Child-Pugh Score Calculator
Grade cirrhosis severity from five parameters — total bilirubin, serum albumin, INR, ascites and hepatic encephalopathy. Live 5–15 point total, Class A/B/C and published survival context.
Calculate the score
Enter the five values below. The score, class and breakdown update live as you type. Each parameter scores 1, 2 or 3 points.
Your Child-Pugh result
Well-compensated liver function.
| Parameter | Value | Pts |
|---|
1-year ~100% · 3-year ~85% Per published data (Pugh et al., 1973 and subsequent studies); estimates vary across studies and populations. Group figures — not a personal prediction.
Scoring reference
The standard Child-Pugh thresholds used by the calculator above.
| Parameter | 1 point | 2 points | 3 points |
|---|---|---|---|
| Total bilirubin | < 2 mg/dL | 2–3 mg/dL | > 3 mg/dL |
| Serum albumin | > 3.5 g/dL | 2.8–3.5 g/dL | < 2.8 g/dL |
| INR | < 1.7 | 1.7–2.3 | > 2.3 |
| Ascites | None | Mild | Moderate to severe |
| Encephalopathy | None | Grade 1–2 | Grade 3–4 |
About the Child-Pugh score
The Child-Pugh classification — also known as the Child-Turcotte-Pugh score (CTP) — is the classic bedside method for grading cirrhosis severity in chronic liver disease. This CTP score calculator applies the standard Child-Pugh criteria: five Child-Pugh parameters (Child-Pugh bilirubin, Child-Pugh albumin, Child-Pugh INR, Child-Pugh ascites and Child-Pugh encephalopathy), each worth 1 to 3 Child-Pugh points, as shown in the Child-Pugh score chart above. If you are learning how to calculate the Child-Pugh score, the worked examples show exactly how the points add up.
The total gives the Child-Pugh score interpretation across the three Child-Pugh classes: Child-Pugh Class A, Child-Pugh Class B or Child-Pugh Class C — broadly, compensated cirrhosis versus decompensated cirrhosis. This page also puts the classes in context with Child-Pugh survival figures (Child-Pugh 1-year survival and Child-Pugh 3-year survival, per published data), explains the Child-Pugh vs MELD difference, handles unit conversions such as bilirubin umol/L to mg/dL and albumin g/L to g/dL, and follows the West Haven criteria for hepatic encephalopathy grading. Used as a liver cirrhosis score calculator, cirrhosis severity calculator, cirrhosis prognosis calculator or liver disease severity score, this free online Child-Pugh score calculator is strictly educational: it does not diagnose, and it cannot replace your doctor’s assessment.
What the classes mean
Total 5–15 points. Survival figures are per published data; estimates vary.
| Class | Points | Description | 1-year survival* | 3-year survival* |
|---|---|---|---|---|
| A | 5–6 | Well-compensated liver function | ~100% | ~85% |
| B | 7–9 | Significant functional compromise | ~80% | ~57% |
| C | 10–15 | Decompensated liver disease | ~45% | ~35% |
*Per published data (Pugh et al., 1973 and subsequent studies); estimates vary across studies and populations.
Example cases
Load a worked Child-Pugh example into the calculator to see how each class is reached. Values are illustrative teaching examples, not real patients.
Case 1 — Class A (5 pts)
Bilirubin 1.2 mg/dL, albumin 4.1 g/dL, INR 1.1, no ascites, no encephalopathy.
Case 2 — Class B (9 pts)
Bilirubin 2.4 mg/dL, albumin 3.1 g/dL, INR 1.8, mild ascites, no encephalopathy.
Case 3 — Class C (15 pts)
Bilirubin 5.8 mg/dL, albumin 2.4 g/dL, INR 2.7, moderate-to-severe ascites, encephalopathy grade 3–4.
Frequently asked questions
What is the Child-Pugh score?
The Child-Pugh score — also called the Child-Turcotte-Pugh (CTP) score — is a system for grading the severity of chronic liver disease, most often cirrhosis. It was introduced by Pugh and colleagues in 1973 to help assess operative risk in patients with bleeding oesophageal varices, and it is still widely used as a general measure of how well the liver is functioning.
Which five factors does the Child-Pugh score use?
Total bilirubin, serum albumin, INR (a blood-clotting measure), the amount of ascites (fluid in the abdomen), and the grade of hepatic encephalopathy (brain dysfunction caused by liver failure). Each factor scores 1 to 3 points.
How is the Child-Pugh total calculated?
Add the five point values together. The total ranges from 5 to 15: 5–6 points is Class A, 7–9 points is Class B, and 10–15 points is Class C. A higher total reflects more severe liver dysfunction.
What do Child-Pugh Class A, B, and C mean?
Class A (5–6 points) indicates well-compensated liver function; Class B (7–9) indicates significant functional compromise; Class C (10–15) indicates decompensated liver disease. These are broad categories used for communication and comparison — they are not a diagnosis for any individual.
What survival figures are associated with each Child-Pugh class?
Per published data (estimates vary across studies and populations): Class A — about 100% one-year and 85% three-year survival; Class B — about 80% one-year and 57% three-year survival; Class C — about 45% one-year and 35% three-year survival. These figures come from the original 1973 report and later studies; they describe groups, not individuals.
How is ascites graded in the Child-Pugh score?
In the Child-Pugh system ascites is graded clinically as none (1 point), mild or slight (2 points), or moderate to severe (3 points). The assessment is usually made by physical examination and imaging, so it involves clinical judgment.
How is hepatic encephalopathy graded in the Child-Pugh score?
Encephalopathy is graded as none (1 point), grade 1–2 (2 points), or grade 3–4 (3 points), following the West Haven criteria. Grades 1–2 cover subtle changes such as altered sleep patterns, mild confusion, or a flapping tremor (asterixis); grades 3–4 cover marked confusion, stupor, and coma. Grading requires a clinician’s assessment.
What is the difference between Child-Pugh and MELD?
Child-Pugh mixes laboratory values with clinical assessments (ascites and encephalopathy, which are somewhat subjective). MELD (Model for End-Stage Liver Disease) is calculated purely from laboratory values — bilirubin, INR, creatinine, and sodium — and is the score used for liver-transplant allocation in many countries. This tool calculates Child-Pugh only; it does not calculate MELD or MELD-Na.
Can the Child-Pugh score change over time?
Yes. The score reflects the patient’s current status, so it can improve or worsen as bilirubin, albumin, INR, ascites, or encephalopathy change. Clinicians often recalculate it at follow-up visits.
Does a higher Child-Pugh score guarantee a worse outcome for me?
No. The score describes the average outlook for groups of patients with similar scores; individual outcomes vary widely and depend on the cause of liver disease, other health conditions, and treatment. Only your own doctor can interpret what a score means for you.
Why does the calculator ask for measurement units?
Laboratories report bilirubin in mg/dL or µmol/L, and albumin in g/dL or g/L, depending on the country. The calculator converts your entries automatically (µmol/L ÷ 17.1 = mg/dL; g/L ÷ 10 = g/dL) before applying the standard thresholds.
Is this Child-Pugh calculator a medical diagnosis?
No. It is an educational tool that performs the standard Child-Pugh arithmetic. It does not diagnose liver disease, stage your condition, or predict your personal outcome, and it cannot replace a clinician’s assessment. All treatment decisions should be made with a qualified doctor.
Who is this Child-Pugh calculator for?
It is designed for education and quick reference — for example, medical students learning the score, clinicians double-checking the arithmetic, and patients or caregivers who want to understand a score their doctor has mentioned. Anyone with liver disease should discuss results with their own healthcare team.
What should I do with my Child-Pugh result?
Treat it as background information, not guidance. If a score was calculated from your own lab results, bring the numbers — and any questions — to your doctor or liver specialist (hepatologist), who can interpret them in the context of your full medical picture.
Free tool by NRTechStudio