Child-Pugh Score

The Child-Pugh Score, also known as the Child-Turcotte-Pugh Score, is a fundamental prognostic classification system used clinically to assess the severity and prognosis of chronic liver disease, most notably cirrhosis. It is also crucial for predicting perioperative mortality and guiding therapeutic decisions. The score is calculated based on five parameters, two clinical and three laboratory: hepatic encephalopathy (assessing the degree of neurological dysfunction), ascites (assessing abdominal fluid accumulation), and the serum levels of bilirubin, albumin, and the prothrombin time (or, more commonly today, the INR - International Normalized Ratio). Each of these parameters is assigned a score of 1, 2, or 3, based on predefined thresholds indicating increasing severity. The total sum of these points, ranging from 5 to 15, classifies patients into three distinct prognostic classes: Class A (5-6 points), indicating well-compensated liver disease and the best prognosis; Class B (7-9 points), indicating significant functional impairment; and Class C (10-15 points), indicating severely decompensated disease with the worst prognosis. This classification has direct implications for patient management, being used to determine the need for liver transplant listing and to adjust the dosage of drugs that are metabolized by the liver to avoid toxicity.