Stages of Cirrhosis Severity Child Pugh Score Calculator

Bilirubin

Albumin

Ascites

PT (%)

Encephalopathy


Score : - Classification :

What Is the Child-Pugh Score?

The Child-Pugh Score, also known as the Child-Turcotte-Pugh (CTP) classification, is a clinical tool used by healthcare professionals to evaluate the severity and prognosis of chronic liver disease, especially cirrhosis. It plays a crucial role in helping doctors understand how well a patient’s liver is functioning and in making important decisions about treatment, monitoring, and possible liver transplantation.

This scoring system considers five key measurements that reflect the liver’s ability to perform its normal functions. These include:

  • Bilirubin: A waste product from the breakdown of red blood cells. High levels may indicate liver dysfunction.
  • Albumin: A protein made by the liver. Low levels suggest poor liver synthetic function.
  • Ascites: The presence of fluid in the abdomen due to liver damage. The more severe the ascites, the more advanced the disease.
  • Prothrombin Time (PT%): A measure of how quickly blood clots. Liver disease can impair clotting ability, making PT a key indicator.
  • Hepatic Encephalopathy: A condition caused by toxins affecting the brain due to poor liver function. It ranges from mild confusion to coma.

Each of these factors is given a score from 1 to 3, with 1 indicating normal or mild conditions and 3 indicating more severe impairment. The scores are then added together to produce a total score ranging from 5 to 15. Based on this total, the liver disease is classified into one of three categories:

  • Class A (5–6 points): Least severe liver disease, often with good liver function and a better long-term outlook.
  • Class B (7–9 points): Moderately severe liver disease, with more symptoms and a higher risk of complications.
  • Class C (10–15 points): Most severe liver disease, associated with poor liver function, high risk of complications, and often considered for liver transplantation.

The Child-Pugh Score is widely used in clinical practice because it offers a simple, reliable way to assess liver disease progression. It helps guide decisions such as when to refer a patient for a transplant evaluation, how aggressively to treat the disease, and what the expected survival might be. However, it's important to note that while the score provides valuable insight, it should always be used alongside other medical evaluations and in consultation with a healthcare provider.

How to Use the Calculator

The Child-Pugh Score Calculator is designed to be easy to use, even for non-medical users. By answering a few questions about lab results and physical symptoms, you can quickly get an idea of how severe liver disease might be. Follow the steps below to use the calculator effectively:

Step-by-Step Instructions:

  1. Start at the top of the calculator form. You’ll see several categories, each with a set of radio button options to choose from.
  2. Select one option in each category:
    • Bilirubin: Choose the range that matches your bilirubin test result (in µmol/l).
    • Albumin: Select the correct range based on your albumin level (in g/l).
    • Ascites: Choose “Absent,” “Moderate,” or “Permanent,” depending on whether fluid buildup in the abdomen is present and how severe it is.
    • PT (%): Pick the correct range for your Prothrombin Time percentage. This value is usually provided by your blood test results.
    • Encephalopathy: Choose the description that matches your current mental state — “Absent,” “Moderate,” or “Disabling.”
  3. Click the “Calculate” button at the bottom of the form once you’ve selected all values.

How the Calculator Works:

Each answer you select is assigned a numerical score between 1 and 3. The calculator automatically adds up these five values to generate a total score between 5 and 15. This score is then matched to a classification category:

  • Score 5–6: Class A (Mild)
  • Score 7–9: Class B (Moderate)
  • Score 10–15: Class C (Severe)

The result will be displayed immediately on the screen in the “Score” and “Classification” fields. You can then use this information to better understand the stage of liver disease and discuss the result with your doctor.

Note: This calculator is a helpful tool but is not a substitute for a professional medical diagnosis. Always consult a healthcare provider for a complete evaluation.

Score Components Explained

The Child-Pugh Score is based on five important medical indicators. Each one reflects a different aspect of liver function. Below is a detailed explanation of what each component means and how it contributes to the overall score:

Bilirubin Levels

Bilirubin is a yellow substance produced when the body breaks down red blood cells. The liver usually processes bilirubin and removes it from the body through bile. When the liver isn’t working properly, bilirubin builds up in the blood, causing jaundice (yellowing of the skin and eyes).

  • Less than 35 µmol/l: Normal or mild increase – 1 point
  • 35–50 µmol/l: Moderate increase – 2 points
  • Over 50 µmol/l: High level – 3 points

Albumin Levels

Albumin is a protein made by the liver that helps maintain fluid balance in the body. Low albumin levels indicate that the liver isn’t producing enough protein, which is a sign of advanced liver disease.

  • Over 35 g/l: Normal – 1 point
  • 28–35 g/l: Slightly low – 2 points
  • Under 28 g/l: Significantly low – 3 points

Ascites Condition

Ascites refers to the buildup of fluid in the abdomen, which can occur when the liver is damaged and unable to manage blood flow properly. It can range from being absent to permanent and difficult to treat.

  • Absent: No visible fluid – 1 point
  • Moderate: Some fluid, but controllable – 2 points
  • Permanent: Constant fluid, difficult to manage – 3 points

Prothrombin Time (PT%)

Prothrombin Time measures how long it takes your blood to clot. The liver makes proteins that help with blood clotting. If liver function is poor, PT will be longer, and the PT percentage will be lower, indicating an increased risk of bleeding.

  • Above 50%: Normal or near-normal clotting – 1 point
  • 40–50%: Some delay in clotting – 2 points
  • Below 40%: Significant delay – 3 points

Encephalopathy Stage

Hepatic Encephalopathy is a condition caused by toxins building up in the brain due to poor liver function. It can affect thinking, behavior, and consciousness. This is a serious sign of advanced liver disease.

  • Absent: No mental or behavioral changes – 1 point
  • Moderate: Confusion or personality changes – 2 points
  • Disabling: Severe symptoms such as drowsiness, disorientation, or coma – 3 points

Each of these components plays a key role in understanding how well the liver is functioning. By assigning a score to each one, the Child-Pugh system provides a clear and structured way to evaluate liver disease severity.

Understanding Your Score

Once you’ve selected the appropriate values for each of the five categories in the Child-Pugh Calculator, the tool will automatically add the points to give you a total score. This score helps classify the severity of liver disease into three categories: Class A, B, or C.

Total Score and Classification

Each of the five components (bilirubin, albumin, ascites, prothrombin time, and encephalopathy) is scored from 1 to 3. The total score will fall between 5 and 15 and is grouped as follows:

  • Class A (5–6 points): Indicates mild liver disease
  • Class B (7–9 points): Indicates moderate liver disease
  • Class C (10–15 points): Indicates severe liver disease

What Each Class Means

Class A – Mild Cirrhosis: This stage reflects relatively good liver function. Patients in this category usually have fewer symptoms and a better prognosis. Treatment may involve regular monitoring and lifestyle changes, with a lower risk of complications.

Class B – Moderate Cirrhosis: At this stage, liver function is moderately impaired. Patients may experience more noticeable symptoms, such as fatigue, fluid buildup, or mental confusion. Close medical supervision is needed, and treatment plans may become more intensive.

Class C – Severe Cirrhosis: This classification indicates advanced liver damage. Patients often have serious symptoms and are at high risk for complications such as bleeding, infections, and liver failure. Class C patients may be considered for liver transplant evaluation.

Understanding your classification can help you and your healthcare provider make informed decisions about treatment, lifestyle adjustments, and long-term care planning.

Important: While the Child-Pugh Score provides helpful insight, it should always be interpreted by a medical professional alongside other clinical assessments and test results.

What to Do After Getting Your Result

After using the Child-Pugh Score Calculator and receiving your result, it’s important to take the next steps wisely. This tool gives you a helpful overview of your liver’s condition, but it should never replace professional medical advice. Understanding your score is just the beginning of managing liver disease effectively.

Why You Should Discuss the Result with a Healthcare Provider

Your total score and classification (A, B, or C) give a general idea of how severe your liver disease might be. However, only a qualified healthcare provider can interpret these results accurately within the full context of your health. Lab tests, imaging, medical history, and physical examination are all essential for a complete diagnosis.

A doctor can help you:

  • Understand what the score means in your specific situation
  • Check for any complications or risks related to your liver function
  • Determine if additional tests or monitoring are needed
  • Adjust medications or treatments based on your liver health

How This Information May Influence Treatment Decisions

The Child-Pugh classification helps doctors plan the best approach to managing liver disease. Based on your result, your healthcare provider may recommend one or more of the following:

  • Class A (Mild): Regular check-ups, lifestyle changes, and ongoing monitoring to prevent disease progression
  • Class B (Moderate): More frequent monitoring, possible medication changes, and evaluation for potential complications
  • Class C (Severe): Intensive care, advanced treatment options, and possible referral for liver transplant assessment

This score can also help doctors estimate your risk of complications like variceal bleeding, fluid buildup, or brain fog (hepatic encephalopathy), which may require specific interventions.

In summary: Knowing your score is helpful, but using that knowledge in partnership with a medical professional is what truly leads to better outcomes. Always share your results with your doctor to ensure you receive the right care and guidance based on your condition.

FAQs

Here are some frequently asked questions to help you better understand the Child-Pugh Score and how this calculator can assist you in monitoring liver health:

1. What is the purpose of the Child-Pugh Score?

The Child-Pugh Score is used to evaluate the severity of liver disease, particularly cirrhosis. It helps doctors assess liver function and predict the risk of complications or the need for a liver transplant.

2. Can I use this calculator without lab results?

Some of the categories, like bilirubin, albumin, and PT%, require recent lab results. To get an accurate score, it's best to enter values based on official test reports from your healthcare provider.

3. What do the classifications A, B, and C mean?

Class A: Mild liver disease
Class B: Moderate liver disease
Class C: Severe liver disease

These classifications help determine how advanced your liver damage is and what type of care you might need.

4. Is a higher score better?

No, in the Child-Pugh scoring system, a higher score means worse liver function. The lowest possible score is 5 (best), and the highest is 15 (most severe).

5. How often should I check my score?

The score should be reassessed when new lab results are available or if your symptoms change. It’s also useful for regular follow-ups if you’re under medical supervision for liver disease.

6. Can this score predict life expectancy?

The Child-Pugh Score offers a general idea of prognosis but does not provide exact life expectancy. It’s one tool among many that doctors use to evaluate your condition and plan treatment.

7. Is this tool a replacement for seeing a doctor?

No. While the calculator gives useful information, it cannot replace a professional medical evaluation. Always consult a healthcare provider for a full diagnosis and treatment plan.

8. What should I do if I get a Class C result?

If your score falls in Class C, it indicates severe liver disease. You should contact your healthcare provider immediately to discuss further evaluation and possible treatment options, including liver transplant assessment.

Disclaimer

The Child-Pugh Score Calculator is intended for informational and educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. While this tool can help users better understand the severity of liver disease based on commonly used clinical criteria, it should not be used to make medical decisions without consulting a qualified healthcare provider.

Always seek the advice of your physician or other licensed medical professionals with any questions you may have regarding a medical condition. Do not disregard or delay professional medical advice because of something you read or calculate using this tool.

References

  • Schiff, E.R., Maddrey, W.C., & Sorrell, M.F. (2011). Schiff's Diseases of the Liver. 11th ed. Wiley-Blackwell.
  • Zakim, D., & Boyer, T.D. (2002). Hepatology: A Textbook of Liver Disease. 4th ed. Saunders.
  • Sherlock, S., & Dooley, J. (2002). Diseases of the Liver and Biliary System. 11th ed. Wiley-Blackwell.
  • Friedman, L.S., & Keeffe, E.B. (2003). Handbook of Liver Disease. 2nd ed. Saunders.