# Child-Pugh Score (Cirrhosis Severity)

Calculate the Child-Pugh score to grade chronic liver disease / cirrhosis severity and estimate perioperative mortality. Five parameters scored 1–3 each (total 5–15): Total bilirubin (<2 mg/dL =1, 2–3 =2, >3 =3) — supports mg/dL or µmol/L input (auto ÷17.1); Serum albumin (>3.5 g/dL =1, 2.8–3.5 =2, <2.8 =3); INR (<1.7 =1, 1.7–2.3 =2, >2.3 =3); Ascites (absent =1, slight/controlled =2, moderate–severe =3); Hepatic encephalopathy (none =1, grade I–II =2, grade III–IV =3). Classes: A (5–6) well-compensated (1-y ~100%, 2-y ~85%); B (7–9) significant compromise (1-y ~80%, 2-y ~60%); C (10–15) decompensated (1-y ~45%, 2-y ~35%). Derived from Pugh et al. 1973 (Br J Surg) and the original Child-Turcotte classification. Not medical advice.

> Canonical page: https://elysiatools.com/en/tools/child-pugh-score

- **Category:** Health

- **Keywords:** Child-Pugh, Child Turcotte Pugh, cirrhosis, liver disease, hepatic, bilirubin, albumin, INR, ascites, encephalopathy, perioperative, transplant

## Overview

Calculate a Child-Pugh score from bilirubin, albumin, INR, ascites, and hepatic encephalopathy findings. The tool returns a total score from 5 to 15, Child-Pugh class A, B, or C, and the associated approximate one- and two-year survival estimates. It is not medical advice.

## Inputs

- **Bilirubin** (number): Total serum bilirubin. Select the unit. mg/dL thresholds: <2 (1), 2–3 (2), >3 (3); µmol/L is auto-converted (÷17.1).
- **Bilirubin unit** (select): Unit of the entered bilirubin value. µmol/L is converted to mg/dL (÷17.1) for scoring.
- **Albumin (g/dL)** (number): Serum albumin in g/dL. >3.5 (1), 2.8–3.5 (2), <2.8 (3).
- **INR** (number): International normalized ratio (INR) or prothrombin time-derived. <1.7 (1), 1.7–2.3 (2), >2.3 (3).
- **Ascites** (select): Absent =1; slight / medically controlled =2; moderate to severe / refractory =3.
- **Hepatic encephalopathy** (select): None =1; grade I–II (suppressed with therapy) =2; grade III–IV (refractory) =3.

## When to use

- Assess the severity of chronic liver disease or cirrhosis using five standard clinical parameters.
- Convert a bilirubin value entered in µmol/L to mg/dL for Child-Pugh scoring.
- Review the score class and approximate survival estimates for clinical discussion or documentation.

## How it works

- Enter total bilirubin and select either mg/dL or µmol/L as the unit.
- Enter serum albumin in g/dL and the INR value.
- Select the applicable ascites and hepatic encephalopathy categories.
- The tool assigns 1 to 3 points for each parameter, adds the points, and returns the Child-Pugh class and approximate survival estimates.

## Use cases

- Clinicians and trainees reviewing cirrhosis severity from laboratory and clinical findings.
- Medical documentation and case discussions requiring a standardized Child-Pugh class.
- Checking how bilirubin units and changes in ascites or encephalopathy affect the total score.

## Frequently asked questions

### What does the Child-Pugh score measure?

It grades chronic liver disease or cirrhosis severity using bilirubin, albumin, INR, ascites, and hepatic encephalopathy.

### What is the Child-Pugh score range?

The total ranges from 5 to 15, with each of the five parameters scored from 1 to 3.

### How are Child-Pugh classes defined?

Class A is 5–6, Class B is 7–9, and Class C is 10–15.

### Can I enter bilirubin in µmol/L?

Yes. Select µmol/L, and the tool converts the value to mg/dL by dividing by 17.1.

### Is the Child-Pugh result medical advice?

No. The result is an informational calculation and should not replace assessment by a qualified healthcare professional.

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