Child-Pugh Score for Cirrhosis Mortality: online calculator

Nataliia Lopina January 12, 2022

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The Child-Pugh Score can be useful in the prognosis of patients with cirrhosis, but more recent scores like the MELD score and MELD-Na have become more used given their better prognostic value.

Estimates cirrhosis severity.

NB! For patients with unexpectedly high or low scores, consider comparing the Child-Pugh score with another score like the MELD Score.

Child-Pugh score for cirrhosis mortality based on addition of assigned points.

Bilirubin (Total)	<2 mg/dL (<34.2 µmol/L)	+ 1
	2-3 mg/dL (34.2-51.3 µmol/L)	+ 2
	>3 mg/dL (>51.3 µmol/L)	+ 3
Albumin	>3.5 g/dL (>35 g/L)	+ 1
	2.8-3.5 g/dL (28-35 g/L)	+ 2
	<2.8 g/dL (<28 g/L)	+ 3
INR	<1.7	+ 1
	1.7-2.2	+ 2
	>2.2	+ 3
Ascites	Absent	+ 1
	Slight	+ 2
	Moderate	+ 3
Encephalopathy See Encephalopathy grades	No Encephalopathy	+ 1
	Grade 1-2	+ 2
	Grade 3-4	+ 3

Interpretation of results:

Points total	Child Class	Life Expectancy	One-year survival, %	Two-year survival, %	Abdominal surgery peri-operative mortality
5-6 points	Child Class A	15-20 years	100	85	10%
7-9 points	Child Class B	about 10 years Indication for transplant evaluation	81	57	30%
10-15 points	Child Class C	1-3 years	45	35	82%

Encephalopathy Grades:

Grade 0: normal consciousness, personality, neurological examination, electroencephalogram
Grade 1: restless, sleep disturbed, irritable/agitated, tremor, impaired handwriting, 5 cps waves
Grade 2: lethargic, time-disoriented, inappropriate, asterixis, ataxia, slow triphasic waves
Grade 3: somnolent, stuporous, place-disoriented, hyperactive reflexes, rigidity, slower waves
Grade 4: unrousable coma, no personality/behavior, decerebrate, slow 2-3 cps delta activity

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Literature

Child CG, Turcotte JG. Surgery and portal hypertension. In: The liver and portal hypertension. Edited by CG Child. Philadelphia: Saunders 1964:50-64.
Pugh RN, Murray-Lyon IM, Dawson JL, Pietroni MC, Williams R (1973). Transection of the oesophagus for bleeding oesophageal varices. The British journal of surgery 60 (8) https://pubmed.ncbi.nlm.nih.gov/4541913/

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