The Child-Pugh score assesses liver functional reserve. Which variable is NOT included in the Child-Pugh scoring system?
- A Serum albumin
- B Serum alkaline phosphatase ✓
- C Prothrombin time (INR)
- D Degree of ascites
Correct answer: B. Serum alkaline phosphatase
Explanation
The Child-Pugh score incorporates five variables: (1) serum bilirubin, (2) serum albumin, (3) prothrombin time/INR, (4) ascites severity, and (5) hepatic encephalopathy grade. Alkaline phosphatase is NOT included. Child-Pugh A (5–6 points) indicates good hepatic reserve with acceptable surgical risk; B (7–9) intermediate; C (10–15) poor reserve with prohibitive surgical risk. MELD score (bilirubin, INR, creatinine) is used for transplant prioritization.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
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