Child - Pugh classification of severity of liver disease

Last reviewed 07/2021

The Child- Pugh classification is a means of assessing the severity of liver cirrhosis.

Score 1 2 3
bilirubin (micromol/l) <34 34-50 >50
albumin (g/l) >35 28-35 <28
PT (s prolonged) <4 4-6 >6
encephalopathy none mild marked
ascites none mild marked

If there is primary biliary cirrhosis or sclerosing cholangitis then bilirubin is classified as <68=1; 68-170=2; >170=3.

The individual scores are summed and then grouped as:

  • <7 = A
  • 7-9 = B
  • >9 = C

A C classification forecasts a survival of less than 12 months.

From: Pugh RNH, Murray-Lyon IM, Dawson JL et al. Transection of the oesophagus for bleeding oesophageal varices. Br J Surg 1973;60:649-9.