Child-Pugh Score for Cirrhosis Mortality

What is the Child-Pugh score?  

Child-Pugh is the system that is used to evaluate the prognosis. This score is measured to predict the strength of treatment required and the necessity of liver transplant.

The need of this score is when a patient is suffering from liver diseases, primarily cirrhosis. Child-Pugh score is also known as Child-Pugh classification and child criteria. Child scores provide a forecast of the severity of the diseases as well as the expected survival rate according to the condition.

Calculate the Child-Pugh Score

Pugh-child score uses the score of five clinical measures of liver diseases. Each measure is given a score of 1, 2 and 3 where 3 is the most severe one.

The five clinical measure are listed below:

1. Total bilirubin: yellowish compound produced due to hemoglobin breakdown in bile.
2. Serum albumin: production of blood protein in liver
3. Prothrombin time, prolongation: time taken by the blood to clot
4. Ascites: fluid in the peritoneal cavity
5. Hepatic encephalopathy: liver disease causing brain disorder

The requirement to use our online Child’s Calculator

Simple and easy to use you just have to follow these simple steps to calculate Child’s Pugh:

• Measure or see the last measurement of patients Bilirubin and insert it in the provided area. However, you don’t have to convert as both units are available on the calculator.
• Use the last measurement and add the correct albumin range in the field.
• Afterward, choose the right INR range as the parameters can be relentlessly high in case of cirrhosis in the liver.
• Ascites require subjective evaluation. Make sure you remember to take a treatment response in consideration
• Hepatic encephalopathy; consider this according to the situation

Add all the details and the results will pop up in no time. You can use the results to check for the severity of the disease. However, the main purpose of this score is to assess patients with liver cirrhosis.

Interpretation of Child-Pugh score:

• When score is 5 to 6 points
• Least severe liver disease with 95% of survival rate in upcoming one to five years 
• description: well-functioning liver

Class B

• score 7 to 9
• moderate-severe liver diseases with 75% of survival rate in upcoming one to five years
• description: significant functional compromise

Class C

• score 10 to 15 points
• the most severe liver disease with 50% of the survival rate in the upcoming one to five years
• description: decompensation of the liver

Class A is when the condition is normal and the patient’s liver is functioning properly. Class B suggests moderate condition and Class C is when the condition is worst.

Hepatic encephalopathy staging - West Haven criteria

Hepatic encephalopathy is one of the factors to determine Pugh-child score. The term encephalopathy means brain disease or disorder and hepatic is the adjective that indicates that these diseases are due to liver malfunction.

The primary cause of this condition is due to hyperammonemia; high ammonia concentration in blood.

This condition is further categorized into four grades. West Haven criteria is helpful to understand the grade of hepatic encephalopathy. Here are the changes seen in patients according to each class.

Grade I

• Anxiety while sleeping
• Confusion
• Nervousness or ecstasy
• Face issues while solving simple math problems

Grade II

• Inapt behavior changes
• Personality alteration
• Speech difficulty
• Confusion for a time

Grade III- gross disorientation

• Slightly responsive to strong stimuli
• Confusion overtime 
• Somnolence / semistupor

 Grade IV

• Coma
• Unresponsive to any kind of stimuli