How to Manage a Patient on the Floor

ACLF is essentially cirrhosis that's decompensated plus another organ system. In Europe and North America predominantly the most common causes now of cirrhosis are alcohol, non-alcoholic fatty liver disease and viral hepatitis like hepatitis C which tends to be on the decline with the new treatments. The European cliff definition has actually been derived from a previous critical care score so SOPHIS scores tend to follow that line. If for example you have either non-neurologic or non-renal extra hepatic organ failure that you need to at least have mild hepatic and cathalopathy.