Fig. 1

Flow chart of the study design. ACLF was diagnosed and graded according to the criteria of the APASL ACLF Research Consortium (AARC). Eighty-six patients (21 patients from the derivation cohort and 65 from the validation cohort) had no baseline data of lactate and were excluded. Survival status (or hospital mortality, whichever occurred sooner) was identified using follow-up for 90 days after admission. Abbreviations: ACLF, acute-on-chronic liver failure; HBV-ACLF, hepatitis b related ACLF; AARC, Asian Pacific Society for the Study of the Liver ACLF research consortium