Child-Pugh Score
Classifies cirrhosis severity and prognosis
Also written as: Child-Pugh, Child-Turcotte-Pugh.
- Highest activation tier
- Recommended
- How it is scored
- Scored in code; a detected disagreeing draft value is flagged for correction
- Care settings
- Inpatient, Outpatient
When it activates
Scribeable activates a calculator from the encounter. The Child-Pugh Score can activate when the transcript or pasted chart context documents any of these:
- Cirrhosis classification
- Surgical risk in liver disease
- Prognosis discussion
- Hepatic reserve assessment
A coded diagnosis can also activate it. ICD-10 prefixes carried by the registry: K70, K71, K72, K74, K76.
Note-type scope: it activates on notes whose subject resolves to hepatology, gi, hospital medicine, critical care. A note that resolves to another subject does not carry it even when the clinician's specialty matches; a note with no resolvable subject (a generic consultation) falls back to the specialty match.
Inputs the note needs
5 inputs. Each is resolved from the transcript, the pasted chart context and charted labs; at this calculator’s tier a missing input is never requested, and a missing required input keeps the score out of the draft.
| Input | Type | Unit / options | Guidance |
|---|---|---|---|
| Total bilirubin | lab | mg/dL | Child-Pugh: <2=1, 2–3=2, >3=3 points. |
| Serum albumin | lab | g/dL | Child-Pugh: >3.5=1, 2.8–3.5=2, <2.8=3 points. |
| INR | lab | Child-Pugh: <1.7=1, 1.7–2.3=2, >2.3=3 points. | |
| Ascites presence/severity | exam | ||
| Hepatic encephalopathy grade | exam |
Scoring
Each parameter 1-3 points. Bilirubin, Albumin, INR, Ascites, Encephalopathy.
bili Total bilirubin + alb Serum albumin + INR INR + ascites Ascites presence/severity + enceph Hepatic encephalopathy grade
Interpretation
Class A (5-6): 100% 1-year survival. Class B (7-9): 80%. Class C (10-15): 45%.
Evidence
Sources carried in Scribeable's citation registry for this calculator.
- Pugh RN et al. Transection of the oesophagus for bleeding oesophageal varices (Child-Pugh Score)Pugh et al. (Child-Pugh) 1973 · 1973 · link last verified 2026-03-23
How Scribeable handles it in the note
When an encounter activates the Child-Pugh Score (its highest tier is recommended), Scribeable does not ask you for missing inputs. The score is computed in code from whatever inputs resolve from the transcript, the pasted chart context or charted labs; a computed value is written into the draft only when every required input already resolves.
The score is computed in code from the resolved inputs, not recalled by the language model. If the draft states a Child-Pugh Score value that disagrees with the computed one, the disagreement is flagged to the second drafting pass, which is instructed to correct the score and its interpretation before you see the note.
Classified as a staging or classification system: activated strictly, because a wrong stage on the wrong patient is a documentation hazard.
See it activate on your own encounter
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