Data on demographics, aetiology of cirrhosis (alcohol related liver disease (ARLD) v non-ARLD), Acute Physiology and Chronic Health Evaluation (APACHE) II score, critical care unit and hospital outcome and level of organ support were collected. Results 31,921 patients with cirrhosis were identified in the study period out of 1,208,336 total ICU admissions (2.6%). 11,090 patients were identified as having alcohol as an aetiological factor (34%). 183 patients out of a total 14,200 identified ICU admissions (1.3%) in 1996 had cirrhosis rising

to 4,207 out of 136,351 HTS assay (3.1%, p<0.001) in 2012. Although coverage in the CMP did increase over this time period, the extrapolated numbers show an increase from 1,050 out of 79,800 (1.3%) to 4750 out of 153,600 (3.1%). The crude critical care unit mortality of patients with cirrhosis was 45% in 1996 falling to 31% in 2012 (p<0.001). Crude hospital mortality was 59% in 1996 and fell to 46% in 2012 (p<0.001). Mean (SD) AZD4547 APACHE II score in 1996 was 19.9(8.7)

and was unchanged at 19.5(7.1) in 2012. For patients with cirrhosis secondary to alcohol, crude hospital mortality fell from 69% in 1996 to 58% in 2012 (p<0.001). Mean APACHE II score for patients with ARLD in 2012 was 20.6 (7.0) but lower (19.0 (7.2)) for patients with a non-ARLD. Patients with ARLD had higher peak serum creatinine levels during click here the critical care unit stay (mean (SD) 161(149) μmol/l v 142(130) μmol/l for non-ARLD in 2012). Conclusion The incidence of cirrhosis

in ICU patients is rising but the survival rates for these patients have improved significantly during the last two decades. Patients with cirrhosis secondary to alcohol excess have higher mortality rates which may be partly explained by higher levels of organ failure severity (particularly renal dysfunction). Patients with cirrhosis and organ failure warrant a trial of organ support and prognostic pessimism is not justified. Disclosures: Julia Wendon – Consulting: Pulsion, Excalenz William Bernal – Consulting: Vital Therapies Inc The following people have nothing to disclose: Mark J. McPhail, Francesca Par-rott, David A. Harrison, Kathy M. Rowan Background: Acute on chronic liver failure (ACLF) in hospitalized patients with cirrhosis is associated with multi-system organ failure and poor prognosis, with estimated mortality rates as high as 50%. The nationwide prevalence of hospitalizations for ACLF in the US and the associated economic burden are not known. We aim to determine the costs and in-hospital mortality associated with ACLF in the US. Methods: The National Inpatient Sample was queried between the years 2007-2011 and rates of hospitalization, mortality and costs associated with ACLF were analyzed.