Objectiv To investigate the prognostic factors of adult patients with acute liver failure through a retrospective cross-sectional study.Methods Retrospectively collected A three armour hospital of hunan province from 2020 to 2023 were analyzed the clinical data of patients with acute liver failure.By t test and chi-square test and rank and inspection to the single factor analysis of indicators,and Logistic regression analysis was carried out on the differences of indicators.Results Among the 139 patients,80 patients were improved and 59 patients were not improved.The age of the patients ranged from 19 to 79 years.Univariate analysis showed that the total bile acid,direct bilirubin,and glomerular filtration rate in the improved group were higher than those in the non-improved group,and the creatinine,uric acid,cystatin C,potassium,phosphorus,prothrombin ac-tivity,international standard ratio,and activated partial thromboplastin in the improved group were lower than those in the non-improved group.Logistic regression analysis showed that creatinine(OR=2.92,95%CI:1.13-7.54),total bile acid(OR=0.23,95%CI:0.05-0.95),international standard ratio(OR=8.73,95%CI:2.25-33.86)were the independent influencing factors for acute liver failure.The abnormal increase of creatinine and international standard ratio may increase the risk of disease dete-rioration,and the increase of total bile acids may reduce the risk of disease deterioration.Conclusion Creatinine ratio,total bile acid,international standard is independent impact factors for acute liver failure.Abnormal creatinine and the ratio of interna-tional standard rise may increase the risk of progression of the disease patients,patients with the increase of total bile acid could reduce the risk of deterioration.