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Child–Pugh

Classifies cirrhosis as A, B or C from three laboratory tests and two clinical findings, for prognosis, surgical risk and drug dose adjustment.

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Check the population, units and version. The result shows the formula or classification; it does not make an automatic treatment decision.

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Method · Limits of application

Child–Pugh/Pugh 1973: 5 items 1–3, classes A 5–6/B 7–9/C 10–15

Child–Pugh characterizes the severity and prognosis of cirrhosis, using clinical assessment of ascites and encephalopathy as well as laboratory tests. Those two components depend on judgment and received treatment; document the condition assessed. In this interface, coagulation uses INR rather than seconds of prothrombin-time prolongation. Mortality figures from Mansour 1997 belong to that cohort of patients with cirrhosis undergoing elective or emergency abdominal surgery and are not automatic individual predictions. The score does not replace assessment of the cause of liver disease or a specific medication-dosing rule.

Conditions of use

Check the population, units, inclusion and exclusion criteria, and version in the original source. A result alone does not establish a diagnosis, discharge decision or prescription.

Documented parameters

Total bilirubin
Albumin
INR
Ascites
Hepatic encephalopathy

3/3 reference cases checked. Numerical tests are not clinical validation.

Sources and documentation

Documented formula

Transcribed from the source or a recorded revision; this is not a clinical recommendation.

Each of 5 items scores 1–3 points. Total 5–15.

Class A: 5–6 · Class B: 7–9 · Class C: 10–15.

References

Identifier: child-pugh

Original clinical content: Brazilian Portuguese.

Method version

Child–Pugh/Pugh 1973: 5 items 1–3, classes A 5–6/B 7–9/C 10–15

child-pugh@native-2026-10-03+9dab34a4ea66

Source for the active edition

The bibliographic edition identifies the source. By itself, it proves neither full conformity of the formula nor clinical approval.

Synthetic cases checked (3)

Synthetic cases for checking the implementation, with no patient data.

Case 1

reference-001

Inputs

Total bilirubin: < 2 mg/dL
Albumin: > 3.5 g/dL
INR: < 1.7
Ascites: Absent
Hepatic encephalopathy: Absent

{
  "bili": "1",
  "alb": "1",
  "inr": "1",
  "ascite": "1",
  "ence": "1"
}

Expected result

{
  "score": 5,
  "level": "low",
  "verdict": "Classe A"
}

Actual result

{
  "score": 5,
  "class": "A"
}

Case 2

reference-002

Inputs

Total bilirubin: 2 to 3 mg/dL
Albumin: 2.8 to 3.5 g/dL
INR: < 1.7
Ascites: Absent
Hepatic encephalopathy: Absent

{
  "bili": "2",
  "alb": "2",
  "inr": "1",
  "ascite": "1",
  "ence": "1"
}

Expected result

{
  "score": 7,
  "level": "mid",
  "verdict": "Classe B"
}

Actual result

{
  "score": 7,
  "class": "B"
}

Case 3

reference-003

Inputs

Total bilirubin: > 3 mg/dL
Albumin: < 2.8 g/dL
INR: 1.7 to 2.3
Ascites: Moderate to severe or refractory
Hepatic encephalopathy: Grades I–II (or controlled)

{
  "bili": "3",
  "alb": "3",
  "inr": "2",
  "ascite": "3",
  "ence": "2"
}

Expected result

{
  "score": 13,
  "level": "high",
  "verdict": "Classe C"
}

Actual result

{
  "score": 13,
  "class": "C"
}

Code and reproducibility

This tool’s code on GitHub

Download code and tests

Sources, version and reproduction instructions

The code tests are technical checks. Clinical approval and professional translation review are recorded separately.

Relationship with cancer research

General context — relationship to be defined

A resource for general clinical contexts. This edition does not assign a specific oncological relationship; selecting it for a study requires a justified question, population and purpose.