ChildPughscore

The ChildPughscore, commonly known as the Child-Pugh score or Child-Pugh-Turcotte score, is a clinical tool used to assess the severity of chronic liver disease and cirrhosis and to estimate patient prognosis. It was originally developed by Child and Turcotte in 1964 and later modified by Pugh and colleagues in 1973. The score remains widely used to help guide treatment decisions, including evaluation for surgery or liver transplantation, and to stratify risk.

The score uses five parameters: bilirubin, albumin, international normalized ratio (INR) or prothrombin time (PT), ascites, and hepatic encephalopathy. Each parameter is assigned 1 to 3 points, giving a total score range of 5 to 15. Higher scores indicate more severe liver dysfunction. Specific thresholds commonly used are: bilirubin, <2 mg/dL = 1, 2–3 mg/dL = 2, >3 mg/dL = 3; albumin, >3.5 g/dL = 1, 3.0–3.5 = 2, <3.0 = 3; INR/PT, INR <1.7 = 1, 1.7–2.3 = 2, >2.3 = 3; ascites, none = 1, mild/moderate = 2, severe/refractory = 3; encephalopathy, none = 1, grade I–II = 2, grade III–IV = 3.

Interpretation classifies total scores as: A (5–6), B (7–9), and C (10–15), with progressively worse prognosis from A to C. Limitations include subjectivity in grading ascites and encephalopathy, nonlinearity of the scale, and reduced applicability in acute liver failure. In contemporary practice, the Child-Pugh score complements other systems like the MELD score for transplantation prioritization and risk assessment.