EVAL Foundation For practitioners Updated March 22, 2024

Child-Pugh Score for Cirrhosis Mortality

Estimates cirrhosis severity

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GradeDescription
0Normal consciousness, personality, neuro exam, EEG.
1Restless, sleep disturbed, irritable, tremor, impaired handwriting, 5 cps waves
2Lethargic, time-disoriented, inappropriate, asterixis, ataxia, slow triphasic waves
3Somnolent, stuporous, place-disoriented, hyperactive reflexes, rigidity, slower waves
4Unrousable coma, no personality, decerebrate, slow 2-3 cps delta activity

 

Source: FDA

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Reference

Summary

Usage

The Child-Pugh Score estimates cirrhosis severity and can be used to assess the prognosis of patients with cirrhosis. More recent scores, such as the MELD score, provide better prognostic value, and have become more widely used.

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Summary

The Child-Pugh (CTP) Score is obtained by adding the points for each parameter.

 

Parameter1 point2 Points3 Points
AscitesAbsentSlightModerate
EncephalopathyAbsentGrade 1-2Grade 3-4
Bilirubin (mg/dL)< 22 - 3> 3
Albumin (g/dL)> 3.52.8 - 3.5< 2.8
INR< 1.71.7 - 2.3> 2.3

 

Class A (5 - 6 points)

  • Life Expectancy: 15-20 years
  • Abdominal surgery peri-operative mortality: 10%

 

Class B (7 - 9 points)

  • Indication for transplant evaluation.
  • Abdominal surgery peri-operative mortality: 30%

 

Class C (10 - 15 points)

  • Life expectancy: 1-3 years
  • Abdominal surgery peri-operative mortality: 82%
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  • Jennifer Glen , DNP, FNP-BC — EVAL Health, Chief Medical Officer