Advanced Child-Pugh Score Calculator | Liver Disease Severity

Advanced Child-Pugh Score Calculator

Assess liver disease severity using bilirubin, albumin, coagulation status, ascites, and hepatic encephalopathy. The calculator provides the total Child-Pugh score, Class A/B/C classification, component breakdown, and a visual severity scale.
mg/dL. Standard Child-Pugh thresholds: <2, 2–3, >3.
g/dL. Thresholds: >3.5, 2.8–3.5, <2.8.
INR <1.7 = 1 point, 1.7–2.3 = 2 points, >2.3 = 3 points.
Ascites assessment is clinical and may be influenced by treatment response.
Uses hepatic encephalopathy grade as part of the Child-Pugh score.
Please enter valid bilirubin, albumin, and coagulation values.
Total Child-Pugh Score
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Child-Pugh Class
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Score Range
5–15
5 — Class A 7 — Class B 10 — Class C 15

Component Score Breakdown

Enter the laboratory values and clinical findings to see the component breakdown.

Component Chart

The component chart will appear after calculation.

Severity Visualization

Enter the required values to determine the Child-Pugh class.

Child-Pugh Scoring Criteria

Component 1 Point 2 Points 3 Points
Total bilirubin <2 mg/dL 2–3 mg/dL >3 mg/dL
Albumin >3.5 g/dL 2.8–3.5 g/dL <2.8 g/dL
INR <1.7 1.7–2.3 >2.3
PT prolongation <4 sec 4–6 sec >6 sec
Ascites None Mild / slight Moderate to severe
Encephalopathy None Grade I–II Grade III–IV

Interpretation

The Child-Pugh score will be calculated from five components, each contributing 1 to 3 points.

About the Child-Pugh Score

The Child-Pugh score, also called the Child-Turcotte-Pugh score, is a clinical scoring system used to assess the severity of chronic liver disease and cirrhosis. It combines three laboratory variables and two clinical variables.

The five components are total bilirubin, serum albumin, prothrombin time or INR, ascites, and hepatic encephalopathy. Each component receives 1, 2, or 3 points according to the severity of the abnormality or clinical finding.

Child-Pugh Class A

A total score of 5 or 6 points corresponds to Child-Pugh Class A. This represents the lowest severity category within the Child-Pugh classification.

Child-Pugh Class B

A total score of 7 to 9 points corresponds to Child-Pugh Class B and represents an intermediate level of hepatic dysfunction.

Child-Pugh Class C

A total score of 10 to 15 points corresponds to Child-Pugh Class C, the highest severity category in the Child-Pugh classification.

Why Bilirubin Matters

Bilirubin is one of the laboratory components of the Child-Pugh score. Higher bilirubin concentrations receive more points because they indicate greater impairment of hepatic processing and excretion.

Why Albumin Matters

Albumin is synthesized primarily by the liver. Lower serum albumin receives a higher Child-Pugh score and contributes to the overall assessment of hepatic dysfunction.

INR and Prothrombin Time

Coagulation abnormalities are included in the Child-Pugh system because the liver produces many coagulation factors. The calculator allows either INR or prothrombin-time prolongation to be used.

Ascites

Ascites is scored according to its clinical severity. The traditional Child-Pugh system assigns 1 point for absent ascites, 2 points for mild or slight ascites, and 3 points for moderate to severe ascites.

Hepatic Encephalopathy

Hepatic encephalopathy is the neurological component of the Child-Pugh score. No encephalopathy receives 1 point, Grade I–II receives 2 points, and Grade III–IV receives 3 points.

Frequently Asked Questions

What is the maximum Child-Pugh score?

The maximum Child-Pugh score is 15 points because each of the five components can contribute up to 3 points.

What score is Child-Pugh Class A?

A total score of 5–6 points is classified as Child-Pugh Class A.

What score is Child-Pugh Class B?

A total score of 7–9 points is classified as Child-Pugh Class B.

What score is Child-Pugh Class C?

A total score of 10–15 points is classified as Child-Pugh Class C.

Can INR be used instead of PT?

Yes. INR is commonly used as a substitute for prothrombin-time prolongation in modern versions of the Child-Pugh calculation.

Does Child-Pugh diagnose cirrhosis?

No. The Child-Pugh score is a severity and prognostic classification system. It should not be used alone to diagnose cirrhosis or determine an individual's treatment.

Is Child-Pugh the same as MELD?

No. Child-Pugh and MELD are different liver disease scoring systems. Child-Pugh incorporates bilirubin, albumin, coagulation status, ascites, and encephalopathy, whereas MELD uses laboratory variables such as bilirubin, INR, creatinine and sodium, with MELD 3.0 also incorporating albumin and sex.