The Child-Pugh score is a clinical tool used to assess the severity of liver cirrhosis and predict perioperative mortality risk by evaluating five key parameters. These parameters are total bilirubin, albumin level, international normalized ratio (INR), presence of ascites, and degree of hepatic encephalopathy. Each parameter is assigned a score of 1 to 3, with higher scores indicating greater severity.

Here's how the scoring works:

- **Total bilirubin**:
  - Less than 2 mg/dL (34.2 mcmol/L) = 1 point
  - Between 2 and 3 mg/dL (34.2-51.3 mcmol/L) = 2 points
  - Greater than 3 mg/dL (51.3 mcmol/L) = 3 points

- **Albumin**:
  - Greater than 3.5 g/dL (35 g/L) = 1 point
  - Between 2.8 and 3.5 g/dL (28-35 g/L) = 2 points
  - Less than 2.8 g/dL (28 g/L) = 3 points

- **INR**:
  - Less than 1.7 = 1 point
  - Between 1.7 and 2.2 = 2 points
  - Greater than 2.2 = 3 points

- **Ascites**:
  - Absent = 1 point
  - Slight = 2 points
  - Moderate = 3 points

- **Encephalopathy**:
  - No encephalopathy = 1 point
  - Grade 1-2 = 2 points
  - Grade 3-4 = 3 points

The total Child-Pugh score is the sum of all points from the five categories, resulting in a score that ranges from 5 to 15. The score is then interpreted to determine the class and associated risk:

- A total score of 5 or 6 falls within Class A, where the risk of perioperative mortality is estimated to be 29%.
- Scores ranging from 7 to 9 correspond to Class B, which carries a 38% risk of perioperative mortality.
- A score of 10 or higher is categorized as Class C, indicating a high risk of perioperative mortality at 88%.

This systematic approach enables healthcare providers to evaluate the severity of liver disease and make informed medical decisions based on the patient's risk profile.

The Child-Pugh score is a clinical tool designed for assessing the prognosis of chronic liver disease, primarily cirrhosis. It is particularly useful in predicting mortality rates in patients with liver cirrhosis, aiding in clinical decision-making and patient counseling.

The score is determined by five primary components: total bilirubin, albumin, international normalized ratio (INR), ascites, and encephalopathy. Each component is assigned a score of 1 to 3 based on the severity of the patient's condition. 

Total bilirubin, albumin, and INR are biochemical markers reflecting liver function. Higher bilirubin and INR or lower albumin levels indicate more severe liver dysfunction and receive higher scores. Ascites and encephalopathy are clinical manifestations of liver disease. The presence and severity of these conditions also contribute to the overall score.

The sum of these scores is used to classify patients into three risk classes: Class A (score <= 6), Class B (score 7-9), and Class C (score >= 10). Each class corresponds to a different risk of perioperative mortality, with Class A having the lowest risk (29%) and Class C the highest (88%). 

The Child-Pugh score, therefore, provides a quantitative measure of disease severity in liver cirrhosis, helping clinicians to stratify risk and guide treatment decisions.

Child-Pugh score for mortality in liver cirrhosis