Child-Pugh Score Calculator

The Child-Pugh Score is a clinical grading system used to assess the severity of liver cirrhosis and predict prognosis. It helps clinicians determine a patient's liver reserve, guide treatment decisions, and evaluate candidacy for surgical procedures or liver transplantation.

The five parameters are: total bilirubin (mg/dL), serum albumin (g/dL), INR (prothrombin time), presence and severity of ascites, and degree of hepatic encephalopathy. Each parameter is scored 1 to 3 points based on defined thresholds, giving a total score between 5 and 15.

Class A (score 5–6) indicates well-compensated cirrhosis with the best prognosis. Class B (score 7–9) represents significant functional compromise. Class C (score 10–15) indicates decompensated cirrhosis with the poorest prognosis and highest surgical risk.

Class A patients have approximately 95% 1-year survival and 90% 2-year survival. Class B patients have roughly 75% 1-year survival and 60% 2-year survival. Class C patients have around 50% 1-year survival and 35% 2-year survival, reflecting severely impaired hepatic function.

INR (International Normalized Ratio) replaces prothrombin time in the original scoring system to standardize coagulation assessment. An INR below 1.7 scores 1 point, 1.7–2.3 scores 2 points, and above 2.3 scores 3 points, reflecting declining hepatic synthetic function.

Both assess liver disease severity, but the MELD (Model for End-Stage Liver Disease) score uses only objective lab values (bilirubin, INR, creatinine) and is now preferred for liver transplant allocation. The Child-Pugh Score includes subjective clinical assessments (ascites and encephalopathy grading) and is still widely used for surgical risk stratification and prognosis.

Yes. Child-Pugh Class A patients are generally considered acceptable surgical candidates with a perioperative mortality risk around 10%. Class B carries roughly 30% risk, often requiring optimization before elective surgery. Class C patients carry over 80% perioperative mortality risk and are generally not candidates for elective surgery.

The Child-Pugh Score includes subjective parameters (ascites and encephalopathy grades) that can vary between assessors. It was originally designed for patients with alcoholic cirrhosis and may be less accurate in other etiologies. It also does not account for renal function, which strongly influences prognosis in advanced liver disease.