LiverpoolMedics - Resource for Liverpool Medics - Students Studying Medicine in Liverpool UK

The Child-Pugh Score is used to determine the prognosis of chronic liver disease, in particular cirrhosis. Originally, the Child-Pugh Score was used to predict mortality during surgery however it is now used to assess prognosis and the aggressiveness of treatment, including the value of a liver transplantation. The Child-Pugh Score is classified into Classes A to C, the latter predicting the worst prognosis.

You must give information about all five assessments - bilirubin, albumin, INR, ascites and hepatic encephalopathy - in order to determine the Child-Pugh Score for this patient.

Bilirubin:

>50 micromol/L

34 - 50 micromol/L

<34 micromol/L

Serum Albumin:

<28 g/L

28 - 35 g/L

>35

INR:

>2.20

1.71 - 2.20

<1.71

Ascites:

Severe

Mild

None

Hepatic encephalopathy:

Grade III - IV (or refractory)

Grade I = II (or suppressed with medication)

None

References

Pugh RN, Murray-Lyon IM, Dawson JL, et. al. Transection of the oesophagus for bleeding oesophageal varices. Br J Surg. 1973; 60:646.
Child CG, Turcotte JG. The Liver and Portal Hypertension. Philadelphia, WB Saunders Co. 1964.
Trey C, Burns DG, Saunders SJ. Treatment of hepatic coma by exchange blood transfusion. NEJM. 1966; 274:473.
Guidelines for malaria prevention in travellers from the UK. Public Health England. 2013. Info

Last Update: 31 January 2008