How is the Child-Pugh score calculated?

Five parameters each score 1–3 points: bilirubin ( 3 mg/dL), albumin (>3.5, 2.8–3.5, 2.3), ascites (none, slight, moderate-to-severe), and encephalopathy (none, grade 1–2, grade 3–4). The total runs from 5 to 15.

What are the Child-Pugh classes?

Class A is 5–6 points (well-compensated), Class B is 7–9, and Class C is 10–15 (decompensated). The classes carry broadly different published survival figures, shown as approximate references that vary by source.

How does it differ from MELD?

Both grade liver-disease severity, but Child-Pugh uses bilirubin, albumin, INR, ascites, and encephalopathy, while MELD is a continuous score from bilirubin, creatinine, INR (and sodium) used mainly for transplant prioritisation. This tool computes Child-Pugh.

Does any of the data I enter leave my browser?

No. The scoring runs entirely in your browser; nothing you enter is sent to a server or stored. The print option produces a clean worksheet you can save as a PDF.

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Child-Pugh score calculator

Score the five Child-Pugh-Turcotte parameters — bilirubin, albumin, INR, ascites, and hepatic encephalopathy — for the cirrhosis severity class (A, B, or C). A severity score for a patient already diagnosed with chronic liver disease, not a diagnosis — and nothing you enter leaves your device.

For a patient already diagnosed with cirrhosis, enter the three labs and set the ascites and encephalopathy grades. Each of the five parameters scores 1, 2, or 3 points; the total runs 5–15.

Laboratory values

Bilirubin (mg/dL)

Enter a value—

Albumin (g/dL)

Enter a value—

INR (ratio)

Enter a value—

Ascites

Hepatic encephalopathy

Child-Pugh total

Enter the three lab values to see the total and its cited Child class.

The Child-Pugh score grades the severity of cirrhosis in a patient already diagnosed with chronic liver disease. It does not diagnose cirrhosis, decide surgical operability or transplant candidacy, or replace hepatology assessment.

Severity score, not a diagnosis. This is a point-tally of values you enter for a patient ALREADY DIAGNOSED with chronic liver disease / cirrhosis — it does not diagnose cirrhosis, does not decide surgical operability or transplant candidacy, and does not replace hepatology assessment. The Class and any survival or surgical-risk figures are published references that vary by source and era, not a verdict or disposition for an individual patient. Scores support, not replace, clinical judgement.

Privacy: Runs entirely in your browser — nothing you enter is sent to a server or stored.

Point thresholds, class cut-offs, and survival figures reproduced from: Tsoris A, Marlar CA. Use of the Child Pugh Score in Liver Disease. StatPearls [Internet]. NCBI Bookshelf NBK542308..

How the Child-Pugh score works

The Child-Pugh-Turcotte score grades the severity of established cirrhosis from five parameters — serum bilirubin, albumin, INR, the degree of ascites, and the grade of hepatic encephalopathy — each scored 1 to 3. The 5–15 total maps to Class A (well-compensated), B, or C (decompensated), which carry broadly different published survival figures. It is a severity grade for a patient already diagnosed with liver disease; it does not diagnose cirrhosis or decide whether surgery or transplant is appropriate.

Many teams still total the parameters on a scrap of paper. If you run a gastroenterology clinic workflow on Avinya Plus, the same arithmetic can live on the note: build the five parameters into a gastroenterology template and total them with the formula engine, so the class sits beside the labs instead of on a calculator. The arithmetic is the engine's; the assessment stays yours.

Frequently asked questions

How is the Child-Pugh score calculated?: Five parameters each score 1–3 points: bilirubin (<2, 2–3, >3 mg/dL), albumin (>3.5, 2.8–3.5, <2.8 g/dL), INR (<1.7, 1.7–2.3, >2.3), ascites (none, slight, moderate-to-severe), and encephalopathy (none, grade 1–2, grade 3–4). The total runs from 5 to 15.
What are the Child-Pugh classes?: Class A is 5–6 points (well-compensated), Class B is 7–9, and Class C is 10–15 (decompensated). The classes carry broadly different published survival figures, shown as approximate references that vary by source.
Does the score diagnose cirrhosis or decide surgery?: No. It grades severity in a patient already diagnosed with chronic liver disease. It does not diagnose cirrhosis, decide surgical operability or transplant candidacy, or replace hepatology assessment.
How does it differ from MELD?: Both grade liver-disease severity, but Child-Pugh uses bilirubin, albumin, INR, ascites, and encephalopathy, while MELD is a continuous score from bilirubin, creatinine, INR (and sodium) used mainly for transplant prioritisation. This tool computes Child-Pugh.
Does any of the data I enter leave my browser?: No. The scoring runs entirely in your browser; nothing you enter is sent to a server or stored. The print option produces a clean worksheet you can save as a PDF.

Sources

Tsoris A, Marlar CA. Use of the Child Pugh Score in Liver Disease. StatPearls [Internet]. NCBI Bookshelf NBK542308.

The five-parameter point thresholds and the Class A/B/C cut-offs are reproduced from StatPearls (NBK542308). Survival percentages vary by source and era and are shown as approximate published references. The score grades severity in a patient already diagnosed with cirrhosis; it does not diagnose or decide operability. Reviewed against the source on 2026-06-29.

Keep the severity grade on the record.

In Avinya Plus you can build the Child-Pugh parameters into a gastroenterology template, total them automatically, and keep the class on the note. See it on a quick demo.