{"id":66657,"date":"2026-10-12T09:11:46","date_gmt":"2026-10-12T06:11:46","guid":{"rendered":"https:\/\/wpcalc.com\/en\/?p=66657"},"modified":"2026-10-12T09:11:46","modified_gmt":"2026-10-12T06:11:46","slug":"child-pugh-score-calculator","status":"publish","type":"post","link":"https:\/\/wpcalc.com\/en\/medical\/child-pugh-score-calculator\/","title":{"rendered":"Child-Pugh Score Calculator"},"content":{"rendered":"<section class=\"not-prose calculator-box\" aria-labelledby=\"calculator-title\"><div class=\"flex items-baseline sm:items-center justify-between gap-2 sm:gap-3\"><div class=\"flex flex-col sm:flex-row sm:items-center gap-2\"><span class=\"icon icon-calculator text-primary-700! text-base! dark:text-primary-300!\" aria-hidden=\"true\"><\/span><h2 id=\"calculator-title\" class=\"text-lg font-display font-bold\">Classify Cirrhosis Severity with the Child-Pugh Score<\/h2><\/div><div class=\"calcdash-favorite group\">\n  <button type=\"button\" class=\"favorite\" id=\"favorite\" data-favorite-id=\"66657\" data-favorite-title=\"Child-Pugh Score\" data-favorite-url=\"https:\/\/wpcalc.com\/en\/medical\/child-pugh-score-calculator\/\" data-favorite-excerpt=\"Enter bilirubin, albumin, INR or PT prolongation, and the severity of ascites and encephalopathy to get the Child-Pugh score (5\u201315 points) and class A, B or C for cirrhosis severity.\" aria-label=\"Add to Favorites\" data-favorite-icon=\"icon icon-flask\">\n    <span class=\"icon icon-shape-star-empty\" aria-hidden=\"true\"><\/span>\n  <\/button>\n  <div class=\"calcdash-favorite__tip\" aria-hidden=\"true\">\n   <span class=\"favorite-tooltip\" id=\"favorite-tooltip\"><\/span>\n  <\/div>\n  <span class=\"sr-only\" role=\"status\" id=\"favorite-status\"><\/span>\n<\/div><\/div><form action=\"https:\/\/wpcalc.com\/en\/medical\/child-pugh-score-calculator\/\" method=\"POST\" class=\"calculator\" id=\"calculator-66657\" data-post=\"66657\"><fieldset class=\"fieldset-input is-2\"><legend class=\"sr-only\">Input Fields<\/legend><div class=\"field has-term\" id=\"input-1\"><label for=\"field-1\">Total bilirubin<\/label><div class=\"term\">Bili<\/div>  <div class=\"absolute bottom-0 left-16 top-8 w-2 h-0.5 bg-blue-500\"><\/div><div class=\"field-group\"><input type=\"text\" name=\"total_bilirubin\" id=\"field-1\" aria-describedby=\"calc-info-1\" data-number inputmode=\"decimal\" autocomplete=\"off\" spellcheck=\"false\" min=\"0.1\" max=\"50\" value=\"2.5\"\/><div class=\"grid grid-cols-1\"><select id=\"field-2\" name=\"unit\" aria-label=\"Unit\"><option value=\"mgdl\" selected>mg\/dL<\/option><option value=\"umol\">\u00b5mol\/L<\/option><\/select><svg class=\"pointer-events-none col-start-1 row-start-1 mr-2 size-5 self-center justify-self-end text-gray-500 sm:size-4\" viewBox=\"0 0 16 16\" fill=\"currentColor\" aria-hidden=\"true\" data-slot=\"icon\">\n              <path fill-rule=\"evenodd\" d=\"M4.22 6.22a.75.75 0 0 1 1.06 0L8 8.94l2.72-2.72a.75.75 0 1 1 1.06 1.06l-3.25 3.25a.75.75 0 0 1-1.06 0L4.22 7.28a.75.75 0 0 1 0-1.06Z\" clip-rule=\"evenodd\" \/>\n            <\/svg><\/div><\/div><small id=\"calc-info-1\">From your blood test<\/small><\/div><div class=\"field has-term\" id=\"input-2\"><label for=\"field-3\">Serum albumin<\/label><div class=\"term\">Alb<\/div>  <div class=\"absolute bottom-0 left-16 top-8 w-2 h-0.5 bg-blue-500\"><\/div><div class=\"field-group\"><input type=\"text\" name=\"serum_albumin\" id=\"field-3\" aria-describedby=\"calc-info-3\" data-number inputmode=\"decimal\" autocomplete=\"off\" spellcheck=\"false\" min=\"0.5\" max=\"6\" value=\"3\"\/><div class=\"grid grid-cols-1\"><select id=\"field-4\" name=\"unit\" aria-label=\"Unit\"><option value=\"gdl\" selected>g\/dL<\/option><option value=\"gl\">g\/L<\/option><\/select><svg class=\"pointer-events-none col-start-1 row-start-1 mr-2 size-5 self-center justify-self-end text-gray-500 sm:size-4\" viewBox=\"0 0 16 16\" fill=\"currentColor\" aria-hidden=\"true\" data-slot=\"icon\">\n              <path fill-rule=\"evenodd\" d=\"M4.22 6.22a.75.75 0 0 1 1.06 0L8 8.94l2.72-2.72a.75.75 0 1 1 1.06 1.06l-3.25 3.25a.75.75 0 0 1-1.06 0L4.22 7.28a.75.75 0 0 1 0-1.06Z\" clip-rule=\"evenodd\" \/>\n            <\/svg><\/div><\/div><small id=\"calc-info-3\">From your blood test<\/small><\/div><div class=\"field\" id=\"input-3\"><label for=\"field-5\">Clotting measure<\/label><div class=\"grid grid-cols-1\"><select id=\"field-5\" name=\"clotting_measure\"><option value=\"inr\" selected>INR<\/option><option value=\"pt\">PT prolongation<\/option><\/select><svg class=\"pointer-events-none col-start-1 row-start-1 mr-2 size-5 self-center justify-self-end text-gray-500 sm:size-4\" viewBox=\"0 0 16 16\" fill=\"currentColor\" aria-hidden=\"true\" data-slot=\"icon\">\n              <path fill-rule=\"evenodd\" d=\"M4.22 6.22a.75.75 0 0 1 1.06 0L8 8.94l2.72-2.72a.75.75 0 1 1 1.06 1.06l-3.25 3.25a.75.75 0 0 1-1.06 0L4.22 7.28a.75.75 0 0 1 0-1.06Z\" clip-rule=\"evenodd\" \/>\n            <\/svg><\/div><\/div><div class=\"field has-term\" id=\"input-4\"><label for=\"field-6\">INR \/ PT prolongation<\/label><div class=\"term\">INR<\/div>  <div class=\"absolute bottom-0 left-16 top-8 w-2 h-0.5 bg-blue-500\"><\/div><input type=\"text\" name=\"inr_pt_prolongation\" id=\"field-6\" aria-describedby=\"calc-info-6\" data-number inputmode=\"decimal\" autocomplete=\"off\" spellcheck=\"false\" min=\"0.5\" max=\"30\" value=\"1.8\"\/><small id=\"calc-info-6\">INR value, or prothrombin time in seconds above the control value<\/small><\/div><div class=\"field\" id=\"input-5\"><label for=\"field-7\">Ascites<\/label><div class=\"grid grid-cols-1\"><select id=\"field-7\" name=\"ascites\"><option value=\"none\">None<\/option><option value=\"slight\" selected>Slight (controlled medically)<\/option><option value=\"moderate\">Moderate to severe (poorly controlled)<\/option><\/select><svg class=\"pointer-events-none col-start-1 row-start-1 mr-2 size-5 self-center justify-self-end text-gray-500 sm:size-4\" viewBox=\"0 0 16 16\" fill=\"currentColor\" aria-hidden=\"true\" data-slot=\"icon\">\n              <path fill-rule=\"evenodd\" d=\"M4.22 6.22a.75.75 0 0 1 1.06 0L8 8.94l2.72-2.72a.75.75 0 1 1 1.06 1.06l-3.25 3.25a.75.75 0 0 1-1.06 0L4.22 7.28a.75.75 0 0 1 0-1.06Z\" clip-rule=\"evenodd\" \/>\n            <\/svg><\/div><\/div><div class=\"field\" id=\"input-6\"><label for=\"field-8\">Hepatic encephalopathy<\/label><div class=\"grid grid-cols-1\"><select id=\"field-8\" name=\"hepatic_encephalopathy\"><option value=\"none\" selected>None<\/option><option value=\"grade12\">Grade I\u2013II (mild)<\/option><option value=\"grade34\">Grade III\u2013IV (severe)<\/option><\/select><svg class=\"pointer-events-none col-start-1 row-start-1 mr-2 size-5 self-center justify-self-end text-gray-500 sm:size-4\" viewBox=\"0 0 16 16\" fill=\"currentColor\" aria-hidden=\"true\" data-slot=\"icon\">\n              <path fill-rule=\"evenodd\" d=\"M4.22 6.22a.75.75 0 0 1 1.06 0L8 8.94l2.72-2.72a.75.75 0 1 1 1.06 1.06l-3.25 3.25a.75.75 0 0 1-1.06 0L4.22 7.28a.75.75 0 0 1 0-1.06Z\" clip-rule=\"evenodd\" \/>\n            <\/svg><\/div><\/div><\/fieldset><div class=\"buttons\"><button type=\"submit\" data-text=\"Re-Calculate\" id=\"calculate-button\" data-post=\"66657\">Calculate<\/button><button type=\"reset\">Reset<\/button><\/div><div class=\"field is-checkbox hidden!\" id=\"field-auto-calc\"><input type=\"checkbox\" id=\"auto-calc\"><label for=\"auto-calc\">Calculate automatically<\/label><small>If enabled, the result will update automatically when you change any value.<\/small><\/div><div class=\"fieldset-result is-hidden\" aria-labelledby=\"result-title\" aria-live=\"polite\" role=\"region\"> <h3 class=\"result-title bg-gradient-to-r from-primary-50 to-gray-50 dark:from-primary-900 dark:to-gray-800\" id=\"result-title\"><span class=\"icon icon-s-pulse\" aria-hidden=\"true\"><\/span> Your Child-Pugh Result<\/h3><div class=\"result-box\"><div class=\"field-result\" id=\"output-1\"><span class=\"field-title\"><span>Child-Pugh score<\/span><span class=\"result-term\">C-P<\/span><\/span><span class=\"field-value\" id=\"result-1\" data-unit=\"points\"><\/span><button type=\"button\" class=\"copy-result\" data-tooltip=\"Copy Result\" aria-label=\"Copy Result\"><span class=\"copy-icon icon icon-document-copy\" aria-hidden=\"true\"><\/span><\/button><\/div><div class=\"field-result is-column\" id=\"output-2\"><span class=\"field-title\"><span>Child-Pugh class<\/span><\/span><span class=\"field-value\" id=\"result-2\"><\/span><button type=\"button\" class=\"copy-result\" data-tooltip=\"Copy Result\" aria-label=\"Copy Result\"><span class=\"copy-icon icon icon-document-copy\" aria-hidden=\"true\"><\/span><\/button><\/div><div class=\"field-result is-column\" id=\"output-3\"><span class=\"field-title\"><span>What this means<\/span><\/span><span class=\"field-value\" id=\"result-3\"><\/span><button type=\"button\" class=\"copy-result\" data-tooltip=\"Copy Result\" aria-label=\"Copy Result\"><span class=\"copy-icon icon icon-document-copy\" aria-hidden=\"true\"><\/span><\/button><\/div><\/div><div class=\"result-actions\"><button type=\"button\" class=\"copy-link\"><svg viewBox=\"0 0 20 20\" fill=\"currentColor\" aria-hidden=\"true\"><path d=\"M12.232 4.232a2.5 2.5 0 0 1 3.536 3.536l-1.225 1.224a.75.75 0 0 0 1.061 1.06l1.224-1.224a4 4 0 0 0-5.656-5.656l-3 3a4 4 0 0 0 .225 5.865.75.75 0 0 0 .977-1.138 2.5 2.5 0 0 1-.142-3.667l3-3Z\"\/><path d=\"M11.603 7.963a.75.75 0 0 0-.977 1.138 2.5 2.5 0 0 1 .142 3.667l-3 3a2.5 2.5 0 0 1-3.536-3.536l1.225-1.224a.75.75 0 0 0-1.061-1.06l-1.224 1.224a4 4 0 1 0 5.656 5.656l3-3a4 4 0 0 0-.225-5.865Z\"\/><\/svg><span class=\"copy-link__text\">Copy link to this calculation<\/span><\/button><span class=\"sr-only\" role=\"status\" id=\"copy-link-status\"><\/span><\/div><\/div><a href=\"#respond\" class=\"hidden transition-opacity duration-300 opacity-0 w-50 text-sm justify-center items-center gap-2 px-4 py-2 rounded bg-gray-200 text-gray-700 hover:bg-gray-300\" id=\"leave-comment\"><span class=\"icon icon-comments\" aria-hidden=\"true\"><\/span>Leave a Comment<\/a><\/form><\/section><section id=\"calc-reactions\" class=\"not-prose hidden my-12 bg-gradient-to-r from-primary-50 to-gray-50 border border-indigo-100 rounded-xl px-6 py-4 shadow-sm\" data-post=\"66657\" aria-live=\"polite\" aria-labelledby=\"calc-reactions-title\"><p id=\"calc-reactions-title\" class=\"text-sm text-gray-500 text-center mb-2\">How did this result make you feel?<\/p><div role=\"group\" aria-labelledby=\"calc-reactions-title\" class=\"grid grid-cols-3 sm:flex sm:flex-row sm:justify-around gap-4 sm:items-center sm:flex-wrap\"><button type=\"button\" aria-pressed=\"false\" class=\"reaction-btn flex flex-col items-center gap-1 text-sm text-gray-700 hover:text-primary-600 cursor-pointer transition-transform hover:scale-105\" data-reaction=\"like\"><span class=\"reaction-count\" data-reaction-count=\"like\">0<\/span><span class=\"reaction text-3xl\" aria-hidden=\"true\">\ud83d\ude00 <\/span><span class=\"reaction-description font-medium\">Like <\/span><\/button><button type=\"button\" aria-pressed=\"false\" class=\"reaction-btn flex flex-col items-center gap-1 text-sm text-gray-700 hover:text-primary-600 cursor-pointer transition-transform hover:scale-105\" data-reaction=\"helpful\"><span class=\"reaction-count\" data-reaction-count=\"helpful\">0<\/span><span class=\"reaction text-3xl\" aria-hidden=\"true\">\ud83d\udca1 <\/span><span class=\"reaction-description font-medium\">Helpful <\/span><\/button><button type=\"button\" aria-pressed=\"false\" class=\"reaction-btn flex flex-col items-center gap-1 text-sm text-gray-700 hover:text-primary-600 cursor-pointer transition-transform hover:scale-105\" data-reaction=\"confused\"><span class=\"reaction-count\" data-reaction-count=\"confused\">0<\/span><span class=\"reaction text-3xl\" aria-hidden=\"true\">\ud83d\ude15 <\/span><span class=\"reaction-description font-medium\">Confused <\/span><\/button><button type=\"button\" aria-pressed=\"false\" class=\"reaction-btn flex flex-col items-center gap-1 text-sm text-gray-700 hover:text-primary-600 cursor-pointer transition-transform hover:scale-105\" data-reaction=\"disappointed\"><span class=\"reaction-count\" data-reaction-count=\"disappointed\">0<\/span><span class=\"reaction text-3xl\" aria-hidden=\"true\">\ud83d\ude1e <\/span><span class=\"reaction-description font-medium\">Disappointed <\/span><\/button><button type=\"button\" aria-pressed=\"false\" class=\"reaction-btn flex flex-col items-center gap-1 text-sm text-gray-700 hover:text-primary-600 cursor-pointer transition-transform hover:scale-105\" data-reaction=\"inaccurate\"><span class=\"reaction-count\" data-reaction-count=\"inaccurate\">0<\/span><span class=\"reaction text-3xl\" aria-hidden=\"true\">\u274c <\/span><span class=\"reaction-description font-medium\">Inaccurate <\/span><\/button><\/div><div id=\"reaction-message\" class=\"hidden mt-8 rounded-md border border-primary-100 bg-white\/50 backdrop-blur-sm px-4 py-2 text-sm text-center shadow-sm\"><\/div><\/section><div class=\"calcdash-ad not-prose calcdash-ad--calc_result calcdash-ad--in-article\"><ins class=\"adsbygoogle\" style=\"display:block\" data-ad-client=\"ca-pub-1721569815777345\" data-ad-slot=\"6317458308\" data-ad-layout=\"in-article\" data-ad-format=\"fluid\"><\/ins><script>(adsbygoogle = window.adsbygoogle || []).push({});<\/script><\/div>\n<style id=\"wpcoderpro-inline-1\">.formula-box {\r\n\tborder-bottom: none !important;\r\n}<\/style><section class=\"formula-box\" aria-labelledby=\"formula-title\">\r\n\t<div id=\"formula-title\" class=\"not-prose font-display mb-4\"><span class=\"icon icon-formula\" aria-hidden=\"true\"><\/span><h2>Child-Pugh Score Formula<\/h2><\/div>\r\n\t<figure class=\"not-prose formula\">\r\n\t\t<figcaption class=\"formula-title\">Formula<\/figcaption>\r\n\t\t<div class=\"text-base text-gray-800\" id=\"formula\">\n\\[ \\text{Child-Pugh score} = P_{\\text{bilirubin}} + P_{\\text{albumin}} + P_{\\text{clotting}} + P_{\\text{ascites}} + P_{\\text{encephalopathy}} \\]\n<\/div>\r\n\t<\/figure>\r\n\t<\/p>\n<p><strong>Where:<\/strong><\/p>\n<ul>\n<li>\\(P_{\\text{bilirubin}}\\) \u2014 points for total bilirubin (mg\/dL): 1 if &lt;2, 2 if 2\u20133, 3 if &gt;3<\/li>\n<li>\\(P_{\\text{albumin}}\\) \u2014 points for serum albumin (g\/dL): 1 if &gt;3.5, 2 if 2.8\u20133.5, 3 if &lt;2.8<\/li>\n<li>\\(P_{\\text{clotting}}\\) \u2014 points for INR: 1 if &lt;1.7, 2 if 1.7\u20132.3, 3 if &gt;2.3 (or PT prolongation: &lt;4 s, 4\u20136 s, &gt;6 s)<\/li>\n<li>\\(P_{\\text{ascites}}\\) \u2014 1 for none, 2 for slight (medically controlled), 3 for moderate to severe (poorly controlled)<\/li>\n<li>\\(P_{\\text{encephalopathy}}\\) \u2014 1 for none, 2 for grade I\u2013II, 3 for grade III\u2013IV<\/li>\n<\/ul>\n<p>Each of the five parameters earns 1, 2 or 3 points, so the total score ranges from 5 to 15. The total is then mapped to a class: A (5\u20136 points), B (7\u20139) or C (10\u201315).<\/p>\n<p>\r\n<\/section>\n<style id=\"wpcoderpro-inline-459\">.calculation-box {\r\n\tborder-bottom: none !important;\r\n}<\/style><section id=\"calculation\" class=\"calculation-box\" aria-labelledby=\"calculation-title\">\r\n\t<div id=\"calculation-title\" class=\"not-prose font-display\"><span class=\"icon icon-unordered-list\" aria-hidden=\"true\"><\/span><h2>Child-Pugh Score \u2013 Calculation Example<\/h2><\/div>\r\n\r\n<\/p>\n<p><strong>Example:<\/strong> a patient with cirrhosis has a total bilirubin of 2.5 mg\/dL, serum albumin of 3.0 g\/dL, INR of 1.8, slight ascites controlled with medication, and no hepatic encephalopathy.<\/p>\n<p>\\[ P_{\\text{bili}} = 2 \\;(2.5 \\text{ mg\/dL is in the 2\u20133 range}), \\quad P_{\\text{alb}} = 2 \\;(3.0 \\text{ g\/dL is in the 2.8\u20133.5 range}) \\]<\/p>\n<p>\\[ P_{\\text{INR}} = 2 \\;(1.8 \\text{ is in the 1.7\u20132.3 range}), \\quad P_{\\text{asc}} = 2, \\quad P_{\\text{enc}} = 1 \\]<\/p>\n<p>\\[ \\text{Score} = 2 + 2 + 2 + 2 + 1 = 9 \\text{ points} \\]<\/p>\n<p><strong>Result:<\/strong> 9 points \u2014 Child-Pugh Class B, indicating significant functional compromise of the liver.<\/p>\n<p>\n\r\n<\/section>\n<h2>How to Use the Child-Pugh Score Calculator<\/h2>\n<ol>\n<li>Enter your <strong>Total bilirubin<\/strong> from your blood test and select the unit (mg\/dL or \u00b5mol\/L).<\/li>\n<li>Enter your <strong>Serum albumin<\/strong> and select the unit (g\/dL or g\/L).<\/li>\n<li>Choose the <strong>Clotting measure<\/strong> you have \u2014 INR or PT prolongation \u2014 and enter the value in the <strong>INR \/ PT prolongation<\/strong> field. If you choose PT prolongation, enter the number of seconds above the control value (e.g. 4.5), not the total prothrombin time.<\/li>\n<li>Select the severity of <strong>Ascites<\/strong>: none, slight (controlled medically), or moderate to severe (poorly controlled).<\/li>\n<li>Select the degree of <strong>Hepatic encephalopathy<\/strong>: none, grade I\u2013II (mild), or grade III\u2013IV (severe).<\/li>\n<li>Read your total score (5\u201315 points), your Child-Pugh class (A, B or C), and the interpretation of the result.<\/li>\n<\/ol>\n<h2>What Is the Child-Pugh Score?<\/h2>\n<p>The Child-Pugh score (also called the Child-Turcotte-Pugh score) is one of the oldest and most widely used tools for grading the severity of chronic liver disease and cirrhosis. It combines two laboratory values (bilirubin and albumin), one measure of blood clotting (INR or prothrombin time), and two clinical features (ascites and hepatic encephalopathy) into a single number from 5 to 15.<\/p>\n<p>The score divides patients into three classes. <strong>Class A (5\u20136 points)<\/strong> represents well-compensated cirrhosis \u2014 the liver still performs most of its functions despite the scarring. <strong>Class B (7\u20139 points)<\/strong> indicates significant functional compromise, and <strong>Class C (10\u201315 points)<\/strong> represents decompensated cirrhosis, where complications such as fluid retention, bleeding risk and confusion have become prominent.<\/p>\n<p>The classification matters because it correlates with survival and surgical risk. In the classic 1973 dataset from Pugh and colleagues, one-year survival was roughly 100% for Class A, 80% for Class B and 45% for Class C, and perioperative mortality rose from about 10% in Class A to over 80% in Class C. Clinicians still use the score to help decide whether elective surgery is reasonably safe, to assess prognosis, and to communicate disease severity in a standardized way. For prioritizing patients for liver transplantation, however, the <a href=\"https:\/\/wpcalc.com\/en\/medical\/meld-na-score-calculator\/\">MELD-Na score<\/a> has largely replaced Child-Pugh.<\/p>\n<h2>Reference Table<\/h2>\n<table>\n<thead>\n<tr>\n<th>Parameter<\/th>\n<th>1 point<\/th>\n<th>2 points<\/th>\n<th>3 points<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td>Total bilirubin (mg\/dL)<\/td>\n<td>&lt; 2<\/td>\n<td>2\u20133<\/td>\n<td>&gt; 3<\/td>\n<\/tr>\n<tr>\n<td>Serum albumin (g\/dL)<\/td>\n<td>&gt; 3.5<\/td>\n<td>2.8\u20133.5<\/td>\n<td>&lt; 2.8<\/td>\n<\/tr>\n<tr>\n<td>INR<\/td>\n<td>&lt; 1.7<\/td>\n<td>1.7\u20132.3<\/td>\n<td>&gt; 2.3<\/td>\n<\/tr>\n<tr>\n<td>PT prolongation (s)<\/td>\n<td>&lt; 4<\/td>\n<td>4\u20136<\/td>\n<td>&gt; 6<\/td>\n<\/tr>\n<tr>\n<td>Ascites<\/td>\n<td>None<\/td>\n<td>Slight<\/td>\n<td>Moderate to severe<\/td>\n<\/tr>\n<tr>\n<td>Hepatic encephalopathy<\/td>\n<td>None<\/td>\n<td>Grade I\u2013II<\/td>\n<td>Grade III\u2013IV<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>Class A = 5\u20136 points, Class B = 7\u20139 points, Class C = 10\u201315 points.<\/p>\n<h2>Assumptions, Limitations and Practical Tips<\/h2>\n<ul>\n<li><strong>It applies to cirrhosis, not acute liver failure.<\/strong> The Child-Pugh score was validated in patients with chronic liver disease and portal hypertension; it is not designed for acute conditions.<\/li>\n<li><strong>Two of the five parameters are clinical judgments.<\/strong> The grading of ascites and encephalopathy depends on how well symptoms are controlled with treatment, so the same patient can score differently over time. An ultrasound-free bedside assessment of ascites and a careful history for encephalopathy are needed.<\/li>\n<li><strong>Interpret borderline values carefully.<\/strong> The score uses fixed cut-offs, so a bilirubin of 1.9 versus 2.1 mg\/dL changes the points even though the clinical difference is tiny. The original Pugh paper also noted that bilirubin thresholds differ in cholestatic diseases such as primary biliary cholangitis.<\/li>\n<li><strong>Unit conversions matter.<\/strong> Bilirubin in \u00b5mol\/L is converted using \\(1 \\text{ mg\/dL} = 17.1\\ \\mu\\text{mol\/L}\\), and albumin in g\/L is divided by 10. Double-check the units on your lab report before entering values.<\/li>\n<li><strong>Anticoagulants affect the INR.<\/strong> If the patient takes warfarin, the INR reflects the medication rather than liver synthetic function, which can inflate the score.<\/li>\n<li><strong>This is an informational tool, not a diagnosis.<\/strong> Always discuss the result with a hepatologist or treating physician. For broader liver risk screening in suspected fibrosis, see the <a href=\"https:\/\/wpcalc.com\/en\/medical\/fib-4-score-calculator\/\">FIB-4 score calculator<\/a>; if cirrhosis affects treatment decisions for atrial fibrillation, the <a href=\"https:\/\/wpcalc.com\/en\/medical\/has-bled-score-calculator\/\">HAS-BLED score calculator<\/a> can help estimate bleeding risk.<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>Enter bilirubin, albumin, INR or PT prolongation, and the severity of ascites and encephalopathy to get the Child-Pugh score (5\u201315 points) and class A, B or C for cirrhosis severity.<\/p>\n","protected":false},"author":3168,"featured_media":0,"comment_status":"open","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[8],"tags":[50],"class_list":["post-66657","post","type-post","status-publish","format-standard","hentry","category-medical","tag-diagnostics"],"acf":[],"_links":{"self":[{"href":"https:\/\/wpcalc.com\/en\/wp-json\/wp\/v2\/posts\/66657","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/wpcalc.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/wpcalc.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/wpcalc.com\/en\/wp-json\/wp\/v2\/users\/3168"}],"replies":[{"embeddable":true,"href":"https:\/\/wpcalc.com\/en\/wp-json\/wp\/v2\/comments?post=66657"}],"version-history":[{"count":1,"href":"https:\/\/wpcalc.com\/en\/wp-json\/wp\/v2\/posts\/66657\/revisions"}],"predecessor-version":[{"id":66658,"href":"https:\/\/wpcalc.com\/en\/wp-json\/wp\/v2\/posts\/66657\/revisions\/66658"}],"wp:attachment":[{"href":"https:\/\/wpcalc.com\/en\/wp-json\/wp\/v2\/media?parent=66657"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/wpcalc.com\/en\/wp-json\/wp\/v2\/categories?post=66657"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/wpcalc.com\/en\/wp-json\/wp\/v2\/tags?post=66657"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}