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Table 1 Child-Pugh classification of hepatic impairment

From: Pharmacokinetics and tolerability of zibotentan (ZD4054) in subjects with hepatic or renal impairment: two open-label comparative studies

  Points scored for observed findings
  1 point 2 points 3 points
Encephalopathy grade* Absent 1 or 2 3 or 4
Ascites Absent Slight Moderate
Serum bilirubin (μmol/L) <34.2 34.2-51.3 >51.3
Serum albumin (g/L) >35 28-35 <28
Prothrombin time (INR) <1.16 1.16-1.56 >1.56
Child-Pugh grade Child-Pugh A Child-Pugh B Child-Pugh C
Points required 5-6 7-9 10-15
  1. INR, international normalized ratio. *Encephalopathy: Grade 0: normal consciousness, personality, neurological examination, electroencephalogram. Grade 1: restless, sleep disturbed, irritable/agitated, tremor, impaired handwriting, 5 cps waves. Grade 2: lethargic, time disorientated, inappropriate, asterixis, ataxia, slow triphasic waves. Grade 3: somnolent, stuporous, place disorientated, hyperactive reflexes, rigidity, slower waves. Grade 4: unrousable coma, no personality/behaviour, decerebrate, slow 2-3 cps delta activity.