AARC-ACLF score
The APASL ACLF Research Consortium (AARC) score grades acute-on-chronic liver failure as defined by APASL: jaundice (bilirubin 85 µmol/L or more) and coagulopathy (INR 1.5 or more) complicated within 4 weeks by ascites and/or encephalopathy. Five variables each score 1 to 3.
Enter the values above.
Points
| Points | Bilirubin | Encephalopathy | INR | Lactate (mmol/L) | Creatinine |
|---|---|---|---|---|---|
| 1 | Below 257 µmol/L (15 mg/dL) | None | Below 1.8 | Below 1.5 | Below 62 µmol/L (0.7 mg/dL) |
| 2 | 257 to 428 µmol/L (15 to 25 mg/dL) | Grade 1 or 2 | 1.8 to 2.5 | 1.5 to 2.5 | 62 to 133 µmol/L (0.7 to 1.5 mg/dL) |
| 3 | Above 428 µmol/L (25 mg/dL) | Grade 3 or 4 | Above 2.5 | Above 2.5 | Above 133 µmol/L (1.5 mg/dL) |
Grade I is a score of 5 to 7, grade II 8 to 10 and grade III 11 to 15. Short-term mortality rises with the grade. Reassess the score over the first week, as a rising score predicts a worse outcome.
References
Choudhury A, Jindal A, Maiwall R, et al. Liver failure determines the outcome in patients of acute-on-chronic liver failure (ACLF): comparison of APASL ACLF research consortium (AARC) and CLIF-SOFA models. Hepatol Int. 2017;11(5):461-471.
Sarin SK, Choudhury A, Sharma MK, et al. Acute-on-chronic liver failure: consensus recommendations of the Asian Pacific association for the study of the liver (APASL): an update. Hepatol Int. 2019;13(4):353-390.