Semin Liver Dis 2019; 39(01): 096-103
DOI: 10.1055/s-0038-1676805
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Child–Pugh Classification: Time to Abandon?

Beverley Kok
1   Division of Gastroenterology (Liver Unit), University of Alberta, Edmonton, Canada
Juan G. Abraldes
1   Division of Gastroenterology (Liver Unit), University of Alberta, Edmonton, Canada
› Author Affiliations
Further Information

Publication History

Publication Date:
11 January 2019 (online)


The Child–Pugh classification is one of the commonest and oldest bedside tools utilized in estimating prognosis in patients with cirrhosis. However, its usage as a risk prediction tool or indeed a decision-making tool should be revisited. In this review, we discuss some inherent issues with the Child–Pugh classification and present a few contexts in which the current usage of Child–Pugh warrants reassessment, elaborating on its utility in acute variceal bleeding, specifically its role in decision-making on early transjugular intrahepatic portosystemic shunt, as well as its use in the context of hepatocellular carcinoma and drug development and dose adjustment.

Financial support


Author Contributions

B.K. and J.G.A. drafted the final manuscript.

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