{"id":28847,"date":"2022-06-22T09:58:38","date_gmt":"2022-06-22T07:58:38","guid":{"rendered":"https:\/\/www.inanutshell.ch\/?page_id=28847"},"modified":"2022-06-22T09:58:38","modified_gmt":"2022-06-22T07:58:38","slug":"child-pugh-score","status":"publish","type":"page","link":"https:\/\/www.inanutshell.ch\/en\/digital-doctors-bag\/child-pugh-score\/","title":{"rendered":"Child-Pugh Score"},"content":{"rendered":"<p>The Child-Pugh score is used to classify the severity of chronic liver disease and cirrhosis to estimate prognosis and mortality. Hepatic encephalopathy is graded according to the <a href=\"#child-pugh-west-haven\">West Haven criteria<\/a> (see appendix).<\/p>\n    <div class=\"medical-calculator child-pugh\" id=\"medical-calculator-child-pugh\">\r\n        <form>\r\n            <div class=\"form-group row\">\r\n                <label for=\"medical-calculator-child-pugh-bilirubin\" class=\"col-sm-3 col-form-label\">\r\n                                    Bilirubin\r\n                                <\/label>\r\n                <div class=\"col-sm-9\">\r\n                    <div class=\"input-group mb-2\">\r\n                        <input type=\"text\" name=\"bilirubin\" id=\"medical-calculator-child-pugh-bilirubin\" class=\"form-control\" placeholder=\"< 21\" aria-label=\"Bilirubin\" aria-describedby=\"medical-calculator-child-pugh-bilirubin-unit\" tabindex=\"1\" inputmode=\"decimal\">\r\n                        <div class=\"input-group-append\">\r\n                            <button class=\"btn btn-secondary\" type=\"button\" id=\"medical-calculator-child-pugh-bilirubin-unit\">\u03bcmol\/l \u21cc<\/button>\r\n                        <\/div>\r\n                        <div class=\"invalid-feedback\" id=\"medical-calculator-child-pugh-bilirubin-error\"><\/div>\r\n                    <\/div>\r\n                    <div class=\"form-check\">\r\n                        <input class=\"form-check-input\" type=\"checkbox\" name=\"pbc_psc\" id=\"medical-calculator-child-pugh-pbc-psc\" tabindex=\"2\">\r\n                        <label class=\"form-check-label\" for=\"medical-calculator-child-pugh-pbc-psc\">\r\n                                                            Cholestatic liver disease (PBC, PSC)\r\n                                                    <\/label>\r\n                    <\/div>\r\n                <\/div>\r\n            <\/div>\r\n            <div class=\"form-group row\">\r\n                <label for=\"medical-calculator-child-pugh-albumin\" class=\"col-sm-3 col-form-label\">\r\n                                    Albumin\r\n                                <\/label>\r\n                <div class=\"col-sm-9\">\r\n                    <div class=\"input-group mb-2\">\r\n                        <input type=\"text\" name=\"albumin\" id=\"medical-calculator-child-pugh-albumin\" class=\"form-control\" placeholder=\"40-49\" aria-label=\"Albumin\" aria-describedby=\"medical-calculator-child-pugh-albumin-unit\" tabindex=\"3\" inputmode=\"decimal\">\r\n                        <div class=\"input-group-append\">\r\n                            <button class=\"btn btn-secondary\" type=\"button\" id=\"medical-calculator-child-pugh-albumin-unit\">g\/l \u21cc<\/button>\r\n                        <\/div>\r\n                        <div class=\"invalid-feedback\" id=\"medical-calculator-child-pugh-albumin-error\"><\/div>\r\n                    <\/div>\r\n                <\/div>\r\n            <\/div>\r\n            <div class=\"form-group row\">\r\n                <label for=\"medical-calculator-child-pugh-inr\" class=\"col-sm-3 col-form-label\">INR<\/label>\r\n                <div class=\"col-sm-9\">\r\n                    <input type=\"text\" class=\"form-control\" name=\"inr\" id=\"medical-calculator-child-pugh-inr\" placeholder=\"1.0-1.2\" aria-label=\"INR\" aria-describedby=\"\" tabindex=\"4\" inputmode=\"decimal\">\r\n                <\/div>\r\n            <\/div>\r\n            <div class=\"form-group row\">\r\n                <div class=\"col-sm-3 col-form-label\">\r\n                                            Hepatic Encephalopathy (<a href=\"#child-pugh-west-haven\">Grading<\/a>)\r\n                                    <\/div>\r\n                <div class=\"col-sm-9\">\r\n                    <div class=\"btn-group-toggle\" data-toggle=\"buttons\">\r\n                        <label class=\"btn btn-outline-secondary btn-block active\">\r\n                            <input type=\"radio\" name=\"hepatic-encephalopathy\" id=\"medical-calculator-child-pugh-hepatic-encephalopathy-1\" value=\"1\" tabindex=\"5\" autocomplete=\"off\" checked>\r\n                                                        None\r\n                                                    <\/label>\r\n                        <label class=\"btn btn-outline-secondary btn-block\">\r\n                            <input type=\"radio\" name=\"hepatic-encephalopathy\" id=\"medical-calculator-child-pugh-hepatic-encephalopathy-2\" value=\"2\" tabindex=\"6\" autocomplete=\"off\">\r\n                                                        Grade I-II\r\n                                                    <\/label>\r\n                        <label class=\"btn btn-outline-secondary btn-block\">\r\n                            <input type=\"radio\" name=\"hepatic-encephalopathy\" id=\"medical-calculator-child-pugh-hepatic-encephalopathy-3\" value=\"3\" tabindex=\"7\" autocomplete=\"off\">\r\n                                                        Grade III\u2013IV\r\n                                                    <\/label>\r\n                    <\/div>\r\n                <\/div>\r\n            <\/div>\r\n            <div class=\"form-group row\">\r\n                <div class=\"col-sm-3 col-form-label\">\r\n                Aszites\r\n                <\/div>\r\n                <div class=\"col-sm-9\">\r\n                    <div class=\"btn-group-toggle\" data-toggle=\"buttons\">\r\n                        <label class=\"btn btn-outline-secondary btn-block\">\r\n                            <input type=\"radio\" name=\"aszites\" id=\"medical-calculator-child-pugh-aszites-1\" value=\"1\" tabindex=\"8\" autocomplete=\"off\" checked>\r\n                                                        Absent\r\n                                                    <\/label>\r\n                        <label class=\"btn btn-outline-secondary btn-block active\">\r\n                            <input type=\"radio\" name=\"aszites\" id=\"medical-calculator-child-pugh-aszites-2\" value=\"2\" tabindex=\"9\" autocomplete=\"off\">\r\n                                                        Slight\r\n                                                    <\/label>\r\n                        <label class=\"btn btn-outline-secondary btn-block\">\r\n                            <input type=\"radio\" name=\"aszites\" id=\"medical-calculator-child-pugh-aszites-3\" value=\"3\" tabindex=\"10\" autocomplete=\"off\">\r\n                                                        Moderate\r\n                                                    <\/label>\r\n                    <\/div>\r\n                <\/div>\r\n            <\/div>\r\n        <\/form>\r\n\r\n        <div class=\"row\">\r\n            <div class=\"col-sm-12\">\r\n                <div id=\"medical-calculator-child-pugh-result-text-a\" class=\"result-text\">\r\n                    <p><h5>Child-Pugh A (<span id=\"medical-calculator-child-pugh-result-value-a\"><\/span> points)<\/h5><\/p>\r\n                                        <p>1-year survival rate: 100 %<\/p>\r\n                    <p>Perioperative mortality in abdominal surgery: 10 %<\/p>\r\n                                    <\/div>\r\n                <div id=\"medical-calculator-child-pugh-result-text-b\" class=\"result-text\">\r\n                    <p><h5>Child-Pugh B (<span id=\"medical-calculator-child-pugh-result-value-b\"><\/span> points)<\/h5><\/p>\r\n                                        <p>1-year survival rate: 79.7 %<\/p>\r\n                    <p>Perioperative mortality in abdominal surgery: 30 %<\/p>\r\n                                    <\/div>\r\n                <div id=\"medical-calculator-child-pugh-result-text-c\" class=\"result-text\">\r\n                    <p><h5>Child-Pugh C (<span id=\"medical-calculator-child-pugh-result-value-c\"><\/span> points)<\/h5><\/p>\r\n                                        <p>1-year survival rate: 44.9 %<\/p>\r\n                    <p>Perioperative mortality in abdominal surgery: 82 %<\/p>\r\n                                    <\/div>\r\n            <\/div>\r\n        <\/div>\r\n\r\n        <div class=\"row\">\r\n            <div class=\"col-sm-12\">\r\n                <h5>\r\n                                            Interpretation\r\n                                    <\/h5>\r\n                <div class=\"table-responsive-sm\">\r\n                    <table class=\"table table-bordered\">\r\n                        <thead>\r\n                            <tr>\r\n                                <th scope=\"col\">\r\n                                                                    Child-Pugh \r\n                                                                <\/th>\r\n                                <th scope=\"col\" class=\"table-col-a\">A<\/th>\r\n                                <th scope=\"col\" class=\"table-col-b\">B<\/th>\r\n                                <th scope=\"col\" class=\"table-col-c\">C<\/th>\r\n                            <\/tr>\r\n                        <\/thead>\r\n                        <tbody>\r\n                            <tr>\r\n                                <td>1-year survival rate <a href=\"#child-pugh-cite-note-4\">[4]<\/a><\/td>\r\n                                <td class=\"table-col-a\">100 %<\/td>\r\n                                <td class=\"table-col-b\">79.7 %<\/td>\r\n                                <td class=\"table-col-c\">44.9 %<\/td>\r\n                            <\/tr>\r\n                            <tr>\r\n                                <td>Perioperative mortality in abdominal surgery <a href=\"#child-pugh-cite-note-5\">[5]<\/a><\/td>\r\n                                <td class=\"table-col-a\">10 %<\/td>\r\n                                <td class=\"table-col-b\">30 %<\/td>\r\n                                <td class=\"table-col-c\">82 %<\/td>\r\n                            <\/tr>\r\n                        <\/tbody>\r\n                    <\/table>\r\n                <\/div>\r\n            <\/div>\r\n        <\/div>\r\n\r\n        <div class=\"row\">\r\n            <div class=\"col-sm-12 mt-3\">\r\n                <h5>\r\n                                    Appendix\r\n                                <\/h5>\r\n                <table class=\"table table-bordered\">\r\n                    <thead>\r\n                        <tr>\r\n                            <th scope=\"col\" colspan=\"2\"><a name=\"child-pugh-west-haven\"><strong>West Haven criteria for the diagnosis of hepatic encephalopathy<\/strong><\/a> <a href=\"#child-pugh-cite-note-1\">[1]<\/a><\/th>\r\n                        <\/tr>\r\n                    <\/thead>\r\n                    <tbody>\r\n                        <tr>\r\n                            <td nowrap>\r\n                                                        Grade I\r\n                                                        <\/td>\r\n                            <td>\r\n                                                        Minor loss of consciousness, euphoria or anxiety, shortened attention span, impaired calculations (addition, subtraction), altered sleep patterns\r\n                                                        <\/td>\r\n                        <\/tr>\r\n                        <tr>\r\n                            <td nowrap>\r\n                                                        Grade II\r\n                                                        <\/td>\r\n                            <td>\r\n                                                        Lethargy or apathy, chronological disorientation, significant alteration in personality, inappropriate behavior, dyspraxia, asterixis\r\n                                                        <\/td>\r\n                        <\/tr>\r\n                        <tr>\r\n                            <td nowrap>\r\n                                                        Grade III\r\n                                                        <\/td>\r\n                            <td>\r\n                                                        Somnolence and stupor, reaction only to stimuli, confusion, severe disorientation, bizarre behavior\r\n                                                        <\/td>\r\n                        <\/tr>\r\n                        <tr>\r\n                            <td nowrap>\r\n                                                        Grade IV\r\n                                                        <\/td>\r\n                            <td>\r\n                                                        Coma\r\n                                                        <\/td>\r\n                        <\/tr>\r\n                    <\/tbody>\r\n                <\/table>\r\n            <\/div>\r\n        <\/div>\r\n\r\n        <div class=\"row\">\r\n            <div class=\"col-sm-12 mt-3\">\r\n                <h5>\r\n                                References\r\n                                <\/h5>\r\n                <ol class=\"references\">\r\n                    <li id=\"child-pugh-cite-note-1\">Vilstrup H, Amodio P, Bajaj J et al. Hepatic encephalopathy in chronic liver disease: 2014 Practice\r\nGuideline by the American Association for the Study of Liver Diseases and the European Association\r\nfor the Study of the Liver. Hepatology 2014; 60: 715-735<\/li>\r\n                    <li id=\"child-pugh-cite-note-2\">Child CG, Turcotte JG. Surgery and portal hypertension. Major Probl Clin Surg 1964; 1: 1-85<\/li>\r\n                    <li id=\"child-pugh-cite-note-3\">Pugh RN, Murray-Lyon IM, Dawson JL et al. Transection of the oesophagus for bleeding oesophageal\r\nvarices. Br J Surg 1973; 60: 646-649<\/li>\r\n                    <li id=\"child-pugh-cite-note-4\">Infante-Rivard C, Esnaola S, Villeneuve JP. Clinical and statistical validity of conventional prognostic\r\nfactors in predicting short-term survival among cirrhotics. Hepatology 1987; 7: 660-664<\/li>\r\n                    <li id=\"child-pugh-cite-note-5\">Mansour A, Watson W, Shayani V et al. Abdominal operations in patients with cirrhosis: still a major\r\nsurgical challenge. Surgery 1997; 122: 730-735; discussion 735-736<\/li>\r\n                <\/ol>\r\n            <\/div>\r\n        <\/div>\r\n    <\/div>\r\n    <script type=\"text\/javascript\">\r\n                var medical_calculator_child_pugh_messages = {\r\n            'bilirubin_micromoles_per_l_out_of_range' : 'Unlikely value (bilirubin): values between 0.1 and 800 \u03bcmol\/l allowed.',\r\n            'bilirubin_mg_per_dl_out_of_range' : 'Unlikely value (bilirubin): values between 0,00584 and 46.78362 mg\/dl allowed.',\r\n            'albumin_grams_per_l_out_of_range' : 'Unlikely value (albumin): values between 0.1 and 70 g\/l allowed.',\r\n            'albumin_grams_per_dl_out_of_range' : 'Unlikely value (albumin): values between 0.01 and 7 g\/dl allowed.',\r\n            'inr_out_of_range' : 'Value improbable (INR): values between 0.1 and 10 allowed.',\r\n        };\r\n            <\/script>\r\n\n","protected":false},"excerpt":{"rendered":"<p>The Child-Pugh score is used to classify the severity of chronic liver disease and cirrhosis to estimate prognosis and mortality. Hepatic encephalopathy is graded according to the West Haven criteria (see appendix).<\/p>\n","protected":false},"author":3,"featured_media":0,"parent":28833,"menu_order":139,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"class_list":["post-28847","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/www.inanutshell.ch\/en\/wp-json\/wp\/v2\/pages\/28847","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.inanutshell.ch\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.inanutshell.ch\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.inanutshell.ch\/en\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.inanutshell.ch\/en\/wp-json\/wp\/v2\/comments?post=28847"}],"version-history":[{"count":1,"href":"https:\/\/www.inanutshell.ch\/en\/wp-json\/wp\/v2\/pages\/28847\/revisions"}],"predecessor-version":[{"id":28848,"href":"https:\/\/www.inanutshell.ch\/en\/wp-json\/wp\/v2\/pages\/28847\/revisions\/28848"}],"up":[{"embeddable":true,"href":"https:\/\/www.inanutshell.ch\/en\/wp-json\/wp\/v2\/pages\/28833"}],"wp:attachment":[{"href":"https:\/\/www.inanutshell.ch\/en\/wp-json\/wp\/v2\/media?parent=28847"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}