Child-Pugh Score for Cirrhosis Mortality: online calculator

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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.

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See Encephalopathy grades


Points 0
* Required

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
AscitesAbsent+ 1
 Slight+ 2
 Moderate+ 3
Encephalopathy
See Encephalopathy grades
No Encephalopathy+ 1
 Grade 1-2+ 2
 Grade 3-4+ 3

Interpretation of results:

Points totalChild ClassLife ExpectancyOne-year survival, %Two-year survival, %Abdominal surgery peri-operative mortality
5-6 pointsChild Class A  15-20 years1008510%  
7-9 points  Child Class B  about 10 years Indication for transplant evaluation  815730%
10-15 pointsChild Class C1-3 years  453582%

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

  1. Child CG, Turcotte JG. Surgery and portal hypertension. In: The liver and portal hypertension. Edited by CG Child. Philadelphia: Saunders 1964:50-64.
  2. 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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