LIVE

Child–Pugh

Compute the Child–Turcotte–Pugh cirrhosis severity score from bilirubin, albumin, INR, encephalopathy, and ascites.

LIVE $0.005 USDC GET /api/calc/child_pugh

Markdown: /docs/child-pugh.md · Canonical: https://magentlab.com/docs/child-pugh

Not a medical device. Not a diagnosis, dose, or listing recommendation.

What it computes

Compute the Child–Turcotte–Pugh cirrhosis severity score from bilirubin, albumin, INR, encephalopathy, and ascites.

When to use

When an agent needs the published Child–Pugh class and must not invent points from a chart narrative.

When not to use

• Not a transplant listing protocol and not a MELD-Na substitute.
• Encephalopathy and ascites are caller-assigned grades. magent does not examine the patient.
• Pugh 1973 scored coagulation as prothrombin time prolonged 1–4 / 4–6 / >6 seconds. This tool accepts INR <1.7 / 1.7–2.3 / >2.3 as the contemporary laboratory substitute.

Formula

Child-Pugh = bilirubin + albumin + INR + encephalopathy + ascites; each 1-3; class A 5-6, B 7-9, C 10-15; max 15

Citation

Title

Transection of the oesophagus for bleeding oesophageal varices

Authors

Pugh RNH, Murray-Lyon IM, Dawson JL, Pietroni MC, Williams R

Source

Br J Surg. 1973;60(8):646-649

DOI

10.1002/bjs.1800600817

Worked example

Try

Opens the live endpoint. Unpaid browser requests show the paywall; agents should send Accept: application/json.

/api/calc/child_pugh?bilirubin_mg_dl=1.0&albumin_g_dl=4.0&inr=1.2&encephalopathy=none&ascites=none

Full URL: https://api.magentlab.com/api/calc/child_pugh?bilirubin_mg_dl=1.0&albumin_g_dl=4.0&inr=1.2&encephalopathy=none&ascites=none

x402 V2 curl

Expect HTTP 402 and a PAYMENT-REQUIRED header until you retry with PAYMENT-SIGNATURE. Incomplete query params return HTTP 400 before any quote or charge. HTTP 503 after a signature: retry the same PAYMENT-SIGNATURE — that is not a new 402.

curl -i -H "Accept: application/json" "https://api.magentlab.com/api/calc/child_pugh?bilirubin_mg_dl=1.0&albumin_g_dl=4.0&inr=1.2&encephalopathy=none&ascites=none"

Cursor mcp.json

Intended config for @magent/mcp. This is not npm @x402/fetch (a payment fetch wrapper).

{
  "mcpServers": {
    "magent": {
      "args": [
        "-y",
        "@magent/mcp"
      ],
      "command": "npx",
      "env": {
        "X402_PRIVATE_KEY": "0xYOUR_SPENDING_KEY"
      }
    }
  }
}

Parameters

Bulk (POST)

POST the same path with a JSON items array. Price is n times the GET unit. Invalid items return HTTP 400 before settlement.

POST /api/calc/child_pugh Max 25 unit_amount * n PREVIEW

• 1 to 25 items. Each item uses the same keys as the GET query parameters.
• The first invalid item fails the whole request (index in the 400 JSON). You are not charged.
• HTTP 200 is {count, path, items}. Each items[i] is the GET 200 body for that row.
• Catalog misses (empty matches, found=false) stay paid 200s inside that slot.
• x402 resource URL is this path plus n and body_sha256. Browsers that prefer text/html get the same paywall as GET; Pay retries POST with the same items.

Example request (fixture)

{
  "items": [
    {
      "albumin_g_dl": "4.0",
      "ascites": "none",
      "bilirubin_mg_dl": "1.0",
      "encephalopathy": "none",
      "inr": "1.2"
    },
    {
      "albumin_g_dl": "4.0",
      "ascites": "none",
      "bilirubin_mg_dl": "1.0",
      "encephalopathy": "none",
      "inr": "1.2"
    }
  ]
}

Open bulk paywall →

Opens a two-item fixture on the API host. Unpaid browsers get the same MetaMask paywall as GET; Pay retries POST with those items.

Example 200 (fixture)

{
  "count": 2,
  "path": "/api/calc/child_pugh",
  "items": [
    {
      "components": [
        {
          "value": 1.0,
          "factor": "bilirubin",
          "points": 1,
          "present": false
        },
        {
          "value": 4.0,
          "factor": "albumin",
          "points": 1,
          "present": false
        },
        {
          "value": 1.2,
          "factor": "inr",
          "points": 1,
          "present": false
        },
        {
          "value": "none",
          "factor": "encephalopathy",
          "points": 1,
          "present": false
        },
        {
          "value": "none",
          "factor": "ascites",
          "points": 1,
          "present": false
        }
      ],
      "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
      "citation": {
        "authors": "Pugh RNH, Murray-Lyon IM, Dawson JL, Pietroni MC, Williams R",
        "doi": "10.1002/bjs.1800600817",
        "id": "pugh-1973",
        "source": "Br J Surg. 1973;60(8):646-649",
        "title": "Transection of the oesophagus for bleeding oesophageal varices"
      },
      "formula": "child_pugh",
      "formula_expression": "Child-Pugh = bilirubin + albumin + INR + encephalopathy + ascites; each 1-3; class A 5-6, B 7-9, C 10-15; max 15",
      "max_score": 15,
      "score": 5,
      "albumin_g_dl": 4.0,
      "bilirubin_mg_dl": 1.0,
      "ascites": "none",
      "child_pugh_class": "A",
      "encephalopathy": "none",
      "inr": 1.2
    },
    {
      "components": [
        {
          "value": 1.0,
          "factor": "bilirubin",
          "points": 1,
          "present": false
        },
        {
          "value": 4.0,
          "factor": "albumin",
          "points": 1,
          "present": false
        },
        {
          "value": 1.2,
          "factor": "inr",
          "points": 1,
          "present": false
        },
        {
          "value": "none",
          "factor": "encephalopathy",
          "points": 1,
          "present": false
        },
        {
          "value": "none",
          "factor": "ascites",
          "points": 1,
          "present": false
        }
      ],
      "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
      "citation": {
        "authors": "Pugh RNH, Murray-Lyon IM, Dawson JL, Pietroni MC, Williams R",
        "doi": "10.1002/bjs.1800600817",
        "id": "pugh-1973",
        "source": "Br J Surg. 1973;60(8):646-649",
        "title": "Transection of the oesophagus for bleeding oesophageal varices"
      },
      "formula": "child_pugh",
      "formula_expression": "Child-Pugh = bilirubin + albumin + INR + encephalopathy + ascites; each 1-3; class A 5-6, B 7-9, C 10-15; max 15",
      "max_score": 15,
      "score": 5,
      "albumin_g_dl": 4.0,
      "bilirubin_mg_dl": 1.0,
      "ascites": "none",
      "child_pugh_class": "A",
      "encephalopathy": "none",
      "inr": 1.2
    }
  ]
}

Response

Example JSON

Machine form of the same example. Frozen fixture. Not a live lookup.

{
  "components": [
    {
      "value": 1.0,
      "factor": "bilirubin",
      "points": 1,
      "present": false
    },
    {
      "value": 4.0,
      "factor": "albumin",
      "points": 1,
      "present": false
    },
    {
      "value": 1.2,
      "factor": "inr",
      "points": 1,
      "present": false
    },
    {
      "value": "none",
      "factor": "encephalopathy",
      "points": 1,
      "present": false
    },
    {
      "value": "none",
      "factor": "ascites",
      "points": 1,
      "present": false
    }
  ],
  "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
  "citation": {
    "authors": "Pugh RNH, Murray-Lyon IM, Dawson JL, Pietroni MC, Williams R",
    "doi": "10.1002/bjs.1800600817",
    "id": "pugh-1973",
    "source": "Br J Surg. 1973;60(8):646-649",
    "title": "Transection of the oesophagus for bleeding oesophageal varices"
  },
  "formula": "child_pugh",
  "formula_expression": "Child-Pugh = bilirubin + albumin + INR + encephalopathy + ascites; each 1-3; class A 5-6, B 7-9, C 10-15; max 15",
  "max_score": 15,
  "score": 5,
  "albumin_g_dl": 4.0,
  "bilirubin_mg_dl": 1.0,
  "ascites": "none",
  "child_pugh_class": "A",
  "encephalopathy": "none",
  "inr": 1.2
}

Errors

Related tools

• MELD-Na — Compute OPTN/UNOS 2016 MELD and MELD-Na from creatinine, bilirubin, INR, sodium, and dialysis.
• Maddrey DF — Compute the 1978 Maddrey discriminant function from patient PT, control PT, and bilirubin.
• FIB-4 — Compute the FIB-4 fibrosis index from age, AST, ALT, and platelets.

Also searched as

• Child-Pugh score
• Child-Turcotte-Pugh
• CTP score
• cirrhosis class
• Pugh 1973
• Child Pugh

Payment

Required query parameters must be present and valid. Invalid params return HTTP 400 JSON before settlement. magent does not charge. Fix the params, then request a new 402 quote for that complete URL. Catalog misses (empty matches, found=false) are valid paid 200s. Unpaid valid requests return HTTP 402 with a base64 PAYMENT-REQUIRED header. HTTP 503 is not a new quote: retry the same PAYMENT-SIGNATURE. Full handshake and shared payment errors: Payments.

Guarantees

• Invalid query parameters return HTTP 400 before settlement. You are not charged.
• Settlement finishes before the tool executes (paymentFlow upfront). Uncertain or failed settlement fails closed (HTTP 503). Retry the same PAYMENT-SIGNATURE.
• HTTP 402 is unpaid only. Do not sign a second authorization because of a 503.
• Execution is timeout-bounded and concurrency-capped.
• Calculator inputs are stored encrypted for allowlisted operators (Magent Console). They are not in public logs, SSH lookups, catalog, or rollups. Request logs store path without query.