Total Bilirubin (mg/dL) Enter total bilirubin level in mg/dL (e.g., 1.5)

Serum Albumin (g/dL) Enter serum albumin level in g/dL (e.g., 3.8)

INR (Prothrombin Time Ratio) Enter INR value as a ratio (e.g., 1.20)

Ascites (severity) Select ascites severity None Mild (controlled with medication) Moderate to severe (refractory) Select the degree of fluid buildup in the abdomen

Hepatic Encephalopathy (grade) Select encephalopathy grade None Grade I-II (mild to moderate) Grade III-IV (severe) Select the level of brain function impairment

Quick Examples:

Mild Liver Disease Advanced Liver Disease

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This calculator is a screening tool only, not a diagnostic instrument. It is not intended to replace professional medical evaluation. Consult a healthcare provider.

What Is Child-Pugh Score

The Child-Pugh score is a number that doctors use to measure how severe chronic liver disease has become. It looks at five simple clinical tests and gives each one a point value. The total score places a person into one of three groups, called Class A, B, or C. These groups help estimate how well the liver is working and what outcomes a person may expect over time. A lower score means the liver disease is generally less advanced.

How Child-Pugh Score Is Calculated

Formula

The calculator takes each of the five clinical measures and assigns it a point value from 1 to 3 based on set cutoff ranges. A value of 1 means the result is closer to normal. A value of 3 means the result shows more severe liver problems. All five point values are added together for a total score between 5 and 15. This total is then matched to a class: Class A is 5 to 6 points, Class B is 7 to 9 points, and Class C is 10 to 15 points.

Why Child-Pugh Score Matters

Knowing your Child-Pugh score helps you and your doctor understand how well your liver is working. The score gives a simple way to track changes over time and may guide decisions about treatment options and the need for further care.

Why Liver Severity Scoring Is Important for Treatment Planning

Without a clear picture of liver disease severity, it may be difficult to know which treatments are appropriate. A higher Child-Pugh score is generally associated with greater risk during surgery, certain medications, and other procedures. Scoring helps doctors identify patients who may need closer monitoring or who may not be good candidates for specific interventions.

For Disease Monitoring Over Time

The Child-Pugh score is often checked at regular visits to see if liver function is staying stable, improving, or getting worse. A change in score from one visit to the next may signal that the disease is progressing. This information may help guide timing for referrals or changes in care plans.

For Prognosis and Survival Estimation

Each Child-Pugh class is associated with different survival estimates over 1 year and 2 years. Class A is generally associated with better outcomes, while Class C is associated with a higher statistical association with complications. These estimates are not guarantees for any single person but may help in discussions about future care needs.

Child-Pugh Score vs MELD Score

The MELD score is another liver scoring system that uses bilirubin, creatinine, and INR to estimate short-term survival. While Child-Pugh includes clinical findings like ascites and encephalopathy, MELD relies only on lab values. MELD is often used for transplant priority, while Child-Pugh is commonly used for overall disease staging. The two scores can give different pictures and are sometimes used together.

Example Calculation

Consider a patient with total bilirubin of 1.5 mg/dL, serum albumin of 3.8 g/dL, INR of 1.2, no ascites, and no hepatic encephalopathy. These values represent a mild liver disease scenario.

First, each value is assigned points. Bilirubin of 1.5 is below 2, so it gets 1 point. Albumin of 3.8 is above 3.5, so it gets 1 point. INR of 1.2 is below 1.7, so it gets 1 point. Ascites of none gets 1 point. Encephalopathy of none gets 1 point. Adding them: 1 + 1 + 1 + 1 + 1 = 5.

Child-Pugh Score: 5 points. Child-Pugh Class: A. Estimated 1-Year Survival: approximately 100%.

A score of 5 places this patient in Class A, which is generally associated with well-compensated liver disease. This result may suggest that current management is appropriate, though regular follow-up with a healthcare provider is still recommended to watch for any changes over time.

Frequently Asked Questions

What do Child-Pugh classes A, B, and C mean?

Class A (5 to 6 points) generally indicates mild or well-compensated liver disease. Class B (7 to 9 points) suggests moderate disease with some loss of liver function. Class C (10 to 15 points) indicates severe disease. These classes help doctors communicate the overall picture of liver health in a simple way.

How often should the Child-Pugh score be checked?

The frequency depends on the stage of liver disease and the judgment of the healthcare provider. For stable disease, it may be checked every 6 to 12 months. For worsening symptoms or after a change in treatment, it may be checked more often to track how the liver is responding.

Does the Child-Pugh score work for acute liver failure?

No, the Child-Pugh score is designed for chronic liver disease, most often cirrhosis. It is not intended for sudden liver failure that develops over days. Other scoring systems are used in acute settings. This calculator should not be used for acute liver conditions.

Can I use this calculator if I have a liver transplant?

This calculator is based on standard criteria for native liver function and may not apply after a liver transplant. Post-transplant care involves different measures of liver health. If you have had a transplant, consult your transplant team for appropriate scoring tools and monitoring.