Mahmud N, et al. - Using both definitions (European Association for the Study of the Liver [EASL] and Asian Pacific Association for the Study of the Liver [APASL]), researchers compared acute-on-chronic liver failure (ACLF) incidence and mortality among a diverse cohort of patients with compensated cirrhosis. From 2008 to 2016, the study sample consisted of patients with incident compensated cirrhosis in the Veterans Health Administration. Data reported that the incidence rate of APASL ACLF was 5.7 per 1,000 person-years, and the incidence rate of EASL ACLF was 20.1. For APASL ACLF, the 28-day and 90-day mortalities were 41.9% and 56.1% respectively, and for EASL ACLF they were 37.6% and 50.4%. Investigators found that patients with hepatitis C or nonalcoholic fatty liver disease had the lowest incidence rates of ACLF but the highest short-term mortality rate. According to this retrospective cohort study, a significant discordance in ACLF events was found by EASL and APASL criteria. Most EASL-alone ACLF patients have preserved liver function, implying the need for more liver-specific criteria for ACLF.