Child-Pugh Score

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About

Grades severity of chronic liver disease using 5 parameters (3 biochemical, 2 clinical), each scored 1–3 points. Total range 5–15. Used for prognosis, surgical risk stratification and drug-dose adjustment in hepatic impairment.

1

Total Bilirubin

— pts

Select a band

1 pt

< 34

Normal / mildly raised

2 pts

34 – 50

Moderately raised

3 pts

> 50

Markedly raised

2

Serum Albumin

— pts

Select a band

1 pt

> 35

Normal

2 pts

28 – 35

Mildly low

3 pts

< 28

Markedly low

3

INR (or PT prolongation)

— pts

Select a band

1 pt

< 1.7

PT < 4 sec prolonged

2 pts

1.7 – 2.3

PT 4 – 6 sec prolonged

3 pts

> 2.3

PT > 6 sec prolonged

4

Ascites

— pts

Clinical assessment

From examination / imaging / response to therapy

1 pt

None

No ascites

2 pts

Mild

Controlled with diuretics

3 pts

Moderate / Severe

Refractory / tense

5

Hepatic Encephalopathy

— pts

West Haven grading

Including effect of any current treatment

1 pt

None

No encephalopathy

2 pts

Grade 1–2

Mild / controlled with medication

3 pts

Grade 3–4

Severe / refractory

✓

Child-Pugh Result

Child-Pugh score
—/ 15

Class

—

Select all five parameters to see the final score, class and prognosis.

A 5–6B 7–9C 10–15

Prognosis

Class A

Score 5–6 · Well-compensated

1-yr survival~100%

2-yr survival~85%

Operative mortality (abd)~10%

Class B

Score 7–9 · Significant compromise

1-yr survival~80%

2-yr survival~60%

Operative mortality (abd)~30%

Class C

Score 10–15 · Decompensated

1-yr survival~45%

2-yr survival~35%

Operative mortality (abd)~70–80%