Child-Pugh Score

Aka: Child-Pugh Score

I. Indications

1. Evaluating prognosis in Cirrhosis

II. Criteria

1. Total Serum Bilirubin
   1. Bilirubin <2 mg/dl: 1 point
   2. Bilirubin 2-3 mg/dl: 2 points
   3. Bilirubin >3 mg/dl: 3 points
2. 
   Serum Albumin
   
   1. Albumin >3.5 g/dl: 1 point
   2. Albumin 2.8 to 3.5 g/dl: 2 point
   3. Albumin <2.8 g/dl: 3 point
3. INR
   1. INR <1.70: 1 point
   2. INR 1.71 to 2.20: 2 point
   3. INR >2.20: 3 point
4. 
   Ascites
   
   1. No Ascites: 1 point
   2. 
      Ascites controlled medically: 2 point
   3. 
      Ascites poorly controlled: 3 point
5. Encephalopathy
   1. No Encephalopathy: 1 point
   2. Encephalopathy controlled medically: 2 point
   3. Encephalopathy poorly controlled: 3 point
    
   
   

   III. Interpretation
   

   1. Child Class A: 5 to 6 points
      1. Life expectancy: 15 to 20 years
      2. Abdominal surgery peri-operative mortality: 10%
   2. Child Class B: 7 to 9 points
      1. Indicated for liver transplantation evaluation
      2. Abdominal surgery peri-operative mortality: 30%
   3. Child Class C: 10 to 15 points
      1. Life expectancy: 1 to 3 years
      2. Abdominal surgery peri-operative mortality: 82%