Child-Pugh Score

Child – Pugh Classification

Total Bilirubin :
Serum Albumin :
INR :
Ascites :
Encephalopathy :

Formula :

  1 point 2 points 3 points
Total bilirubin < 2 2-3 > 3
Serum albumin > 3.5 2.8-3.5 < 2.8
INR > 1.7 1.71-2.20 < 2.20
Ascites None Mild Severe
Hepatic encephalopathy None Grade I-II Grade III-IV

The Child-Pugh Score is a scoring system used to determine the prognosis with cirrhosis and need for liver transplantation.

Explanation of Result :
Class A: 5-6
Class B: 7-9
Class C: 10-15

The prognosis worsens going from A->C and is evidenced by worsening decompensation. However, Child’s classification/score has been largely replaced for hepatic transplantation by MELD scoring.

* Please verify all calculations prior to clinical use.

References

  • Child CG, Turcotte JG. Surgery and portal hypertension. Major Probl Clin Surg. 1964;1:1-85. PMID: 4950264.
  • Pugh RN, Murray-Lyon IM, Dawson JL, Pietroni MC, Williams R. Transection of the oesophagus for bleeding oesophageal varices. Br J Surg. 1973 Aug;60(8):646-9. PMID: 4541913.