The Child–Pugh score has been used since the 1970s to assess the prognosis of chronic liver disease and to guide drug dosing and surgical risk. Class A (5–6 points) is well-compensated, B (7–9) significant impairment and C (10–15) decompensated disease.
How to use the Child–Pugh Score Calculator
- Total bilirubin
- Albumin
- INR
- Ascites
- Hepatic encephalopathy
Results update as you type, and every field accepts the units shown in its menu.
How it works
Each answer carries the points shown in the published score. The calculator adds them up and maps the total to the published interpretation.
Scoring table
| Item | Answers and points |
|---|---|
| Total bilirubin | Below 2 mg/dL (34 µmol/L) = 1; 2–3 mg/dL (34–50 µmol/L) = 2; Above 3 mg/dL (50 µmol/L) = 3 |
| Albumin | Above 3.5 g/dL (35 g/L) = 1; 2.8–3.5 g/dL = 2; Below 2.8 g/dL = 3 |
| INR | Below 1.7 = 1; 1.7–2.3 = 2; Above 2.3 = 3 |
| Ascites | None = 1; Slight (controlled with diuretics) = 2; Moderate to severe (refractory) = 3 |
| Hepatic encephalopathy | None = 1; Grade 1–2 (or suppressed with medication) = 2; Grade 3–4 (or refractory) = 3 |
Inputs explained
| Field | What to enter |
|---|---|
| Total bilirubin | Choose one: Below 2 mg/dL (34 µmol/L), 2–3 mg/dL (34–50 µmol/L), Above 3 mg/dL (50 µmol/L) |
| Albumin | Choose one: Above 3.5 g/dL (35 g/L), 2.8–3.5 g/dL, Below 2.8 g/dL |
| INR | Choose one: Below 1.7, 1.7–2.3, Above 2.3 |
| Ascites | Choose one: None, Slight (controlled with diuretics), Moderate to severe (refractory) |
| Hepatic encephalopathy | Choose one: None, Grade 1–2 (or suppressed with medication), Grade 3–4 (or refractory) |
Health note: this calculator is for education and screening only and is not a diagnosis or treatment advice. Discuss your results with a qualified clinician.
Formula
Score = sum of the points for each item
Worked example
Inputs — Total bilirubin: Below 2 mg/dL (34 µmol/L); Albumin: 2.8–3.5 g/dL; INR: Below 1.7; Ascites: None; Hepatic encephalopathy: None.
Results — Child–Pugh score = 6 / 15; Class and survival = Class A – 1-year survival about 100%, 2-year 85%.
Key terms
- Hepatic encephalopathy
- Brain dysfunction caused by liver failure.
Frequently asked questions
What is Child–Pugh class A?
5–6 points: well-compensated cirrhosis.
How is Child–Pugh different from MELD?
MELD is purely lab-based and used for transplant priority; Child–Pugh includes clinical signs.
Is Child–Pugh used for drug dosing?
Yes – many drug labels give dose adjustments by Child–Pugh class.