Child criteria include A/E:
High-Yield Explanation
Ans. A (Nutrition) or None # Nutriton is factor in child pugh classification (L & B 25th/1083, Schwartz)# Nutriton is not a factor in child pugh classification (Harrison 17th/1923, CMDT 09/ 607, CSDT 12th/583)Table (Harrison): Child-Pugh Classification of CirrhosisFactorUnits123Serum bilirubinmmol/Lmg/dL<34<2.034-512.0-3.0>51>3.0Serum albuming/Lg/dL>35>3.530-353.0-3.5<30<3.0Prothrombin timeSeconds prolonged INR0-4<1.74-61.7-23>6>2.3AscitesNone Easily controlledPoorly controlledHepatic encephalopathyNone MinimalAdvancedNote: The Child-Pugh score is calculated by adding the scores of the five factors and can range from 5-15. Child-Pugh class is either A (a score of 5-6), B (7-9), or C (10 or above). Decompensa tion in dicates cirrhosis with a Child-Pugh score of 7 or more (class B). This level has been the accepted criterion for listing for liver transplantationTable (Swartz): Revised Child Classification of Clinical Severity of CirrhosisFactorABCNutritional status'1ExcellentGoodPoorAscites0NoneMinimal, controlledModerate to severeEncephalopathyNoneMinimal, controlledModerate to severeSerum bilirubin (mg/dL)<22-3>3Serum albumin (g/ dL)>3.52.8-3.S<2.8Prothrombin time (% of control)>7040-70<40