ChildPughskåre

The ChildPughskåre, more commonly known as the Child-Pugh score or Child-Pugh-Turcotte score, is a clinical tool used to assess the prognosis of chronic liver disease, particularly cirrhosis. It combines five parameters that reflect liver function and portal hypertension: total bilirubin, serum albumin, prothrombin time or international normalized ratio (INR), ascites, and hepatic encephalopathy.

Each parameter is assigned a grade of 1 to 3, with higher scores indicating greater severity. The sum of the five grades yields a total score ranging from 5 to 15. Based on the total, patients are categorized into three classes: Class A (5–6) indicates well-compensated disease, Class B (7–9) indicates significant functional compromise, and Class C (10–15) indicates decompensated disease with a poorer prognosis. A higher Child-Pugh score correlates with shorter expected survival and greater risk from procedures.

Uses and limitations: The score is commonly used to estimate prognosis, guide management decisions, and help assess risk for surgical procedures or liver transplantation in some settings. It is often employed alongside other scoring systems, such as the Model for End-Stage Liver Disease (MELD), for transplant prioritization. Limitations include subjective elements (ascites and encephalopathy grading) with interobserver variability, influence from diuretics and treatments, and reduced accuracy in acute liver failure or non-hepatic surgical risk assessment. Despite its age, the Child-Pugh score remains a practical, widely used tool in hepatology for contextualizing disease severity and guiding treatment strategies.