Child-Pugh Score Calculator
Grade the severity of chronic liver disease and cirrhosis with the Child-Pugh score, which sorts patients into class A, B or C and estimates survival. Five factors — total bilirubin, serum albumin, INR, ascites and hepatic encephalopathy — each score 1 to 3 points for a total of 5 to 15. Choose the band that matches each value to get the score, the Child-Pugh class and the approximate one- and two-year survival.
About the Child-Pugh score
The Child-Turcotte-Pugh score grades the severity of chronic liver disease from five factors, each scored 1–3, and classifies patients as A, B or C. Originally devised to predict surgical mortality, it remains widely used for prognosis, procedure risk and drug dosing. Source: Pugh RNH et al., British Journal of Surgery 1973, modifying Child & Turcotte 1964.
Frequently asked questions
How is the Child-Pugh score calculated?
Each of five factors scores 1, 2 or 3 points. Bilirubin: under 2 mg/dL (1), 2–3 (2), over 3 (3). Albumin: over 3.5 g/dL (1), 2.8–3.5 (2), under 2.8 (3). INR: under 1.7 (1), 1.7–2.2 (2), over 2.2 (3). Ascites: none (1), slight/diuretic-controlled (2), moderate or refractory (3). Encephalopathy: none (1), grade 1–2 (2), grade 3–4 (3). The five add up to a total of 5 to 15.
What do the Child-Pugh classes mean?
Child-Pugh class A is 5–6 points (well-compensated disease), class B is 7–9 (significant functional compromise) and class C is 10–15 (decompensated disease). Higher class means worse liver function and prognosis. Class also predicts surgical risk and helps decide on interventions such as TIPS or transplant referral.
What survival does each class carry?
Approximate survival from the classic studies is: class A about 100% at one year and 85% at two years; class B about 80% at one year and 60% at two years; and class C about 45% at one year and 35% at two years. These are population averages and vary with the cause of liver disease, complications and treatment. The calculator shows the same figures beside the class as soon as the five bands are set. Because they come from older cohorts, they may not reflect outcomes achievable today with modern antiviral therapy, variceal management and transplantation.
How does Child-Pugh compare with MELD?
Child-Pugh and MELD both grade the severity of liver disease. Child-Pugh is simple and includes two clinical judgements — ascites and encephalopathy — while MELD and MELD 3.0 are purely lab-based and are used for transplant allocation. Child-Pugh remains widely used for surgical risk, prognosis and drug-dosing guidance. Many clinicians look at both; see our MELD and MELD 3.0 calculators.
What if my values are in SI units?
For the Child-Pugh score, convert bilirubin from µmol/L to mg/dL by dividing by 17.1 (so 34 µmol/L ≈ 2 mg/dL and 51 ≈ 3). Albumin in g/L is a tenth of g/dL (35 g/L = 3.5 g/dL). INR is unit-free. Then pick the matching band. This calculator is an educational reference, not medical advice.
This is a reference tool, not a diagnosis or medical advice. Results depend on the laboratory, assay and clinical context, and reference intervals vary between labs and by age and sex — always read your result against the range printed on your own report and discuss it with a qualified healthcare professional.
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