ChildPugh

The Child-Pugh score, also known as the Child-Pugh-Turcotte score, is a clinical scoring system used to assess the prognosis of chronic liver disease and to estimate hepatic reserve. It was developed in the 1960s to predict survival in cirrhosis and has since become a standard tool in hepatology. The score combines widely available laboratory tests with clinical assessments to provide a practical measure of liver function.

Five parameters are scored 1 to 3 points each: bilirubin, albumin, prothrombin time (or INR), ascites, and hepatic encephalopathy. The total score ranges from 5 to 15 points. Based on the total, patients are categorized into three classes: Class A (5–6 points) indicates well-compensated disease; Class B (7–9) indicates significant functional compromise; and Class C (10–15) indicates advanced liver failure with poor prognosis.

The Child-Pugh classification is used to guide management decisions, including surgical risk, anesthesia considerations, and treatment planning for liver-related procedures. It has historically informed organ transplant prioritization, although the Model for End-Stage Liver Disease (MELD) score now plays a larger role in listing for transplantation in many settings.

Limitations include subjectivity in grading ascites and encephalopathy, inter-observer variability, and reliance on static measurements that may not reflect rapid changes in liver function. It is less accurate for acute liver failure and some non-cirrhotic conditions. Nevertheless, the Child-Pugh score remains a simple, widely used indicator of hepatic reserve and prognosis, frequently used in combination with other scoring systems.