Definition

The most widely accepted definition of acute liver failure is:

“Evidence of coagulation abnormality (usually an international normalized ratio (INR) greater than or equal to 1.5) with any degree of mental alteration (encephalopathy) in a patient without pre-existing cirrhosis and with an illness of less than or equal to 26 weeks duration. Hyperacute liver failure has an onset of ≤7 days, acute liver failure 8-28 days and subacute 4-26 weeks.” [1-2]

Acute on chronic liver disease is decompensation of liver function in a patient with chronic liver disease often precipitated by an event such as infection or gastrointestinal (GI) bleed.

Learning bite

It is important to differentiate acute liver failure from decompensation of chronic liver disease as prognosis and treatment differs.