Child Pugh Score Calculator: get your liver severity class in minutes
This Child Pugh Score Calculator totals five liver function measures—bilirubin, albumin, INR, ascites, and encephalopathy—to produce a score and class (A, B, or C). Clinicians use the result to estimate prognosis and help guide treatment planning.
What the Child-Pugh score measures
The Child-Pugh score (also called Child-Turcotte-Pugh) estimates the severity of chronic liver disease, especially cirrhosis. It combines lab tests with two clinical findings.
Each factor is graded from 1 to 3, where higher grades mean worse liver function. The final score ranges from 5 to 15.
- Bilirubin (mg/dL) reflects bile processing and liver clearance.
- Albumin (g/dL) reflects liver protein synthesis.
- INR reflects blood clotting ability.
- Ascites reflects fluid buildup in the abdomen.
- Hepatic encephalopathy reflects brain effects of liver dysfunction.
Child-Pugh scoring thresholds (the 1–3 point grades)
Use the ranges below to assign points for each category. Your total score determines the class.
Bilirubin points
| Serum bilirubin | 1 point | 2 points | 3 points |
|---|---|---|---|
| mg/dL | < 2 | 2–3 | > 3 |
Albumin points
| Serum albumin | 1 point | 2 points | 3 points |
|---|---|---|---|
| g/dL | > 3.5 | 2.8–3.5 | < 2.8 |
INR points
| INR | 1 point | 2 points | 3 points |
|---|---|---|---|
| INR | < 1.7 | 1.7–2.3 | > 2.3 |
Ascites points
- 1 point: none
- 2 points: mild (controlled with diuretics)
- 3 points: moderate/severe (refractory or requiring frequent paracentesis)
Hepatic encephalopathy points
- 1 point: none
- 2 points: mild–moderate (controlled with medication)
- 3 points: severe (poorly controlled or recurrent)
How the calculator computes the score
The Child Pugh score is calculated as:
Total score = Bilirubin points + Albumin points + INR points + Ascites points + Encephalopathy points
Then the score maps to a class:
| Total Child-Pugh score | Class | Interpretation (simple) |
|---|---|---|
| 5–6 | A | Lower severity |
| 7–9 | B | Moderate severity |
| 10–15 | C | Higher severity |
Unit conversions used by the calculator
Your lab results may be reported in different units. This calculator supports common conversions for bilirubin and INR-related inputs where applicable.
- Bilirubin: if provided in µmol/L, it is converted to mg/dL using mg/dL = µmol/L ÷ 17.1.
- Albumin: typically reported in g/dL. (If your lab uses another unit, use the conversion provided on your lab report before entering values.)
- INR: entered as a dimensionless ratio (no unit conversion needed).
If any input is missing or not a number, the calculator will tell you what to fix and will not compute a result.
Practical examples (how to use it)
Example 1: Class A estimation
Imagine bilirubin 1.2 mg/dL, albumin 3.9 g/dL, INR 1.2, no ascites, and no encephalopathy. These fall into the lowest grades for each lab/clinical item.
Your score becomes 1 + 1 + 1 + 1 + 1 = 5, which maps to Class A.
Example 2: Class C estimation
Now consider bilirubin 4.5 mg/dL, albumin 2.3 g/dL, INR 2.8, moderate/severe ascites, and severe hepatic encephalopathy. Each category receives the highest points.
Your score becomes 3 + 3 + 3 + 3 + 3 = 15, which maps to Class C.
Important limitations and safety notes
The Child-Pugh score is widely used, but it is not a perfect measure of liver function. It was designed for cirrhosis prognosis and may not reflect newer disease models or changes due to treatment.
- Clinical grading matters: ascites and encephalopathy descriptions can vary by clinician and setting.
- Single time-point: scores can shift as labs and symptoms change.
- Not a substitute for medical care: use the result to discuss next steps with a licensed professional.
If you are making urgent health decisions (for example, severe confusion, bleeding, or rapidly worsening abdominal swelling), seek medical care immediately.
Frequently Asked Questions
What is the Child Pugh Score Calculator used for?
The Child Pugh Score Calculator estimates the severity class of chronic liver disease by totaling points from bilirubin, albumin, INR, ascites, and hepatic encephalopathy. Clinicians use the class (A, B, or C) to discuss prognosis, risk, and treatment planning for patients with cirrhosis.
How do I score ascites and encephalopathy?
Ascites is graded based on whether there is none, mild fluid controlled with diuretics, or moderate/severe fluid that is refractory or needs frequent drainage. Encephalopathy is graded as none, mild–moderate controlled with medication, or severe and poorly controlled.
Can I enter bilirubin in µmol/L?
Yes. If your lab reports bilirubin in µmol/L, this calculator converts it to mg/dL using mg/dL = µmol/L ÷ 17.1. Enter the value and choose the correct unit so the score uses the proper thresholds.
Does the Child-Pugh score apply to all liver diseases?
No. The Child-Pugh score was developed for cirrhosis severity and prognosis. It may be less appropriate for certain acute liver conditions or non-cirrhotic causes. A clinician may prefer other tools like MELD for specific situations.
How accurate is a calculator result compared with a doctor’s score?
A calculator can match the standard point thresholds, but it cannot confirm clinical grading or context. Your doctor may interpret ascites and encephalopathy differently and may use updated lab timing. Use the result as a guide for discussion, not a final medical decision.