Child-Pugh Score Calculator

Child-Pugh Score Calculator for Gastroenterology. Classes A (5-6), B (7-9) and C (10-15) summarize increasing impairment in this INR-based variant. They are not guaranteed survival percentages or independent operative clearance.

For shared guidance on choosing a tool and documenting results, read the clinical calculator workflow.

How this calculator works

The common INR-based Child-Pugh variant adds five component scores (1-3 each), total 5-15. Classes are A 5-6, B 7-9 and C 10-15. Bilirubin is mg/dL and albumin g/dL; this is not the cholestatic-disease bilirubin variant.

When to use this calculator

Use the class to describe chronic liver disease in a documented clinical assessment or where a specific medicine label requests it. It does not independently establish cirrhosis, clear someone for surgery, or determine transplant priority.

Inputs used

  • Total bilirubin (mg/dL)
  • Albumin (g/dL)
  • INR
  • Clinician-assessed ascites
  • Clinician-assessed encephalopathy

Clinical interpretation

Classes A (5-6), B (7-9) and C (10-15) summarize increasing impairment in this INR-based variant. They are not guaranteed survival percentages or independent operative clearance.

Worked example

Fictional teaching case. Total bilirubin (mg/dL): 3.5; Albumin (g/dL): 2.7; INR: 1.8; Clinician-assessed ascites: Mild / controlled with treatment; Clinician-assessed encephalopathy: Absent. Result: 11 points. Child-Pugh class C. Contributions in assessment order: 3 + 3 + 2 + 2 + 1 = 11. This is a risk estimate, not a diagnosis, a personal survival prediction, or an automatic treatment/discharge decision.

Limitations and safety notes

Ascites and encephalopathy require clinical assessment. Anticoagulants can distort INR; cholestatic variants have different bilirubin bands. The original 1973 study used PT prolongation, while this explicitly named variant uses INR.

Frequently asked questions

Does Class A mean surgery is safe?

No. Procedure type, portal hypertension, current decompensation, comorbidity, and specialist assessment remain important even with a low class.

What can change the meaning of this result?

Ascites and encephalopathy require clinical assessment. Anticoagulants can distort INR; cholestatic variants have different bilirubin bands. The original 1973 study used PT prolongation, while this explicitly named variant uses INR.

References

  • Original Child-Pugh identity; no abstract available. https://pubmed.ncbi.nlm.nih.gov/4541913/
  • University of Washington Child-Turcotte-Pugh INR variant, input bands and classes. https://www.hepatitisc.uw.edu/page/clinical-calculators/ctp

Editorial review and citation methodology

Maintained by the Quick Medical Calculator Editorial Team. Content record date: September 9, 2026. A content date is not evidence of independent clinical review. Individual clinical sign-off is not recorded on this page.

  • Prefer original validation studies for scoring systems and prediction tools.
  • Use current specialty society guidance, transplant allocation policy, public health guidance, or regulator resources when they govern clinical use.
  • Include limitations and safety notes when a calculator is population-specific, context-dependent, or unsuitable as a standalone decision tool.

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