Child Pugh Score: Mnemonic and Explanation

The Child-Pugh-Turcot (CTP) score consists of 5 clinical features and is used to assess the prognosis of chronic liver disease and cirrhosis.

Mnemonic: A BEAP

  1. Albumin (gm/dl)
  2. Bilirubin (mg/dl)
  3. Encephalopathy (Based on West Haven Criteria)
  4. Ascites
  5. Prothrombin Time (PT) Prolonged or INR

Child Pugh Score

Child-Pugh-Turcot Score

Factor1 point2 points3 points
Bilirubin (mg/dl)< 22 – 3< 3
Albumin (g/dl)> 3.52.8 – 3.5< 2.8
INR or (Prothrombin time [seconds prolonged])< 1.7 (< 4)1.7 – 2.3 (4 – 6)> 2.3 (> 6)
AscitesNoneMild (Diuretic responsive)Moderate or Severe (Diuretic refractory)
Hepatic encephalopathyNoneGrade I – IIGrade III – IV

West Haven Criteria for Hepatic Encephalopathy

West Haven Hepatic Encephalopathy

Interpretation of Child Pugh Turcot Score

PointsClassOne year survivalTwo year survivalOperative mortality
5 – 6A100%85%Low (<5%)
7 – 9B81%57%Moderate (~25%)
10 – 15C45%35%High (>50%)

MELD (Model For End Stage Liver Disease) Score

Model for End-Stage Liver Disease (MELD) is a numerical scale, ranging from 6 (less ill) to 40 (gravely ill), used for liver transplant candidates age 12 and older. It gives each person a ‘score’ (number) based on how urgently he or she needs a liver transplant within the next three months. The number is calculated by a formula using three routine lab test results:

  1. Bilirubin
  2. INR (prothrombin time)
  3. Creatinine

For Pediatric population (<12 years), there is PELD (Pediatric End Stage Liver Disease) Score which uses Albumin, Growth failure and Age <1 year instead of Creatinine.

Calculate MELD score.

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