MELD Score Calculator
Calculate MELD, MELD-Na, and MELD 3.0 scores for liver disease severity and 3-month mortality-oriented reference context.
Child-Pugh Score Calculator
Calculate Child-Pugh score and class for cirrhosis severity. Includes class assignment plus historic survival and perioperative risk context.
⚠️ Worksheet Note: This page provides a reference Child-Pugh class and historic risk context. It is best interpreted with MELD score and the broader clinical picture rather than as a transplant or procedure pathway by itself.
mg/dL
g/dL
Child-Pugh Score6 / 15 — Class A
▼
A (5-6)B (7-9)C (10-15)
Classification
Class A
Child-Pugh A (Well-Compensated)
Bilirubin
1/3
Albumin
2/3
INR
1/3
Ascites
1/3
Encephalopathy
1/3
Child-Pugh Score⧉
6 / 15
Class A
Classification⧉
Child-Pugh A (Well-Compensated)
Score 6
Historic 1-Year Survival⧉
100%
Commonly cited older Child-Pugh survival estimate
Historic 2-Year Survival⧉
85%
Commonly cited older Child-Pugh survival estimate
Perioperative Risk Context⧉
10%
Commonly cited Child-Pugh perioperative mortality context from older literature
Transplant Context⧉
Usually not transplant-focused by Child-Pugh alone
Read alongside MELD score, decompensation history, and the overall hepatology picture
| Parameter | 1 Point | 2 Points | 3 Points |
|---|---|---|---|
| Bilirubin | <2 mg/dL | 2-3 mg/dL | >3 mg/dL |
| Albumin | >3.5 g/dL | 2.8-3.5 g/dL | <2.8 g/dL |
| INR | <1.7 | 1.7-2.3 | >2.3 |
| Ascites | None | Mild/Moderate | Severe |
| Encephalopathy | None | Grade 1-2 | Grade 3-4 |
| Class | Score | 1-Yr Survival | 2-Yr Survival | Periop Mortality |
|---|---|---|---|---|
| A | 5-6 | 100% | 85% | 10% |
| B | 7-9 | 80% | 60% | 30% |
| C | 10-15 | 45% | 35% | 80% |
Planning notes, formulas, and examples
About the Child-Pugh Score Calculator
The Child-Pugh Score Calculator estimates cirrhosis severity using five clinical and laboratory inputs: total bilirubin, serum albumin, INR or prothrombin time, ascites, and hepatic encephalopathy. The score is then grouped into Child-Pugh classes A, B, and C to describe broad severity categories in chronic liver disease.
That classification remains useful because it gives a quick bedside summary of liver disease severity, prognosis context, and procedure-risk context without relying only on a laboratory-only score. It is best read as a reference category rather than a stand-alone management rule.
This page also shows the point breakdown so you can see which component is driving the class assignment.
When This Page Helps
Child-Pugh remains useful because it summarizes liver function in a way that is easy to communicate in notes, conversations, and bedside review. The class helps frame whether the overall picture looks more compensated or more decompensated, which is often the practical question behind the score.
How to Use the Inputs
- Obtain a recent total bilirubin level (mg/dL).
- Obtain serum albumin level (g/dL).
- Obtain INR (or prothrombin time, if that is how your source reports coagulopathy).
- Assess ascites clinically and by imaging context.
- Evaluate hepatic encephalopathy grade.
- Review the class, historic survival figures, and perioperative risk context.
- Interpret the result alongside MELD score and the broader clinical picture.
Formula used
Child-Pugh Score = Bilirubin (1-3) + Albumin (1-3) + INR (1-3) + Ascites (1-3) + Encephalopathy (1-3)
Total Range: 5-15
Class A: 5-6 (more compensated)
Class B: 7-9 (intermediate severity)
Class C: 10-15 (more decompensated)Example Calculation
Result: Score 5 — Class A
Bilirubin <2 (1) + albumin >3.5 (1) + INR <1.7 (1) + no ascites (1) + no encephalopathy (1) = 5 points. That places the result in Child-Pugh Class A on this page.
Tips & Best Practices
- Use INR rather than raw prothrombin time when possible for more standardized scoring.
- Ascites and encephalopathy scoring depend on clinical judgment, so documentation quality matters.
- MELD is often reviewed alongside Child-Pugh rather than instead of it.
- Historical perioperative risk is lowest in Class A and highest in Class C, but procedure-specific assessment still matters.
- Recalculate when clinical status changes because the score is dynamic rather than fixed.
Why The Score Persists
Child-Pugh remains widely recognized because it combines laboratory values with two visible decompensation features: ascites and encephalopathy. That makes it intuitive for bedside severity framing even though more modern scores exist.
Surgical And Prognostic Context
Older literature commonly links Child-Pugh classes with broad survival and perioperative risk ranges. Those figures are useful as historical context, but they should not be treated as precise forecasts for an individual patient or procedure.
Where It Fits Clinically
In practice, Child-Pugh is often reviewed with MELD, renal function, portal-hypertension complications, and the underlying disease cause. The combination usually says more than any single score alone.
Medication And Procedure Context
More advanced Child-Pugh classes can signal that drug metabolism, bleeding risk, encephalopathy risk, and tolerance of procedures deserve closer review. That is best treated as a cue for broader assessment rather than as an automatic rule.
Sources & Methodology
Last updated:
Methodology
This calculator assigns 1 to 3 points across the five classic Child-Pugh components: bilirubin, albumin, INR or prothrombin time, ascites, and encephalopathy. It sums those items into the standard 5-15 total and groups the result into Child-Pugh classes A, B, and C so the user can interpret the score as a practical severity category for cirrhosis.
The page is meant for prognosis framing and bedside communication, not as a complete liver-failure workup. Because ascites and encephalopathy grading are partly subjective, the score should be interpreted together with the clinical picture and, where relevant, MELD-based transplant assessment.
Sources
- Surgery and portal hypertension (PubMed / Major Problems in Clinical Surgery) — Original Child-Turcotte classification source.
- Transection of the oesophagus for bleeding oesophageal varices (PubMed / British Journal of Surgery) — Pugh modification that established the modern Child-Pugh framework.
Frequently Asked Questions
Child-Pugh sorts patients into three broad severity classes, while MELD provides a continuous numeric score. MELD is used more heavily in transplant allocation, while Child-Pugh remains common for bedside severity framing and older surgical-risk literature.
Both can provide context. Child-Pugh class is tied to older perioperative mortality data, while MELD adds a more continuous laboratory-based estimate. Procedure-specific tools may still be more informative for a given operation.
Yes. Ascites and encephalopathy grading are partly subjective, and the score does not directly include renal function. It is useful as a broad category, but it does not capture every prognostic detail.
The score is used broadly across cirrhosis etiologies, but any scoring system can perform differently across populations. Disease cause, renal function, portal-hypertension complications, and acute illness still matter.
Yes. Treatment of the underlying cause and better control of decompensation features can move the score in either direction, which is one reason serial reassessment can be useful.
Higher Child-Pugh classes, especially when paired with decompensation events or a higher MELD score, often contribute to transplant discussion context. The score alone does not determine listing or timing.
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