Child–Pugh score

Child–Pugh score is a system used in medicine to assess the prognosis of chronic liver disease, primarily cirrhosis. Although it was originally used in 1973 to predict mortality during surgery, it is now used to determine the prognosis, as well as the required strength of treatment and the necessity of liver transplantation. The score employs five clinical measures of liver disease. Each measure is scored 1-3, with 3 indicating most severe derangement.

Components of the Child–Pugh score

The five components of the Child–Pugh score are:

• Ascites: The accumulation of fluid in the peritoneal cavity, commonly caused by cirrhosis and severe liver disease.
• Hepatic encephalopathy: A syndrome observed in patients with cirrhosis, defined as a spectrum of neuropsychiatric abnormalities in patients with liver dysfunction.
• Bilirubin: A yellow compound that occurs in the normal catabolic pathway that leads to the breakdown of heme in vertebrates.
• Albumin: A family of globular proteins, the most common of which are the serum albumins.
• Prothrombin time: A blood test that measures how long it takes blood to clot.

Scoring

The points are added up and the class is determined:

• Class A: 5-6 points (compensated disease)
• Class B: 7-9 points (significant functional compromise)
• Class C: 10-15 points (decompensated disease)

Clinical use

The Child–Pugh score is used by doctors to determine the prognosis of chronic liver disease, especially cirrhosis. If the score is high, it can indicate a need for liver transplantation. The score is also used to determine the dosage of certain medications.

See also

• MELD score
• Liver disease
• Liver transplantation

References

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