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What Is the Child-Pugh Score?

By Debra Barnhart
Updated Jan 22, 2024
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Named after its developers, the Child-Pugh score, also known as the Child-Turcotte-Pugh score, is a test that determines the scope and severity of liver failure as well as the prognosis for the patient. This test is used by doctors to evaluate different characteristics of liver function and to assess the degree of cirrhosis, or scarring of the liver. Three categories, or grades, on the Child-Pugh score are used to measure acuteness of liver disease. The liver is vital to the healthy function of the human body and liver disease can be caused by a variety of conditions.

Physicians can gauge different properties of liver performance with the Child-Pugh score, including the degree to which liver breakdown has impacted memory and other brain functions, how much fluid has accumulated in the abdominal cavity, and the likelihood of spontaneous bleeding. These conditions can be symptomatic of liver failure. The Child-Pugh score also measures the excretion of bilirubin, which is the byproduct of old bloods cells broken down by the liver. Blood-clotting factors and albumin production are also measured with this test. Albumin or serum albumin is a protein manufactured by the liver, and it helps to move molecules through the blood.

Three categories — A, B and C — indicate the severity of liver breakdown on the Child-Pugh rating scale. The designation of A indicates that liver disease has not significantly impacted brain function, blood clotting factors, or retention of fluids in the abdomen. Designation of category C means that the liver is clearly impaired and many of the body’s systems are affected.

Chronic liver disease causes cirrhosis, which is a condition where healthy liver tissue is replaced with scar tissue. With severe disease the liver loses its capacity to perform needed body functions. Many people associate cirrhosis with alcoholism, but cirrhosis can sometimes be triggered by a toxin build up resulting from ingestion of a prescription or over-the-counter drug. Hepatitis B and C as well as genetic conditions affecting the metabolism can also damage the liver. Hepatocellular carcinoma, the most common type of liver cancer, occurs only when cirrhosis of the liver is present.

The liver is vital to many body functions. It is responsible for screening blood coming from the digestive tract and filtering out toxins. Bile, produced as a byproduct of the liver’s detoxification process, goes back in the intestines to be expelled in waste. The liver also produces chemicals needed for digestion and helps to regulate the clotting of blood.

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