Calculator Form
Three columns on large screens, two on smaller screens, and one on mobile.
Plotly Graph
The chart displays each component score and the total score. If no result exists yet, it shows an example profile.
Example Data Table
| Case | Bilirubin (mg/dL) | Albumin (g/dL) | INR | Ascites | Encephalopathy | Total | Class |
|---|---|---|---|---|---|---|---|
| Example 1 | 1.4 | 3.8 | 1.3 | None | None | 5 | A |
| Example 2 | 2.5 | 3.0 | 1.9 | Mild | Grade 1–2 | 10 | C |
| Example 3 | 3.6 | 2.9 | 2.0 | Mild | None | 10 | C |
| Example 4 | 2.2 | 3.4 | 1.8 | None | Grade 1–2 | 8 | B |
Formula Used
Child-Pugh Total Score = Bilirubin Points + Albumin Points + INR Points + Ascites Points + Encephalopathy Points
- Bilirubin: < 2 mg/dL = 1 point, 2 to 3 mg/dL = 2 points, > 3 mg/dL = 3 points
- Albumin: > 3.5 g/dL = 1 point, 2.8 to 3.5 g/dL = 2 points, < 2.8 g/dL = 3 points
- INR: < 1.7 = 1 point, 1.7 to 2.2 = 2 points, > 2.2 = 3 points
- Ascites: None = 1 point, Mild/Slight = 2 points, Moderate/Severe = 3 points
- Encephalopathy: None = 1 point, Grade 1–2 = 2 points, Grade 3–4 = 3 points
Class Bands: 5–6 = Class A, 7–9 = Class B, 10–15 = Class C.
How to Use This Calculator
- Enter bilirubin, albumin, and INR values from the patient’s assessment.
- Select the matching ascites severity and hepatic encephalopathy grade.
- Optionally add patient identification and notes for reporting purposes.
- Press Submit to display the result summary above the form.
- Review total score, Child-Pugh class, interpretation panel, and graph.
- Use the CSV or PDF buttons to export the current result.
Professional Article
Why This Score Matters
The Child-Pugh score summarizes five clinical and laboratory markers to estimate hepatic reserve in cirrhosis. It remains useful for bedside stratification because it combines synthetic function, portal hypertension burden, and neurocognitive complications into one compact classification framework used across hepatology and surgery. It is commonly used to communicate severity in a standardized way during referral, treatment planning, and follow-up discussions.
Five Inputs and Their Weights
This calculator assigns 1 to 3 points for total bilirubin, serum albumin, INR, ascites severity, and hepatic encephalopathy grade. Lower bilirubin, higher albumin, and lower INR receive fewer points. None or mild complications score lower than moderate or severe findings, reflecting better preserved liver function. The five-domain design also lets clinicians see whether deterioration is driven by coagulation change, hypoalbuminemia, worsening cholestasis, fluid retention, or overt encephalopathy.
Interpreting the Total
A total of 5 to 6 indicates Class A, usually interpreted as well compensated disease. A score of 7 to 9 indicates Class B with meaningful functional compromise. A score of 10 to 15 indicates Class C, commonly associated with advanced decompensation and substantially higher clinical risk. Because each domain contributes equally in points, modest worsening across several variables may shift class even when one marker alone appears only moderately abnormal.
Using the Graph for Review
The Plotly chart displays each component score and the overall total, helping users identify which variables are driving classification. A balanced low profile suggests stronger reserve, while clustered high scores in bilirubin, INR, ascites, or encephalopathy can quickly reveal why the patient moved into a higher severity class. That visual pattern is especially useful when reviewing serial visits, multidisciplinary discussions, or export summaries.
Example Pattern Analysis
For example, bilirubin 1.4 mg/dL, albumin 3.8 g/dL, INR 1.3, no ascites, and no encephalopathy produce 5 points and Class A. By contrast, bilirubin 3.6 mg/dL, albumin 2.9 g/dL, INR 2.0, mild ascites, and no encephalopathy produce 10 points, placing the patient in Class C.
Clinical Use and Limits
This tool supports structured review, documentation, teaching, and quick comparison of repeated assessments. Still, ascites and encephalopathy grading can be subjective, and the score should not replace clinical judgment, etiology review, imaging, hemodynamics, or transplant evaluation pathways when a patient has active decompensation or rapidly changing status. It is best viewed as a decision-support layer rather than a standalone diagnosis in routine practice settings.
FAQs
What does the Child-Pugh score estimate?
It estimates cirrhosis severity using bilirubin, albumin, INR, ascites, and encephalopathy. The result groups patients into Class A, B, or C for practical clinical stratification.
Can this calculator diagnose liver disease?
No. It organizes available findings into a known severity score. Diagnosis and treatment decisions still require clinician assessment, history, examination, imaging, and relevant laboratory review.
Why do ascites and encephalopathy affect scoring?
They reflect clinical decompensation. When either complication worsens, the assigned points rise, increasing the total score and generally indicating poorer hepatic reserve.
What is the difference between Class A, B, and C?
Class A represents lower severity, Class B indicates moderate functional compromise, and Class C reflects advanced decompensation. Higher classes usually require closer monitoring and broader clinical evaluation.
Should I use this score alone for prognosis?
No. It is helpful, but prognosis also depends on cause of liver disease, kidney function, bleeding risk, infection status, nutritional state, and response to treatment.
Can I export the result after calculation?
Yes. After submission, the page shows the result above the form and enables CSV and PDF export for documentation, reporting, or print workflows.