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Child–Pugh score
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==Scoring== The score employs five clinical measures of liver disease. Each measure is scored 1–3, with 3 indicating most severe derangement.<ref name=Cholongitas>{{cite journal|last=Cholongitas|first=E|author2=Papatheodoridis, GV |author3=Vangeli, M |author4=Terreni, N |author5=Patch, D |author6= Burroughs, AK |title=Systematic review: The model for end-stage liver disease--should it replace Child–Pugh's classification for assessing prognosis in cirrhosis?|journal=Alimentary Pharmacology & Therapeutics|date=Dec 2005|volume=22|issue=11–12|pages=1079–89|doi=10.1111/j.1365-2036.2005.02691.x|pmid=16305721|doi-access=free}}</ref> Either the prothrombin time or INR should be used to calculate the Child–Pugh score, not both. {| class="wikitable" style="border-collapse:collapse" |- ! colspan=2 | Measure ! 1 point ! 2 points ! 3 points |- | colspan=2 | [[Bilirubin|Total bilirubin]], μmol/L (mg/dL) | < 34 (< 2) | 34–50 (2–3) | > 50 (> 3) |- | colspan=2 | [[Serum albumin]], g/dL | > 3.5 | 2.8–3.5 | < 2.8 |- | rowspan=2 | OR | [[Prothrombin time]], prolongation (s) | < 4.0<br> | 4.0–6.0<br> | > 6.0<br> |- | [[International normalized ratio |INR]] | < 1.7 | 1.7–2.3 | > 2.3 |- | colspan=2 | [[Ascites]] | None | Mild (or suppressed with medication) | Moderate to severe (or refractory) |- | colspan=2 | [[Hepatic encephalopathy]] | None | Grade I–II | Grade III–IV |} In [[primary sclerosing cholangitis]] (PSC) and [[primary biliary cholangitis]] (PBC), some use a modified Child–Pugh score where the bilirubin references are changed to reflect the fact that these diseases feature high [[conjugated bilirubin]] levels. The upper limit for 1 point is 68 μmol/L (4 mg/dL) and the upper limit for 2 points is 170 μmol/L (10 mg/dL).<ref>{{Cite journal|last=Working Subgroup (English version) for Clinical Practice Guidelines for Primary Biliary Cirrhosis|date=2014-01-01|title=Guidelines for the management of primary biliary cirrhosis|journal=Hepatology Research|language=en|volume=44|pages=71–90|doi=10.1111/hepr.12270|pmid=24397841|s2cid=42862030 |issn=1872-034X|doi-access=free}}</ref>
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