Child-Pugh Score for Cirrhosis Mortality: online calculator
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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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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