Child-Pugh Score for Cirrhosis Mortality
Estimates cirrhosis severity
Jennifer Glen
Provided by
EVAL Foundation
| Grade | Description |
| 0 | Normal consciousness, personality, neuro exam, EEG. |
| 1 | Restless, sleep disturbed, irritable, tremor, impaired handwriting, 5 cps waves |
| 2 | Lethargic, time-disoriented, inappropriate, asterixis, ataxia, slow triphasic waves |
| 3 | Somnolent, stuporous, place-disoriented, hyperactive reflexes, rigidity, slower waves |
| 4 | Unrousable coma, no personality, decerebrate, slow 2-3 cps delta activity |
Source: FDA
The Child-Pugh Score estimates cirrhosis severity and can be used to assess the prognosis of patients with cirrhosis. More recent scores, such as the MELD score, provide better prognostic value, and have become more widely used.
.Summary
The Child-Pugh (CTP) Score is obtained by adding the points for each parameter.
| Parameter | 1 point | 2 Points | 3 Points |
| Ascites | Absent | Slight | Moderate |
| Encephalopathy | Absent | Grade 1-2 | Grade 3-4 |
| Bilirubin (mg/dL) | < 2 | 2 - 3 | > 3 |
| Albumin (g/dL) | > 3.5 | 2.8 - 3.5 | < 2.8 |
| INR | < 1.7 | 1.7 - 2.3 | > 2.3 |
Class A (5 - 6 points)
- Life Expectancy: 15-20 years
- Abdominal surgery peri-operative mortality: 10%
Class B (7 - 9 points)
- Indication for transplant evaluation.
- Abdominal surgery peri-operative mortality: 30%
Class C (10 - 15 points)
- Life expectancy: 1-3 years
- Abdominal surgery peri-operative mortality: 82%
All questions & possible results
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Bilirubin (Total)
Select one option:
- < 2 mg/dL (< 34.2 µmol/L)
- 2 - 3 mg/dL (34.2 - 51.3 µmol/L)
- > 3 mg/dL (> 51.3 µmol/L)
Albumin
Select one option:
- >3.5 g/dL (> 35 g/L)
- 2.8 - 3.5 g/dL (28 - 35 g/L)
- <2.8 g/dL (< 28 g/L)
INR
Select one option:
- < 1.7
- 1.7 - 2.3
- > 2.3
Ascites
Select one option:
- Absent
- Slight
- Moderate
Encephalopathy
| Grade | Description |
| 0 | Normal consciousness, personality, neuro exam, EEG. |
| 1 | Restless, sleep disturbed, irritable, tremor, impaired handwriting, 5 cps waves |
| 2 | Lethargic, time-disoriented, inappropriate, asterixis, ataxia, slow triphasic waves |
| 3 | Somnolent, stuporous, place-disoriented, hyperactive reflexes, rigidity, slower waves |
| 4 | Unrousable coma, no personality, decerebrate, slow 2-3 cps delta activity |
Source: FDA
Select one option:
- No encephalopathy
- Grade 1-2
- Grade 3-4
Possible results
Child Class B (7-9 pts)
Indication for transplant evaluation.
Abdominal surgery peri-operative mortality: 30%
Consider comparing the Child-Pugh score to another score (like the MELD Score) when there is an unexpectedly high or low score.
Child Class A (5-6 pts)
Life Expectancy: 15-20 years
Abdominal surgery peri-operative mortality: 10%
Consider comparing the Child-Pugh score to another score (like the MELD Score) when there is an unexpectedly high or low score.
Child Class C (10-15 pts)
Life expectancy: 1-3 years
Abdominal surgery peri-operative mortality: 82%
Consider comparing the Child-Pugh score to another score (like the MELD Score) when there is an unexpectedly high or low score.
Literature
- Surgery and portal hypertension. Major Probl Clin Surg. 1964;1:1-85. — Child CG, Turcotte JG.
- Transection of the oesophagus for bleeding oesophageal varices. Br J Surg. 1973 Aug;60(8):646-9. — Pugh RN, Murray-Lyon IM, Dawson JL, Pietroni MC, Williams R.
