Child-Pugh Score
Assesses severity of chronic liver disease and cirrhosis. Guides prognosis and surgical risk.
How to use & interpret
The Child-Pugh score grades the severity of chronic liver disease (cirrhosis) using bilirubin, albumin, INR, ascites and hepatic encephalopathy, classifying patients as A (5–6), B (7–9) or C (10–15).
Class A is well-compensated; class C carries the worst prognosis. It is widely used to estimate peri-operative and procedural risk and to guide drug dosing/avoidance in liver impairment. Two of its components (ascites, encephalopathy) are subjective, which is why MELD is preferred for transplant allocation.
Score interpretation
Score 5–6: Class A — Well-compensated cirrhosis. 1-year survival ~100%.
→ Regular surveillance (AFP + USS 6-monthly). Endoscopy screening for varices. Liver transplant assessment if appropriate.
Score 7–9: Class B — Significant functional compromise. 1-year survival ~80%.
→ Hepatology specialist management. Consider liver transplant referral. Manage complications.
Score 10–15: Class C — Decompensated cirrhosis. 1-year survival ~45%.
→ Urgent liver transplant assessment. Aggressive management of decompensation. Palliative care discussion.
Interpretation bands for the Child-Pugh. Apply clinical judgement and local guidance.
Frequently asked questions
Child-Pugh or MELD?
Child-Pugh is convenient for bedside prognosis, surgical-risk discussion and drug dosing; MELD is objective and better for transplant prioritisation and short-term mortality. They are complementary.
References
- Child CG, Turcotte JG. Surgery and portal hypertension. In: The Liver and Portal Hypertension. 1964.
- Pugh RN et al. Transection of the oesophagus for bleeding oesophageal varices. Br J Surg. 1973.
Related
Curated clinical cross-links plus same-class fallbacks.
- Propranolol (Portal Hypertension) · Antihypertensive
- Carvedilol (Portal Hypertension) · Non-Selective Beta-Blocker with Alpha₁-Blocking Activity
- Amlodipine · Dihydropyridine Calcium Channel Blocker — Raynaud's / Peripheral Vascular Disease / Hypertension
- Selexipag · Pulmonary Arterial Hypertension
- Macitentan · Pulmonary Arterial Hypertension
- Methotrexate (Dermatology — Psoriasis) · Disease-Modifying Antirheumatic / Immunosuppressant
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.