Child-Pugh Score (Child-Turcotte-Pugh)

The Child-Pugh score is the Pugh modification of the original Child-Turcotte grading, substituting prothrombin time (expressed here as INR) for nutritional status. Each of the five variables contributes 1 to 3 points: total bilirubin (1 pt <2, 2 pts 2-3, 3 pts >3 mg/dL), albumin (1 pt >3.5, 2 pts 2.8-3.5, 3 pts <2.8 g/dL), INR (1 pt <1.7, 2 pts 1.7-2.3, 3 pts >2.3), ascites (none / mild-moderate diuretic-responsive / severe or refractory) and hepatic encephalopathy (none / grade I-II / grade III-IV). The total maps to class A (5-6 points, well-compensated), class B (7-9, significant functional compromise) or class C (10-15, decompensated). The 2022 BCLC strategy additionally stratifies compensated patients with ALBI and AFP, but Child-Pugh remains the most widely embedded liver-function grade in hepatobiliary treatment algorithms. Original bilirubin bands were higher for cholestatic disease (primary biliary cholangitis); the standard bands are used here.