14 September 2016 (Wednesday) - Pugh Scoring

Whilst authorising some coagulation results today I saw a diagnosis of “for Pugh score”. This was a new one to me. So I had a look at that font of all wisdom; Wikipedia.

Apparently 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 score employs five clinical measures of liver disease. Each measure is scored 1-3, with 3 indicating most severe derangement.

Measure
1 point
2 points
3 points
Total bilirubin, μmol/L (mg/dL)
<34 (<2)
34-50 (2-3)
>50 (>3)
Serum albumin, g/dL
>3.5
2.8-3.5
<2.8
INR
<4.0
4.0-6.0
> 6.0
Ascites
None
Mild (or suppressed with medication)
Moderate to Severe (or refractory)
Hepatic encephalopathy
None
Grade I-II
Grade III-IV


Chronic liver disease is classified into Child-Pugh class A to C, employing the added score from above.

Points
Class
One year survival
Two year survival
5-6
A
100%
85%
7-9
B
81%
57%
10-15
C
45%
35%



One lives and learns…. Which is why we do CPD…


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