Screening and diagnosis

Classification and risk stratification

Perioperative care

Quality improvement

Patient education

Nonpharmacologic interventions

Therapeutic procedures

Respiratory support

Follow-up and surveillance

Specific circumstances

Preventative measures

Medical management

Surgical interventions

Inpatient care

Diagnostic procedures

Diagnostic investigations

Insufficient evidence to make a recommendation.

Strongly favor this test or intervention.

The Child-Pugh score, also known as the Child-Turcotte-Pugh score, is a clinical calculator used to assess the prognosis of chronic liver disease, primarily cirrhosis. It is specifically designed for patients with liver cirrhosis and helps to determine the severity of the disease, predict mortality, and guide treatment decisions. 

The score is calculated based on five clinical measures: total bilirubin, serum albumin, prothrombin time or INR, ascites, and hepatic encephalopathy. Each of these parameters is scored 1-3 points, and the total score classifies the patient into one of three classes (A, B, or C) with increasing severity and mortality risk.

The Child-Pugh score is not applicable to patients without liver cirrhosis or those with acute liver disease. It also may not be accurate in patients with certain co-existing conditions that can affect the scoring parameters, such as hemolysis affecting bilirubin levels or coagulopathy affecting prothrombin time.

Child-Pugh score for mortality in liver cirrhosis

# Criteria
 ## Total bilirubin
A. < 2 mg/dL [< 34.2 mcmol/L] (+1)
B. 2-3 mg/dL [34.2-51.3 mcmol/L] (+2)
C. > 3 mg/dL [> 51.3 mcmol/L] (+3)
## Albumin
D. > 3.5 g/dL [> 35 g/L] (+1)
E. 2.8-3.5 g/dL [28-35 g/L] (+2)
F. < 2.8 g/dL [< 28 g/L] (+3)
## International normalized ratio
G. < 1.7 (+1)
H. 1.7-2.2 (+2)
I. > 2.2 (+3)
## Ascites
J. Absent (+1)
K. Slight (+2)
L. Moderate (+3)
## Encephalopathy
M. No (+1)
N. Grade 1-2 (+2)
O. Grade 3-4 (+3)

# Conditions
- score <= 6
- score == 7
- score == 8
- score == 9
- score >= 10
- score == 0