The Child-Pugh score, a prognostic measure used in patients with chronic liver disease, is determined by five clinical measures, including total bilirubin level; serum albumin level; prothrombin time expressed by international normalized ratio (INR), presence of ascites (none, mild, severe); and presence of hepatic encephalopathy (none; grade I-II; grade III-IV). Each clinical measure is assigned 1 to 3 points ranging from least severe (1 point) to most severe (3 points).  A total score based on the five clinical measures is used to determine Child-Pugh class of disease (A, B, or C). ■