Child Pugh Score Calculator

The Child-Pugh calculator is the tested tool that tells you the conditions of liver disease and the strength of the required treatment. It calculates the Child-Pugh score to determine the child’s Pugh class through which the probability of survival can be estimated.

Evidence-Based Studies regarding child Pugh score:

Case study 1:

A qualitative study was conducted in April 2014 using the child Pugh score calculator. 38 cases with the malfunctioned liver and surgery requirements were included. The Child-Pugh score included five clinical features to assess the conditions. Its three factors assessed the synthetic function of the liver and two were responsible for the clinical assessment.

A clear picture came out with the assistance of the child Pugh classification. 7 patients were included in Class A with a 29% effective mortality rate, while Class B included 13 patients with 38% and class C included 18 patients with an 88% operative mortality rate. Moreover, with the help of Childs Pugh score chances of death within 30 days after surgery were calculated. Since the publication of research, this cps has undergone many improvements and now use to measure the severity and to predict the survival chance.

Case study2:

In another research Child-Pugh score has been confirmed to predict the accurate rate of death after surgery. It came out that a 10% mortality rate present in class A patient; 30% mortality rate is present in class B patients, and 70 to 80% presence of mortality rate in class C patient. Based on these findings it was concluded that class A patients are safe for surgery and after some treatment surgery can be performed for class B patients. Surgery was not recommended for class C patients.

About child Pugh score:

This child Pugh calculator includes five variables (bilirubin, albumin, ascites, encephalopathy and nutritional status). Each variable has its respective cut-off values to define three separate groups (A, B and C) according to the conditions of severity. The final child Pugh score is the addition of these points and ranges from 5 to 15. It is normally acknowledged that patients who gained score between 5 and 8 will be placed in group A, patients with a score from 9 and 11 have their place in group B and group C have a score range between 12 and 15.

Child-Pugh chart:

Child-Pugh classification:

With the assistance of this tool the child Pugh classification is as follow:

• If the overall score comes between 5–6 then Grade A will be assigned that represents a well-handled disease condition.
• If the overall score comes between 7–9 then Grade B will be assigned that represents a moderate disease condition.
• If the overall score comes between 10–15 then Grade C will be assigned that represents a dangerous liver condition.

About child Pugh calculator:

It is very essential to determine the conditions of a patient who is going through from liver ailments. The outcomes via this tool also suggest the survival rate of the patients based on their health status. This childs pugh calculator calculates the final points, class and life expectancy of the patients without any external assistance.

How to use this child’s Pugh score calculator?

CPS Calculator helps you to calculate the scores 100% free. This tool is simple to use just open it and follow the simple steps explained below to get the final score class survival probability and life expectancy:

Input 1: Bilirubin (Total)

Three following options will be given. You have to select one according to the results of your latest levels.

• mg/dL (<34.2 µmol/L)
• 2-3 mg/dL (34.2-51.3 µmol/L)
• >3 mg/dL (>51.3 µmol/L)

Input 2: Albumin

Three following options will be given. Select the accurate one according to present condition:

• 3.5 g/dL (>35 g/L)
• 2.8-3.5 g/dL (28-35 g/L)
• <2.8 g/dL (<28 g/L)

Input 3: INR

Choose your current ratio from the given ranges:

• <1.7
• 1.7-2.2
• 2.2

Input 4: Ascites

Click the appropriate levels according to your reportfrom the following:

• Absent
• Slight
• Moderate

Input 5: Encephalopathy

Choose one according to psychometric testing:

• No Encephalopathy
• Grade 1-2
• Grade 3-4

Output:

Once you have entered all the above factors just hit the calculate button at the end of the calculator. The next box will display the results automatically in the blink of an eye. As it is a child score calculator so at the end a two-digit child Pugh score will be assigned that will decide the following elements.

• Child Class will come out on the basis of attained scores.
• Life Expectancy will be given in years. It means that the calculator gives you a hint about the remaining years of life after the disease.
• Abdominal surgery peri-operative mortality range will be given in percentage. It is the chance of survival within one month after surgery. It is the hint about the success of the surgery.
• One-year survival probability will be given. It means that how much chances are there for you to survive one year despite the disease.
• As a last output two-year survival probability will be given. It means that how much chances are there for you to survive two years despite the disease.

You can copy the results directly to enter in Pugh chart. Moreover, if you want to make another calculation just hit the reset button at the end.

Fast Facts about child Pugh calculator:

Levels of required inputs by the calculator can be figured out from the following methods:

• Bilirubin: This tool needs the last bilirubin levels. You can find it via a blood test.
• Albumin: You have to add the accurate albumin value from the latest serum-albumin test.
• INR: It is an international normalized ratio related to thickness and thinness of the blood and require as an input by the calculator. In cirrhosis of the liver, this factor can be very high.
• Ascites: This input is the increase of protein fluids in the body. This is the factor that needs individual assessment and can be determined by ultrasound.
• Hepatic encephalopathy grade: This is the decline in brain function and can be assessed through psychometric testing. After its assessment, it will be included as the last input.

Child-Pugh score interpretation and items in the child Pugh score:

Once the final child-pugh scores come out via assistance of child Pugh calculator the next step is to interpret the results. This result is interpreted as fit into one of three classes of illness severity.

How to interpret?

According to the score a specific class will be assigned to the patient. Interpretation is described below:

• If you gained 5-6 points you will be placed in class A. Conditions are not much worst and there are 100% chances to survive one-year despite the disease and 85% chances to survive two years.
• If scores came out from 7 to 9 points. Then you are suffering from a moderate level of illness. It gives you a hint that there are 81% chances to survive one year and 57% chances to survive two years.
• 10 to 15 points represent Class C and show severe kind of illness. In such conditions, there are only 45% chances to survive one year and 35% chances to survive two years because of the liver illness.

When to use the Child-Pugh score?

Once the child Pugh score calculator displays the result, it tells us about child class, life expectancy, one and two-year survival probability and Abdominal surgery peri-operative mortality. Therefore, based on the provided information it evaluates the current health state and decides if the surgery is safe for the patient. All those patients who belong to class A are normally considered safe for the surgery. All those who belong to the Class B should first receive treatment to improve their state. Major surgeries will not be recommended for all those patients who belong to group C.

FAQ’s (Child-Pugh Score):

How is the Child-Pugh score calculated?

Scores are determined by including five clinical aspects of liver disease. A score of 1, 2, or 3 is given to each degree.

What is a CTP score?

The Child- Turcotte-Pugh or CTP score is taken into account to assess the severity of cirrhosis that depends on the different parameters:

• Encephalopathy
• Ascites
• Bilirubin (mg/dL)
• Albumin (g/dL)
• PT (sec prolonged) or INR

Can you live a long life with cirrhosis?

Experts reveal that mostly people with cirrhosis that’s found in its early stage can live healthy lives. Remember that if you are overweight or obese and have diabetes, controlling your blood sugar and losing extra pounds can lessen damage that caused by fatty liver disease.

What are the stages of encephalopathy?

According to the West Haven Criteria, the five stages of hepatic encephalopathy are:

• Stage 0 – At this stage of encephalopathy the symptoms are minimal
• Stage 1 – At this stage of encephalopathy the symptoms are mild in which a shortened attention span and changes to sleep habits like hypersomnia or insomnia may include
• Stage 2 – At this stage of encephalopathy the symptoms are moderate, here you may feel disoriented or lethargic
• Stage 3 – At this stage of encephalopathy the symptoms are severe. Indicates you will be unable to perform even the basic tasks. Also, you will feel confused and experience personality changes
• Stage 4 – This is the stage of encephalopathy that is characterized by coma

What is the first sign of cirrhosis of the liver?

Cirrhosis can cause:

• Weakness
• Loss of appetite
• Easy bruising
• Yellowing of the skin (jaundice)
• Itching and Fatigue

Remember that diagnosis of cirrhosis can be recommended by history of an individual, physical examination and blood tests, and can be confirmed by liver biopsy.

Is ascites a sign of death?

Ascites levels are used as an input in the calculator. it involves the gathering of fluid in your body. In patients with larger levels of ascites, chances of dying increase. Its higher levels also increase the risk of heart attack andsevere liver failure.

How long can you live with Stage 2 cirrhosis?

Recovery of the patient always depends on the type of cirrhosis if someone stops drinking. Only half of the total diagnosed patients with severe alcoholic cirrhosis will survive 2 years, but only 35% survive 5 years after the diagnosis. Recovery rate degenerates after the start of complications.

What is Child-Pugh score used for?

It is a system for the assessment of the prognosis. it includes the compulsory strength of treatment and the requirement of the liver transplant.

What is the first sign of cirrhosis of the liver?

Cirrhosis can be the cause of weakness, decreased need to eat, pale skin condition, jaundice, itching on different areas of the body, and severe tiredness. Diagnosis can be made by taking your history, physical examination of the body and different kinds of blood tests. In some cases, biopsy can be performed as well. After the diagnosis on the basis of tests you can have a hint about the present health conditions with the help of child Pugh calculator but it won’t be a tentative calculation. Consultation with medical expert is the most important factor.

Is Pugh B decompensated for kids?

According to the Child-Pugh scores grade B represent the score ranges from 7 – 9 and cirrhosis will be compensated. If the score come out from 10 – 15 then grade C will be assigned and the conditions of the disease will be decompensated.

Takeaway:

This Child-Pugh calculator can be used when a patient has cirrhosis of the liver. It evaluates the suitable conditions for the liver transplant and can be used as a mortality tool kit.

Disclaimer:

This child Pugh calculator is not appropriate for the diagnosis at home. We planned this tool for educational purposes only and the results that you will get with the ease of this tool is just an estimation. So, you should have to consult with your medical expert for healthier advice.

References:

From Wikipedia, the free encyclopedia – child pugh score interpretation

From the source of NCBI – By PMCID: PMC4048310 – PMID: 24906132 – A New Child-Turcotte-Pugh Class 0 for Patients

By International Journal of Vascular Surgery and Medicine – Comparison of MELD and Child-Pugh Score -child-pugh classification

François Durand, M.D.; Dominique Valla, M.D – Assessment of Prognosis of Cirrhosis – DISCLOSURES Semin Liver Dis. 2008;28(1):110-122.