Teaching Cases - American Society of Hematology


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Teaching Cases

Hematemesis — Marc J. Kahn, MD
Tulane University School of Medicine, New Orleans, LA

I. History	II. Physical Exam	III. Laboratory Data	IV. Differential Diagnosis
V. Pathophysiology	VI. Prognosis/Clinical Course	VII. Teaching Points	VIII. Bibliography

VI. PROGNOSIS/CLINICAL COURSE

Modified Child-Pugh Classification of Liver Disease

	Numerical Score
	1	2	3
Ascites	None	Slight	Mod/severe
Encephalopathy	None	Grade 1-2	Grade 3-4
Albumin (mg/L)	>3.5	2.8-3.5	<2.8
Bilirubin (mg/dL)	<2.0	2.0-3.0	>3.0
PT (seconds increased)	<4	4-6	>6

Total Numerical Score		Child-Pugh Class
5-6		A
7-9		B
10-15		C

The Child-Pugh class assesses the risk of death from liver disease. Determine the patient’s numerical score (1, 2 or 3) for each of the five parameters in the table above. Based on his total numerical score, what is his Child-Pugh class?

	A
	B
	C

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