Child–Pugh Score
Cirrhosis severity grading (A/B/C)
Last updated on: October 9, 2025
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What is Child–Pugh?
Child–Pugh is a five-parameter score for cirrhosis severity. Each parameter is scored 1–3; the sum (5–15) defines class A, B, or C.
Coagulation may be graded by INR or by PT prolongation; provide at least one.
Scoring components
- Bilirubin (mg/dL): < 2 = 1 point, 2–3 = 2, > 3 = 3.
- Albumin (g/dL): > 3.5 = 1, 2.8–3.5 = 2, < 2.8 = 3.
- Coagulation: INR < 1.7 = 1, 1.7–2.3 = 2, > 2.3 = 3; OR PT prolongation < 4 s = 1, 4–6 s = 2, > 6 s = 3.
- Ascites: none = 1, mild/controlled = 2, moderate–severe/refractory = 3.
- Encephalopathy: none = 1, grade I–II = 2, grade III–IV = 3.
Interpretation
Class A (5–6 points):
Compensated disease. Lower short-term mortality compared with B/C.
Class B (7–9 points):
Significant functional compromise. Intermediate risk.
Class C (10–15 points):
Decompensated disease. High risk and poor short-term prognosis.
This page has been medically reviewed by Dr. Khoulah Attia – PharmD, Immunology Specialist.