Rex says
Same equations the textbooks use — just way less awkward. Pop in your stats and I'll tell you what the number actually means for you.
Try a scenario
Click to load — tweak from there.Inputs
Result
Child-Pugh score
9
Child-Pugh class
B
Historical survival estimate
~80% (1yr) / ~60% (2yr)
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How to use this
- 1Enter total bilirubin (mg/dL).
- 2Enter albumin (g/dL).
- 3Enter inr.
- 4Enter ascites.
- 5Enter hepatic encephalopathy.
- 6Read your child-pugh score on the right — it updates as you type.
- 7Hit Share to keep the scenario or send it to someone.
About this calculator
Child-Pugh (Child-Turcotte-Pugh) classifies the severity of liver cirrhosis using bilirubin, albumin, INR (or prothrombin time), ascites, and hepatic encephalopathy, each scored 1-3 points for a total of 5-15. Class A (5-6 points) has the best prognosis, Class B (7-9) intermediate, and Class C (10-15) the worst, with associated one- and two-year survival estimates historically around 100%/85% for A, 80%/60% for B, and 45%/35% for C, though outcomes have improved with modern management. It has long been used to guide surgical risk assessment (cirrhotic patients undergoing abdominal surgery have substantially higher mortality with worsening class), variceal bleeding risk, and eligibility discussions for certain procedures. For liver transplant allocation specifically, the MELD score has largely superseded Child-Pugh because it uses more granular, continuous lab values rather than categorical point cutoffs, so use MELD for transplant listing decisions and Child-Pugh for general severity communication and surgical risk conversations. This tool is for education and workflow support only — not medical advice. Always verify results with a clinician and use clinical judgment alongside your institution's protocols.
Worked example
Using the values the calculator loads with:
Inputs
- Total bilirubin: 2.5 mg/dL
- Albumin: 3 g/dL
- INR: 1.8
- Ascites: Mild/controlled (2pt)
- Hepatic encephalopathy: None (1pt)
Results
- Child-Pugh score: 9
- Child-Pugh class: B
- Historical survival estimate: ~80% (1yr) / ~60% (2yr)
What each field means
Inputs
- Total bilirubin (mg/dL)
- The total bilirubin used in the calculation, measured in mg/dL. Starts at 2.5 mg/dL so you have a working example on load. Accepted range: 0.1–40 mg/dL.
- Albumin (g/dL)
- The albumin used in the calculation, measured in g/dL. Starts at 3 g/dL so you have a working example on load. Accepted range: 1–5.5 g/dL.
- INR
- The inr used in the calculation. Starts at 1.8 so you have a working example on load. Accepted range: 0.8–6.
- Ascites
- Pick the option that matches your situation — the maths changes per option. Choices: None (1pt), Mild/controlled (2pt), Moderate-severe (3pt).
- Hepatic encephalopathy
- Pick the option that matches your situation — the maths changes per option. Choices: None (1pt), Grade 1-2 (2pt), Grade 3-4 (3pt).
Results
- Child-Pugh score
- Returned as a whole number and shown as the headline result. It recalculates instantly whenever you change an input, so you can compare scenarios without reloading.
- Child-Pugh class
- Returned as a plain value. It recalculates instantly whenever you change an input, so you can compare scenarios without reloading.
- Historical survival estimate
- Returned as a plain value. It recalculates instantly whenever you change an input, so you can compare scenarios without reloading.
FAQ
Why has MELD largely replaced Child-Pugh for transplant listing?
MELD uses continuous lab values (bilirubin, creatinine, INR, and now sodium) rather than categorical cutoffs, giving finer discrimination between patients of similar severity, which matters when ranking candidates on a transplant waitlist. Child-Pugh's 1-3 point buckets are simpler but less precise for that specific use.
What is Child-Pugh still used for if not transplant listing?
It remains widely used for estimating surgical risk in cirrhotic patients (mortality rises steeply from Class A to C for abdominal surgery), general prognosis communication, and variceal bleeding risk stratification, where its simplicity and inclusion of clinical findings (ascites, encephalopathy) alongside labs is still valuable.
Why does ascites and encephalopathy matter if they're subjective?
They capture clinically important decompensation that lab values alone miss — a patient can have relatively preserved labs but significant ascites or altered mentation reflecting more advanced disease. Their inclusion is part of why Child-Pugh has remained clinically relevant for decades despite being partly subjective.
Can Child-Pugh class change over time?
Yes, and it should be reassessed at clinically relevant intervals or with any change in status, since cirrhosis severity and decompensation status change with treatment (diuretics for ascites, lactulose for encephalopathy, treating the underlying cause) or disease progression.
Accuracy and limitations
- Population formulas describe averages; individual bodies vary, especially at the extremes of height, age, or muscle mass.
- Results do not account for medical conditions, medication, or pregnancy.
- Use this as a directional reference, not a diagnosis — talk to a clinician before acting on it.
Related tools
Cite this calculator
Writing about this topic? Grab a citation — every link helps keep these tools free.
RevenueLab. (2026). Child-Pugh Score Calculator. Retrieved from https://www.revenuelab.fyi/toolbox/child-pugh-score
<p>Source: <a href="https://www.revenuelab.fyi/toolbox/child-pugh-score" target="_blank" rel="noopener">Child-Pugh Score Calculator — RevenueLab</a> (2026).</p>
Source: [Child-Pugh Score Calculator — RevenueLab](https://www.revenuelab.fyi/toolbox/child-pugh-score) (2026).