18 / Hepatic Function

Child-Pugh Score

Severity of chronic liver disease, graded A to C

Total = bilirubin + albumin + INR + ascites + encephalopathy (5 to 15 points)

Clinical and Laboratory Findings

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Interpretation

Enter values above.

Point thresholds — bilirubin: <2 = 1, 2-3 = 2, >3 = 3. Albumin: >3.5 = 1, 2.8-3.5 = 2, <2.8 = 3. INR: <1.7 = 1, 1.7-2.3 = 2, >2.3 = 3. Ascites and encephalopathy score 1 to 3.
Classes — A: 5-6, B: 7-9, C: 10-15.
For dose adjustment. Many product labels express hepatic dosing in Child-Pugh class rather than a laboratory value, which is why this score matters in pharmacy practice. Always read the individual label — recommendations differ widely between drugs at the same class.
In primary biliary cholangitis the bilirubin thresholds are conventionally raised, because cholestasis elevates bilirubin without equivalent loss of synthetic function.
The score was derived for chronic liver disease and is not validated in acute liver failure.