Abstract: Objective The aim of this study was to explore the short-term prognosis of patients with acute on chronic liver failure (ACLF) and invasive fungal infection (IFI) by the model for end-stage liver disease (MELD), MELD-serum sodium (MELD-Na⁺), APASL-ACLF research consortium score (AARC-ACLF) and chronic liver failure-sequential organ failure assessment (CLIF-SOFA). Methods 60 patients with ACLF and IFI were admitted to our hospital between January 2018 and October 2020, and were given convensional supporting therapy. Thescores of MELD, MELD-Na⁺, AARC-ACLF and CLIF-SOFA were calculated. The predictive efficacy of the four prognostic scoring systems for death risk in patients with ACLF and IFI was evaluated by receiver operating characteristic (ROC) curves. Results At the end of 12 week treatment, the fatality rate in our series was 68.3%; serum bilirubin, INR, creatinine and lactate in 41 dead patients at the peak were (362.9±79.7)μmol/L,(2.3±0.2), (131.7±21.5)μmol/L and (1.6±0.4)mmol/L, all significantly higher than [(277.4±63.6)μmol/L, (1.7±0.1), (102.9±15.3)μmol/L and (1.3±0.3)mmol/L, respectively, P＜0.05], while serum albumin level was (29.6±2.2)g/L, significantly lower than [(31.8±2.7)g/L, P＜0.05] in the survivals; the incidence of hepatic encephalopathy was 43.9%, much higher than 10.5% (P＜0.05) in the survivals; the MELD, MELD-Na⁺, CLIF-SOFA and AARC-ACLF scores were (29.1±7.3), (30.4±7.5), (8.7±1.4) and (9.2±1.1), all significantly higher than [(20.7±4.6), (21.9±5.2),(6.8±1.0) and (7.3±0.8), respectively, P＜0.05] in the survivals; the ROC curves analysis showed that the AUC were 0.687, 0.716, 0.893 and 0.884 by MELD, MELD-Na⁺, CLIF-SOFA and AARC-ACLF scores, respectively, in predicting the 12-week death of patients with ACLF AND IFI, when the cut-off-value were set 22.0, 23.0, 8.0 and 8.0, suggesting the CLIF-SOFA and AARC-ACLF scoring system were superior to the other two (P＜0.05). Conclusion We recommend the AARC-ACLF and CLIF-SOFA scoring system in predicting the short-term fatality in patients with ACLF and IFI.

Key words: Acute on chronic liver failure, Invasive fungal infection, APASL-ACLF research consortium score, Prognosis