Child-Pugh Score Calculator | Cirrhosis Class A/B/C

1. Total Bilirubin mg/dL

2. Serum Albumin g/dL

3. PT (INR) Prothrombin Time

4. Ascites Severity

5. Encephalopathy Hepatic Encephalopathy Grade

Child-Pugh Score

Class A

Life Expectancy: Normal. Perioperative Mortality: 10%.

Show Your Work (Child-Pugh breakdown)

Recent Updates

MELD and MELD 3.0 have largely replaced Child-Pugh for liver transplant allocation, but Child-Pugh remains widely used for cirrhosis prognosis, surgical-risk assessment, and drug dosing in hepatic impairment.
Score components and class cutoffs (Class A 5–6, B 7–9, C 10–15) are unchanged from the original Child-Turcotte-Pugh classification.

Use of the Child-Pugh Score in Liver Disease. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023. PMID: 31194448

Key Knowledge Points

The Child-Pugh Score classifies the severity of liver cirrhosis into three categories: Class A, B, and C.
Class A (5-6 points): Least severe liver disease, 1-year survival approx. 100%.
Class B (7-9 points): Moderately severe liver disease, 1-year survival approx. 80%.
Class C (10-15 points): Most severe liver disease, 1-year survival approx. 45%.
Primary Biliary Cholangitis (PBC) patients have different bilirubin cutoffs for scoring.

About This Child-Pugh Score Calculator

The Child-Pugh Score Calculator (also known as the Child-Turcotte-Pugh score) is the standard prognostic tool for assessing the prognosis of chronic liver disease, primarily cirrhosis. Originally developed to predict mortality during surgery, it is now used to determine prognosis, necessity of liver transplantation, and appropriate treatment strategies.

How to Use This Calculator

This tool evaluates five clinical measures of liver disease. Assign points (1-3) for each variable:

Total Bilirubin: Measures the liver’s ability to excrete bile.
Serum Albumin: Measures the liver’s synthetic function.
PT/INR: Measures the liver’s ability to produce clotting factors.
Ascites: Assessed clinically or by ultrasound.
Hepatic Encephalopathy: Assessed by mental status and neurological exam.

Scoring & Interpretation

The total score ranges from 5 to 15. Patients are grouped into three Child-Pugh Classes:

Class A (5-6 points): Well-compensated disease.
1-year survival: 100%. 2-year survival: 85%.
Class B (7-9 points): Significant functional compromise.
1-year survival: 80%. 2-year survival: 60%.
Class C (10-15 points): Decompensated disease.
1-year survival: 45%. 2-year survival: 35%.

Frequently Asked Questions (FAQ)

1. Child-Pugh vs. MELD Score?

While the Child-Pugh score assesses chronic liver disease severity and surgical risk, the MELD score (Model for End-Stage Liver Disease) is purely objective (lab values only) and is primarily used to prioritize candidates for liver transplantation.

2. How is it used for Primary Biliary Cholangitis (PBC)?

For patients with PBC, the bilirubin thresholds are modified because bilirubin levels tend to be higher. The cutoffs typically change to: Score 1 (< 4 mg/dL), Score 2 (4–10 mg/dL), Score 3 (> 10 mg/dL).

3. What defines “controlled” ascites?

Mild ascites is detectable only by ultrasound or is responsive to diuretics (Score 2). Moderate to severe ascites is clinically evident (distended abdomen) and may be refractory to diuretics (Score 3).

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⚠️ Disclaimer:

This tool is for informational and educational purposes only and is not a substitute for professional clinical judgment. All treatment decisions must be made by a qualified healthcare professional considering the individual patient’s full clinical context.