Exam

Child-Pugh Score

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Child-Pugh Score, Child-Pugh Class, Child-Pugh

  • Indications
  1. Evaluating prognosis in Cirrhosis
  • 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
  • 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%
  • References
  1. Mansour (1997) Surgery 122:730-5 [PubMed]
  2. Propst (1995) Dig Dis Sci 40:1805-15 [PubMed]
  3. Riley (2001) Am Fam Physician 64:1735-40 [PubMed]