Child Pugh Score
ADVERTISEMENT
1
2
3Child-Pugh Score
Patient Name: _______________________________
Date: ______________
Measure
1
2 points
3 points
Units
Patient Number
point
Bilirubin
(total)
<2
2-3
>3
mg/dl
Serum albumin
>35
28-35
<28
g/l
INR
<1.7
1.71-2.20
>2.20
no unit
Ascites
None
Mild
Severe
no unit
Hepatic
None
Grade I-II (or suppressed
Grade III-IV (or
no unit
encephalopathy
with medication)
refractory)
Total Points: __________
Class: __________
1
Interpretation
Points
Class
One year survival
Two year survival
5-6
A
100%
85%
7-9
B
81%
57%
10-15
C
45%
35%
2
MELD Score
__________
Encephalopathy Grade ________
3
ECOG
__________
Portal pressure gradient_________ date_________ (below 10 is ideal)
Barcelona Stage __________
Reason for Cirrhosis
ETOH
Viral
HBV/HCV (circle one)
Other _____________________________________________________
Co-morbidities________________________________________________________________________
1
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Medical