Using scoring systems to work out the prognosis for liver cirrhosis

The stage of liver cirrhosis can be defined by a scoring system such as the Child-Pugh score. This score gives healthcare teams an idea of the severity of the cirrhosis, and an estimate of life expectancy.2

To calculate the Child-Pugh score, certain variables are taken into account:2

The values of the above variables are then used to assign a ‘Child-Pugh grade’ to liver cirrhosis patients. You can be assigned grade A, B or C.2

Another scoring system called the MELD (model for end-stage liver disease) is also used in practice. The MELD score helps to predict survival so that liver transplants can be timed and allocated more effectively.1

Prognosis according to your Child-Pugh grade

Your Child-Pugh grade is used to predict mortality. Survival rates change over time. For example, while Grade A patients have a 1-year survival rate of around 84%, this drops to 44% after 5 years, and to 27% after 10 years.2

Percentage survival in liver cirrhosis

Child-Pugh Grade Child-Pugh Score 1-year survival 5-year survival 10-year survival
A 5-6 84% 44% 27%
B 7-9 62% 20% 10%
C 10-15 42% 21% 0%

Adapted from Whitehead S, et al. 2017

How complications affect liver cirrhosis prognosis

While cirrhosis alone can decrease survival, complications caused by cirrhosis can impact survival too. Complications of cirrhosis include (amongst others):

The impact on life expectancy varies between complications. Ascites, for example, is the most common complication of liver cirrhosis, and is also the complication that most commonly leads to hospital admission. Approximately 15% of patients with ascites die within a year, and 44% die within five years.3

Effective treatment can slow disease progression

The aim of cirrhosis management is to delay the progression of the disease and treat any complications.1 Cirrhosis commonly used to be thought of as completely irreversible, but recent research has demonstrated that early-stage liver damage can be improved and even reversed with certain treatments.3

Management may include specific treatments for the underlying cause, lifestyle changes, diet changes, and vaccinations, amongst other interventions. Abstinence from alcohol is important for both alcoholic cirrhosis and non-alcoholic cirrhosis, as alcohol can increase the rate of disease progression from any cause.1

Get informed and follow the advice of your healthcare team, as this will help you to maintain your health. With good support, you can develop strategies that will help you to get past your fear and live your life. Talk to your healthcare team if you need further information or support.


  1. Perri GA, Khosravani H. Complications of end-stage liver disease. Can Fam Physician. 2016;62(1):44-50.
  2. Whitehead S, et al. SPS NHS. What is the Child-Pugh Score. Available at: (Last accessed August 2020)
  3. Nusrat S, et al. Cirrhosis and its complications: Evidence based treatment. World J Gastroenterol 2014 May 14; 20(18): 5442-5460
  4. Plymouth Hospital Staff. Plymouth Hospital. Living with Liver Disease. Available at: Last accessed: November 2020

May 2021. GL-HEP-XIF-2000185

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