i
Child-Pugh Score — About
The Child-Pugh score grades severity of chronic liver disease using 5 parameters (3 biochemical, 2 clinical), each scored 1–3 points. Total range 5–15. Used for prognosis, surgical risk stratification, and to guide drug-dose adjustments in hepatic impairment.
Select an option for each of the five parameters below. The score, class and prognosis update live.
1
Total Bilirubin
— pts
Enter a measured value or select a band
μmol/L
Enter a value to auto-score, or pick a band below.
2
Serum Albumin
— pts
Enter a measured value or select a band
g/L
Enter a value to auto-score, or pick a band below.
3
INR (or PT prolongation)
— pts
Enter the INR or select a band
INR
Enter a value to auto-score, or pick a band below.
4
Ascites
— pts
Clinical assessment
5
Hepatic Encephalopathy
— pts
West Haven grading
✓
Total Score & Class
Total Child-Pugh Score
—
/
15
Awaiting input
Select all five parameters to see the final score, class and prognosis.
Class A
Score 5 – 6 · Well-compensated
1-yr survival: ~100%
2-yr survival: ~85%
Operative mortality (abd): ~10%
Class B
Score 7 – 9 · Significant compromise
1-yr survival: ~80%
2-yr survival: ~60%
Operative mortality (abd): ~30%
Class C
Score 10 – 15 · Decompensated
1-yr survival: ~45%
2-yr survival: ~35%
Operative mortality (abd): ~70 – 80%
Anaesthetic implications:
Class A patients tolerate most procedures with standard precautions.
Class B requires careful preoperative optimisation and avoidance of hepatotoxic drugs.
Class C carries very high perioperative mortality — elective surgery is generally contra-indicated;
only life-saving procedures should be undertaken, ideally at a transplant centre.
Clinical Disclaimer: Score is a guide only. Bilirubin thresholds differ in primary
cholestatic disease (PBC/PSC: 1 pt <68, 2 pts 68–170, 3 pts >170 μmol/L). Always interpret in
clinical context, alongside MELD score and assessment of frailty/comorbidity. The developer accepts
no liability for clinical decisions made using this tool.