Ineffective hemostasis or a paradoxical prothrombotic state of Acute-on-chronic liver disease (ACLF) has been well established. However, the minor and major bleeding events has not been described yet. We observe the patients' major and minor bleeding events and use 4 criteria, which include BARC, ISTH, TIMI, Gusto ,to evaluate the incident rate of bleeding events in ACLF patients and pre-ACLF patients.

Inclusion Criteria:

• patient with previously or undiagnosed chronic liver disease/cirrhosis;
• serum bilirubin higher than 3 mg/dl (51 mmol/L) or ALT>10ULN（male 300 U/L; female 200 U/L)

Exclusion Criteria:

• those who had or been diagnosed hepatocellular carcinoma or other types of malignancies;
• pregnancy;
• obstructive biliary diseases or other disease lead to bilirubin evaluation;
• using steroid or immunosuppressant in 4 weeks;
• prior surgeries including splenectomy，subtotal splenectomy and disconnection，liver transplantation.
• combine with other disease lead to organ failure including heart failure (NYHA IV),respiratory failure（PaO2<60mmHg),renal insufficiency(CKD 5) and conscious disturbance (GCS<8)

pre-acute-on-chronic liver failure and acute-on-chronic liver failure