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Child-Pugh Score Calculator

Enter the five component points to get the Child-Pugh score and class.

How it is calculated

This tool adds up points you have already assigned. It does not take lab values. For each of the five components (bilirubin, albumin, INR, ascites, encephalopathy) you enter a whole number of points from 1 to 3, where 1 is the mildest finding and 3 the most severe on the Child-Pugh point table. The score is total = bilirubin + albumin + INR + ascites + encephalopathy, from 5 to 15. The class is then assigned by the total: 5 to 6 is Class A, 7 to 9 is Class B and 10 to 15 is Class C. A value that is not a whole number, or is outside 1 to 3, gives no result. Converting a measured bilirubin, albumin or INR value into points must be done with the standard point table first. The score supports clinical judgement, it does not replace it.

Worked example

A patient with cirrhosis is graded from the point table as follows: bilirubin 2 points, albumin 2 points, INR 1 point, ascites 2 points, and encephalopathy 1 point. Adding them: 2 + 2 + 1 + 2 + 1 = 8. A total of 8 falls in the 7 to 9 range, so the tool reports a score of 8 and Class B. If the INR and encephalopathy points were each one higher (2 and 2), the total would be 10, which moves the patient to Class C.

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Common mistakes

  • Typing the actual lab values, such as a bilirubin of 2.4 or an INR of 1.7. The fields take the points (1, 2 or 3) for each component, so a decimal gives no result.
  • Leaving a field at its default of 1 without checking it. Every field starts at 1, so a forgotten component quietly counts as the mildest finding and lowers the total.
  • Entering 0 for a normal finding. The lowest value is 1 point, so 0 is rejected and no result appears.
  • Using the score for an acute illness or as the only prognostic tool. It describes chronic liver disease, and the class is a broad grouping.
  • Comparing the class directly with a MELD score. They are separate systems with different scales and cannot be converted by this tool.

Sources

About this calculator

The Child-Pugh score grades the severity of chronic liver disease (cirrhosis) from five clinical measures — total bilirubin, serum albumin, INR (a standardised measure of blood clotting), ascites, and hepatic encephalopathy — each scored 1 to 3 points. This calculator does not convert lab values: you enter the 1, 2 or 3 points you have already assigned to each component, and it adds them up. The total (5–15) maps to three classes: Class A (5–6), well-compensated disease with good short-term prognosis; Class B (7–9), significant functional compromise; and Class C (10–15), decompensated, poor-prognosis disease.

Hepatologists and surgeons use it to estimate a cirrhotic patient's operative risk before non-transplant surgery, to gauge prognosis, and — historically — to help prioritize liver transplant candidates, though the newer MELD score has largely replaced Child-Pugh for formal transplant allocation while it remains widely used at the bedside.

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Comments (1)

  • Editorial team

    The total is only as reliable as the five points you feed in. Ascites and encephalopathy are bedside judgements, so two assessors can reasonably assign different points and land in different classes; bilirubin, albumin and INR need the point table applied correctly first. A class shows a risk group, not a decision, and treatment choices belong with the treating hepatology team. Which component do you find hardest to grade, and what makes it unclear?

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