How bad a patient’s liver disease is can be reasonably estimated by various scoring systems that are based on laboratory values and findings on physical exam. The two most useful are the Child-Turcotte-Pugh scale and the MELD score. The former (often referred to simply as the Child’s scale) takes into account the degree of encephalopathy and ascites, as well as blood test results to gauge how well the liver is functioning (bilirubin excretion, albumin synthesis, and blood clotting factor production) to form three classes: Child’s A, B, and C. Child’s A cirrhotics have well compensated liver disease and don’t have significant problems with confusion, spontaneous bleeding, or abdominal fluid accumulation. Child’s C cirrhotics, on the other hand, are quite symptomatic, sick, and tenuous.
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