Child-Pugh score — májcirrhosis stádium

Ez az eszköz kizárólag oktatási célra szolgál, és nem jelent vagy helyettesít szakmai tanácsot. Az eszköz nem használható orvosi diagnózis felállítására és/vagy orvosi kezelés nyújtására.

General description
The Child-Pugh score (sometimes the Child-Turcotte-Pugh score) is used to assess the prognosis of chronic liver disease, mainly cirrhosis. Although it was originally used to predict mortality during surgery, it is now used to determine the prognosis, as well as the required strength of treatment and the necessity of liver transplantation. The tool calculates Child-Pugh class and mediated survival rates based on five prognostic factors: total bilirubin, serum albumin, INR, ascites and encephalopathy grade.

Total Bilirubin:
- <2 mg/dL (<34 µmol/L) (1 point)
- 2-3 mg/dL (34-50 µmol/L) (2 points)
- > >3 mg/dL (>50 µmol/L) (3 points)

Serum Albumin:
- >3,5 g/dL (>35 g/L) (1 point)
- 2,8-3,5 g/dL (28-35 g/L) (2 points)
- <2,8 g/dL (<28 g/L) (3 points)

INR:
- < 1,7 (1 point)
- 1,7–2,3 (2 points)
- > 2,3 (3 points)

Ascites:
- Absent (1 point)
- Slight (2 points)
- Moderate (3 points)

Encephalopathy:
- None (1 point)
- Grade 1: Sleep disturbances; impaired concentration; depression, anxiety, or irritability. (2 points)
- Grade 2: Drowsiness; disorientation; poor short-term memory; disinhibited behavior. (2 points)
- Grade 3: Somnolence; confusion; amnesia; anger, paranoia, or other bizarre behavior. (3 points)
- Grade 4: Coma. (3 points)

Child CG, Turcotte JG (1964). "Surgery and portal hypertension". In Child CG. The liver and portal hypertension. Philadelphia: Saunders. pp. 50–64.

Pugh RN, Murray-Lyon IM, Dawson JL, Pietroni MC, Williams R (1973). "Transection of the oesophagus for bleeding oesophageal varices". The British journal of surgery 60 (8): 646–9.

D’Amico G, Garcia-Tsao G, Pagliaro L. Natural history and prognostic indicators of survival in cirrhosis: a systematic review of 118 studies. J Hepatol 2006;44:217–231.

European Association for the Study of the Liver. EASL Clinical Practice Guidelines for the management of patients with decompensated cirrhosis. Journal of Hepatology. 2018;69(2):406–460.