIF-OF subscores.
Educational use only. This calculator supports clinical discussion and does not replace physician judgment.
What is acute-on-chronic liver failure (ACLF)?
Acute-on-chronic liver failure is a serious syndrome seen in people with underlying chronic liver disease or cirrhosis who develop sudden decompensation and one or more organ failures. ACLF is associated with high short-term mortality, so early recognition and risk stratification are essential.
Why use a CLIF-C ACLF calculator?
The CLIF-C ACLF model was developed to estimate short-term mortality in patients who already meet ACLF criteria. It combines:
- CLIF-OF score (degree of organ dysfunction/failure across six systems),
- Age, and
- White blood cell count (marker of systemic inflammation).
By putting these elements together, clinicians can better communicate prognosis, triage intensity of care, and reassess trajectory over time.
Formula used in this page
This calculator uses the commonly cited CLIF-C ACLF equation:
CLIF-C ACLF = 10 × (0.33 × CLIF-OF + 0.04 × Age + 0.63 × ln(WBC) − 2)
CLIF-OF is the sum of six organ subscores (each 1-3), and WBC should be entered in ×10⁹/L.
How to interpret the result
General risk framing
- < 45: Lower estimated short-term risk relative to other ACLF patients
- 45-54.9: Intermediate risk
- 55-64.9: High risk
- ≥ 65: Very high risk; urgent multidisciplinary review is critical
Exact mortality percentages vary by cohort, treatment intensity, infection control, transplant access, and ICU resources.
Clinical context matters
No score should be used in isolation. A patient with ACLF needs full bedside assessment including precipitating events (infection, bleeding, alcohol-associated hepatitis, drug injury), dynamic lab trends, hemodynamics, lactate, and response to therapy. Repeat scoring over time is often more informative than one value.
Important limitations
- Input quality determines output quality (unit errors can meaningfully distort estimates).
- Different hospitals may use protocol-specific cutoffs for organ subscores.
- Scores are population-based and do not perfectly predict individual outcomes.
- This tool is not a transplant listing decision engine by itself.
Practical workflow tips
- Calculate at admission, then repeat every 24-48 hours in unstable patients.
- Document assumptions used for organ subscores.
- Discuss results in multidisciplinary rounds (hepatology, critical care, infectious disease, transplant team).
- Use trends to support goals-of-care conversations with patients and families.
Final note
If you are a clinician, use this calculator as a quick bedside companion. If you are a patient or caregiver, please use this page only to understand terminology and ask better questions during medical visits. For urgent concerns, seek emergency medical care.