Child_Pugh_Score - In primary sclerosing cholangitis (PSC)...

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Child-Pugh Score The Child-Pugh score (sometimes the Child-Turcotte-Pugh score) is used to assess the prognosis of chronic liver disease, mainly cirrhosis. Although it was originally used to predict mortality during surgery, it is now used to determine the prognosis, as well as the required strength of treatment and the necessity of liver transplantation. Scoring The score employs five clinical measures of liver disease. Each measure is scored 1-3, with 3 indicating most severe derangement. Measure 1 point 2 points 3 points units Bilirubin (total) <34 (<2) 34-50 (2-3) >50 (>3) μ mol/l (mg/dL) Serum albumin >35 28-35 <28 mg/L INR <1.7 1.71-2.20 > 2.20 no unit Ascites None Suppressed with medication Refractory no unit Hepatic encephalopathy None Grade I-II (or suppressed with medication) Grade III-IV (or refractory) no unit It should be noted that different textbooks and publications use different measures. Some older reference works substitute PT prolongation for INR.
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Unformatted text preview: In primary sclerosing cholangitis (PSC) and primary biliary cirrhosis (PBC), 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 mol/l (4 mg/dL) and the upper limit for 2 points is 170 mol/l (10 mg/dL). Interpretation Chronic liver disease is classified into Child-Pugh class A to C, employing the added score from above. Points Class Life expectancy Perioperative mortality 5-6 A 15-20 10% 7-9 B Candidate for transplant 30% 10-15 C 1-3 months 82% Other scoring systems Although the Child-Turcotte scoring system was the first of its kind in stratifying the seriousness of end-stage liver disease, it is by no means the only one. The Model for End-Stage Liver Disease (MELD) is used increasingly to assess patients for liver transplantation, although both scores seem to be more or less equivalent....
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