There are different systems to help categorize the severity of liver cirrhosis, including the Child-Pugh score and the MELD (model of end-stage liver disease) score.

Child-Pugh score

In the 1960s, Child and Turcotte developed a classification system for cirrhosis patients, which was then modified in the 1970s by Pugh to create the Child-Pugh scoring system.2

The Child-Pugh score looks at the following five criteria (click on each one to find out more):2

Depending on severity, each of these criteria is given a score between 1 and 3, and then all the scores are added together to give a total score, which is then used to give the patient a Child-Pugh grade:2

Child-Pugh grades2

  • Child-Pugh-A (total number 5 to 6): good liver function
  • Child-Pugh-B (total number 7 to 9): moderate liver function
  • Child-Pugh-C (10 to 15 points total): poor liver function

The higher the score, the worse the prognosis is for the patient.2

The MELD-Score

The MELD system is useful in helping healthcare teams to prioritize patients with end-stage liver disease who are waiting for a liver transplant. It is calculated by measuring various blood values, such as sodium levels, bilirubin levels and creatinine levels.3

A MELD scores helps to determine the risk of a patient dying in the next three months, also known as the three-month mortality risk, unless they have a liver transplant. For example, a patient with a MELD score less than 9 would have a 1.9% risk of dying in the next three months, whereas a patient with a MELD score greater than 40 would have a 71.3% risk of dying.3

Patient with higher MELD scores can be moved higher up on the waiting list for a life-saving liver transplant that could extend their life for years.3

The higher the score, the worse the prognosis is for the patient.


  1. British Liver Trust. Cirrhosis of the liver. Available at: (Last accessed September 2020)
  2. SPS NHS. What is the Child-Pugh Score. Available at: (Last accessed August 2020)
  3. Holland K, Healthline. 2019. Available at: (Last accessed September 2020)

May 2021. GL-HEP-XIF-2000182

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