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|
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%|
- 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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- 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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