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Child-Pugh: cirrhosis class

Hepatology & GI

Older than MELD but still the language of surgical risk, drug dosing and variceal prophylaxis decisions.

What you enter

  • Bilirubin: <2 mg/dL (<34 µmol/L) / 2–3 mg/dL (34–50) / >3 mg/dL (>50)
  • Albumin: >3.5 g/dL (>35 g/L) / 2.8–3.5 g/dL (28–35) / <2.8 g/dL (<28)
  • INR: <1.7 / 1.7–2.3 / >2.3
  • Ascites: None / Mild / diuretic-controlled / Moderate-severe / refractory
  • Encephalopathy: None / Grade 1–2 (or controlled) / Grade 3–4 (or refractory)
FORMULABilirubin + albumin + INR + ascites + encephalopathy, 1–3 each; A 5–6, B 7–9, C 10–15
SourcePugh RN et al. Transection of the oesophagus for bleeding oesophageal varices. Br J Surg 1973;60:646-9ReviewedFormula and thresholds checked against the source on 2026-08-22. If the source updates, this line will say so.