Child-Pugh Score: The Complete Clinical Guide
Assessing cirrhosis severity, surgical risk stratification, prognosis, and liver transplant criteria
What Is the Child-Pugh Score?
The Child-Pugh score (originally Child-Turcotte, modified by Pugh in 1973) is a validated scoring system for assessing the severity of chronic liver disease and cirrhosis. It scores five clinical and laboratory parameters — bilirubin, albumin, INR, ascites, and hepatic encephalopathy — each from 1 to 3, giving a total of 5–15 points. This classifies patients into Class A (compensated), B (significant impairment), or C (decompensated) cirrhosis.
Despite the development of the MELD score, Child-Pugh remains widely used for surgical risk stratification, prognostication, and clinical assessment. EASL and NICE guidelines continue to recommend it as part of routine cirrhosis assessment.
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- Child CG, Turcotte JG. Surgery and portal hypertension. Major Probl Clin Surg. 1964;1:1-85.
- Pugh RN, Murray-Lyon IM, Dawson JL, et al. Transection of the oesophagus for bleeding oesophageal varices. Br J Surg. 1973;60(8):646-649.
- EASL Clinical Practice Guidelines on the management of hepatic encephalopathy. J Hepatol. 2022;77(3):807-855.
- NICE NG50. Cirrhosis in over 16s: assessment and management. Updated 2023.
⚠️ Medical Disclaimer: For educational and documentation purposes only. All results must be validated by a qualified hepatologist before clinical use.