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9%). Ammonia levels were a significant predictor of HE occurrence, higher HE grades and 30-day mortality (p 0.05; each). The dynamic increase in the ammonia levels over 7days could predict nonsurvivors and progression of HE (p 0.05; each). Ammonia, HE grade, SIRS, bilirubin, INR, creatinine, lactate and age were the independent predictors of 30-day mortality in ACLF patients. HE in ACLF is common and is associated with systemic inflammation, poor liver functions and high disease severity. Ammonia levels are associated with the
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