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  Clinical Calculators - Child-Pugh Score  

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.

    >50 micromol/L  
    34 - 50 micromol/L  
    <34 micromol/L  
  Serum Albumin:      
    <28 g/L  
    28 - 35 g/L  
    1.71 - 2.20  
  Hepatic encephalopathy:      
    Grade III - IV (or refractory)  
    Grade I = II (or suppressed with medication)  



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


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Last Update: 31 January 2008