How do I determine the Child-Pugh class?

You need bilirubin, albumin, INR and a clinical grade of ascites and encephalopathy. Each item scores 1–3; a total of 5–15 sets the class: 5–6 → A, 7–9 → B, 10–15 → C. The calculator does this automatically.

What do classes A, B and C mean?

A is compensated cirrhosis with a good prognosis (≈100% one-year survival), B is significant (≈80%), C is decompensated with the worst prognosis (≈45%). The class affects operability and management.

How is Child-Pugh different from MELD?

Child-Pugh includes clinical signs (ascites, encephalopathy) and gives class A/B/C, while MELD is computed only from labs and gives a score for the transplant queue. They are often used together.

What units for bilirubin and albumin?

Bilirubin in µmol / L, albumin in g / L, INR is unitless. The point thresholds in the calculator are set for these units.

Does the calculator make a diagnosis?

No. It is a severity scale, not a diagnosis. The grade of ascites and encephalopathy is assessed clinically by a doctor, who also makes treatment decisions.

Child-Pugh calculator (cirrhosis severity class)

The Child-Pugh score rates cirrhosis severity from five items: bilirubin, albumin, INR, ascites and hepatic encephalopathy. Enter the labs and pick the grade of ascites and encephalopathy — the calculator adds the points and returns class A, B or C. It is a tool for clinicians and understanding, not self-diagnosis.

Determine the Child-Pugh class

Enter bilirubin, albumin and INR and pick the grade of ascites and encephalopathy.

Child-Pugh classes and prognosis

Class by total score and approximate one-year survival. Values are approximate and do not replace a doctor’s assessment and work-up.

Total score	Class and prognosis
5–6	A — compensated (≈100% / year)
7–9	B — significant (≈80%)
10–15	C — decompensated (≈45%)

What the Child-Pugh score is

Child-Pugh is a classification of liver cirrhosis severity. It combines two labs of the liver’s synthetic function (albumin, INR), bilirubin and two clinical signs (ascites, encephalopathy) into a single class — A, B or C.

The class reflects how well the liver compensates and is used for prognosis, surgical risk and management.

How the points are scored

Each of the five items scores 1, 2 or 3 points. Bilirubin: <34 → 1, 34–50 → 2, >50 µmol / L → 3. Albumin: >35 → 1, 28–35 → 2, <28 g / L → 3. INR: <1.7 → 1, 1.7–2.3 → 2, >2.3 → 3.

Ascites and encephalopathy are scored clinically: none → 1, mild/controlled → 2, marked/refractory → 3. The total ranges from 5 to 15.

Classes and prognosis

5–6 points is class A (compensated cirrhosis, about 100% one-year survival). 7–9 is class B (significant, about 80%). 10–15 is class C (decompensated, about 45%).

The class helps decide operability, medication and the need for transplantation. It is followed over time together with other data.

Child-Pugh and MELD

Child-Pugh and MELD address a similar task — cirrhosis severity — differently: Child-Pugh includes clinical signs (ascites, encephalopathy), while MELD uses only objective labs and drives the transplant queue.

They are often used together. We have a separate MELD calculator — handy to compare both results.

A clinician’s tool, not self-diagnosis

The calculator helps you understand your result and prepare to talk to your doctor. Grading ascites and encephalopathy, and the final decisions, are made by a hepatologist.

Frequently asked questions

You need bilirubin, albumin, INR and a clinical grade of ascites and encephalopathy. Each item scores 1–3; a total of 5–15 sets the class: 5–6 → A, 7–9 → B, 10–15 → C. The calculator does this automatically.
A is compensated cirrhosis with a good prognosis (≈100% one-year survival), B is significant (≈80%), C is decompensated with the worst prognosis (≈45%). The class affects operability and management.
Child-Pugh includes clinical signs (ascites, encephalopathy) and gives class A/B/C, while MELD is computed only from labs and gives a score for the transplant queue. They are often used together.
Bilirubin in µmol / L, albumin in g / L, INR is unitless. The point thresholds in the calculator are set for these units.
No. It is a severity scale, not a diagnosis. The grade of ascites and encephalopathy is assessed clinically by a doctor, who also makes treatment decisions.

Bilirubin, albumin, INR — values from your labs

Upload your report — AI reads liver values together, links them and explains what to do.

Decode my lab results

This calculator is for reference and information only and is not a diagnosis. Liver disease severity and treatment decisions are determined by a doctor.