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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