Child-Pugh Score (Liver Cirrhosis)
Liver cirrhosis severity and survival prognosis assessment.
About this calculator
The Child-Pugh score grades cirrhosis severity and predicts survival. Developed by Child and Turcotte (1964), modified by Pugh (Br J Surg, 1973). Uses 5 parameters: total bilirubin, albumin, prothrombin time or INR, ascites, hepatic encephalopathy. Each scored 1-3 points; total 5-15. Classes. A (5-6) – compensated cirrhosis, 1-year survival 100%, 2-year 85%. B (7-9) – subcompensated, 1-year 80%, 2-year 60%. C (10-15) – decompensated, 1-year 45%, 2-year 35%. Clinical use. Stratification before elective surgery in cirrhosis: class A – most surgeries tolerated, B – elevated risk requiring nutritional and coagulation correction, C – elective surgery contraindicated except liver transplantation. Drug dosing: in class B-C many hepatically cleared drugs require dose reduction or substitution (midazolam, lidocaine, direct anticoagulants). Transplant listing. Until 2002 Child-Pugh was the main selection criterion, now replaced by MELD/MELD-Na in US and Europe due to better discrimination in decompensated patients. Child-Pugh retains a role in overall clinical assessment and surgical risk decisions. Limitations. Subjective components – ascites and encephalopathy graded clinically, not reproducible across centers. Does not distinguish alcoholic, viral, autoimmune cirrhosis with different trajectories. In patients with TIPS, ascites may resolve but prognosis remains poor – the score underestimates risk.
Source
Formula version: child-pugh-1973-v1
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