Child-Pugh Score Calculator
The Child-Pugh score grades the severity of chronic liver disease and cirrhosis. It combines two clinical findings (ascites and hepatic encephalopathy) with three laboratory values (total bilirubin, serum albumin and INR), each scored from 1 to 3 points. The total of 5 to 15 maps to Class A, B or C, which guides prognosis and surgical risk assessment. Select each parameter band below and the calculator returns the total score and class. This is an educational tool to support understanding, not a diagnosis or a substitute for clinical judgment.
Child-Pugh scoring
Total = bilirubin + albumin + INR + ascites + encephalopathy
Each parameter scores 1, 2 or 3 points
Class A = 5 to 6; Class B = 7 to 9; Class C = 10 to 15
Minimum total 5; maximum total 15
The score sums the five point values. Higher totals indicate worse hepatic function and a higher operative and mortality risk.
Child-Pugh class context
- Class A (5 to 6): well-compensated disease.
- Class B (7 to 9): significant functional compromise.
- Class C (10 to 15): decompensated disease.
- Used to assess surgical risk and prognosis in cirrhosis.
- Often considered alongside the MELD score.
Child-Pugh score: frequently asked questions
What is the Child-Pugh score?
The Child-Pugh score grades the severity of chronic liver disease using five factors: total bilirubin, serum albumin, INR (or prothrombin time), ascites and hepatic encephalopathy. Each scores 1 to 3 points, giving a total of 5 to 15.
What do the Child-Pugh classes mean?
A total of 5 to 6 points is Class A (well-compensated disease), 7 to 9 is Class B (significant functional compromise) and 10 to 15 is Class C (decompensated disease). Higher classes carry worse prognosis and surgical risk.
How are bilirubin, albumin and INR scored?
Bilirubin under 2 mg/dL scores 1, 2 to 3 scores 2, over 3 scores 3. Albumin over 3.5 g/dL scores 1, 2.8 to 3.5 scores 2, under 2.8 scores 3. INR under 1.7 scores 1, 1.7 to 2.3 scores 2, over 2.3 scores 3.
How are ascites and encephalopathy scored?
Each is graded none (1 point), mild or grade 1 to 2 (2 points), or moderate to severe or grade 3 to 4 (3 points). These are clinical assessments made by the treating team.
Is this a diagnosis?
No. The Child-Pugh score is a prognostic grading tool used by clinicians. This calculator is educational and does not replace medical assessment.
Official sources
- National Institute of Diabetes and Digestive and Kidney Diseases: Cirrhosis information.
- National Library of Medicine (NCBI): Child-Pugh classification literature.
Reviewed by the CalculatorHub team, edited by James Graham, 17 June 2026. See our methodology.