What is the Child-Pugh score?

The Child-Pugh score is a clinical scoring system used to assess the severity of cirrhosis. It combines five parameters — bilirubin, albumin, PT/INR, ascites, and hepatic encephalopathy — each scored 1–3, for a total of 5–15 points. The score classifies patients into Class A, B, or C.

What does each class mean?

Class A (5–6 points) indicates well-compensated cirrhosis with a 1-year survival of approximately 95–100%. Class B (7–9 points) indicates significant functional compromise (~80% 1-year survival). Class C (10–15 points) indicates decompensated cirrhosis (~45% 1-year survival).

How is PT/INR scored?

Prothrombin time prolongation is scored as: 1–4 seconds (score 1), 4–6 seconds (score 2), or more than 6 seconds (score 3). If INR is used instead, the thresholds are: less than 1.7 (score 1), 1.7–2.3 (score 2), or greater than 2.3 (score 3).

Does this tool give medical advice?

No. This calculator is for educational and informational purposes only. All clinical decisions must be made by a qualified healthcare professional, taking into account the full clinical picture of the individual patient.

Is the Child-Pugh score the same as MELD?

No. The MELD (Model for End-Stage Liver Disease) score is a separate and more mathematically precise scoring system now preferred for organ allocation. However, the Child-Pugh score remains widely used for clinical prognosis, surgical risk assessment, and drug dosing guidance.

What are the limitations of the Child-Pugh score?

The score includes subjective parameters (ascites, encephalopathy) that can vary between observers. It was originally developed for predicting outcomes after portocaval shunt surgery, so it may not perfectly predict outcomes in all contexts. Modern guidelines often supplement it with MELD for transplant decisions.

Child-Pugh Score Calculator — Cirrhosis Severity

Child-Pugh Score

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out of 15 possible points

— Select all parameters

5 15

Class Reference & Prognosis

Score 5–6 — Compensated Cirrhosis

1-year survival ~95–100% | 2-year survival ~90%

Well-tolerated disease; low surgical risk

Score 7–9 — Significant Compromise

1-year survival ~80% | 2-year survival ~60%

Moderate surgical risk; consider transplant evaluation

Score 10–15 — Decompensated Cirrhosis

1-year survival ~45% | 2-year survival ~35%

High surgical risk; urgent transplant evaluation warranted

Clinical Interpretation

Select a value for each of the 5 parameters to see the interpretation.

Medical Disclaimer: This tool is for educational and informational purposes only. It does not constitute medical advice, diagnosis, or treatment. The Child-Pugh score should always be interpreted by a qualified healthcare professional in the context of the patient's complete clinical picture. Survival estimates are population-level approximations and may not apply to individual patients.

How it works

Select the appropriate value for each of the 5 clinical parameters.

Each parameter is scored 1 (best) to 3 (worst) based on measured values or clinical findings.

The total score is calculated automatically as you make selections.

Review the Child-Pugh Class (A, B, or C) and the associated 1-year and 2-year survival estimates.

Use the results to support clinical decision-making alongside a qualified hepatologist.

Use cases

Stratify cirrhosis severity for clinical decision-making.

Estimate 1-year and 2-year survival in patients with chronic liver disease.

Assess candidacy for liver transplantation or major surgery.

Guide dosing adjustments for medications metabolized by the liver.

Monitor disease progression over serial clinical assessments.

Educate medical students and residents on hepatic function scoring.

Frequently Asked Questions

Child-Pugh Score Calculator

Clinical Parameters