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Child–Pugh cirrhosis score

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

All grade 1 (class A)

Given: albumin_g_dl=4.0ascites=nonebilirubin_mg_dl=1.0encephalopathy=noneinr=1.2

Bilirubin 1.0 → 1; albumin 4.0 → 1; INR 1.2 → 1; encephalopathy none → 1; ascites none → 1
Score = 5; class A

Also searched as

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

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

Call

Expect HTTP 402 until you retry with PAYMENT-SIGNATURE. Incomplete query params return HTTP 400 before any quote or charge.

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"

Parameters

Name	Type	Required	Description
`bilirubin_mg_dl`	number	optional	Total bilirubin in mg/dL (0.1-40). Provide this or bilirubin_umol_l. <2.0 scores 1; 2.0-3.0 scores 2; >3.0 scores 3.
`bilirubin_umol_l`	number	optional	Total bilirubin in µmol/L. Converted as mg/dL = µmol/L / 17.1.
`albumin_g_dl`	number	optional	Albumin in g/dL (1-6). Provide this or albumin_g_l. >3.5 scores 1; 2.8-3.5 scores 2; <2.8 scores 3.
`albumin_g_l`	number	optional	Albumin in g/L. Converted as g/dL = g/L / 10.
`inr`	number	required	INR (0.8-10). Contemporary substitute for Pugh PT-prolongation seconds. <1.70 scores 1; 1.70-2.30 scores 2; >2.30 scores 3.
`encephalopathy`	string	required · none, grade_1_2, grade_3_4	Caller-assigned encephalopathy grade. none scores 1; grade_1_2 scores 2; grade_3_4 scores 3. magent does not examine the patient.
`ascites`	string	required · none, slight, moderate	Caller-assigned ascites. none scores 1; slight scores 2; moderate scores 3. magent does not examine the patient.

Bulk (POST)

POST the same path with a JSON items array. The first item is the GET unit; each additional item is $0.002. Invalid items return HTTP 400 before settlement.

POST /api/calc/child_pugh Max 25 unit_amount + extra_item_amount * (n - 1) extra $0.002 PREVIEW

1 to 25 items. Each item uses the same keys as the GET query parameters.
POST of 1 item costs the same as GET. Lists longer than 25: chunk into multiple POSTs. Extra items still execute; do not pad dummy rows.
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,
      "bilirubin_mg_dl": 1.0,
      "inr": 1.2,
      "albumin_g_dl": 4.0,
      "ascites": "none",
      "child_pugh_class": "A",
      "encephalopathy": "none"
    },
    {
      "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,
      "bilirubin_mg_dl": 1.0,
      "inr": 1.2,
      "albumin_g_dl": 4.0,
      "ascites": "none",
      "child_pugh_class": "A",
      "encephalopathy": "none"
    }
  ]
}

Response

Field	Type	Description
`formula`	string	child_pugh
`formula_expression`	string	Exact expression used
`score`	integer	Total points 5-15
`max_score`	integer	Always 15
`child_pugh_class`	string	A (5-6), B (7-9), or C (10-15)
`bilirubin_mg_dl`	number	Normalized bilirubin in mg/dL
`albumin_g_dl`	number	Normalized albumin in g/dL
`inr`	number	Input INR
`encephalopathy`	string	Caller-assigned none, grade_1_2, or grade_3_4
`ascites`	string	Caller-assigned none, slight, or moderate
`components`	array	Per-factor 1-3 points
`citation`	object	Pugh 1973 citation
`disclaimer`	string	Not-a-device notice

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,
  "bilirubin_mg_dl": 1.0,
  "inr": 1.2,
  "albumin_g_dl": 4.0,
  "ascites": "none",
  "child_pugh_class": "A",
  "encephalopathy": "none"
}

Client errors (HTTP 400)

Invalid params return 400 without charge. Shared HTTP 402 and 503 meanings: Payments.

HTTP	Code	When
400	`invalid_bilirubin`	bilirubin_mg_dl (0.1-40) or bilirubin_umol_l (2-684) is required Returned before settlement; you are not charged.
400	`invalid_albumin`	albumin_g_dl (1-6) or albumin_g_l (10-60) is required Returned before settlement; you are not charged.
400	`invalid_inr`	inr must be a number from 0.8 to 10 Returned before settlement; you are not charged.
400	`invalid_encephalopathy`	encephalopathy must be none, grade_1_2, or grade_3_4. Returned before settlement; you are not charged.
400	`invalid_ascites`	ascites must be none, slight, or moderate. Returned before settlement; you are not charged.
400	`invalid_items`	POST body must be a JSON object with only an items array Returned before settlement; you are not charged.
400	`invalid_item_count`	items must be an array of 1 to 25 objects Returned before settlement; you are not charged.
400	`invalid_item`	each items entry must be a JSON object Returned before settlement; you are not charged.

Related tools

MELD-Na — Agents must not invent MELD-Na from model memory. This endpoint computes the published OPTN/UNOS 2016 MELD-Na score from creatinine, bilirubin, INR, sodium, and dialysis; pay per request with x402 USDC on Base.
Maddrey DF — Compute the 1978 Maddrey discriminant function from patient PT, control PT, and bilirubin.
FIB-4 — Agents must not invent FIB-4 from model memory. This endpoint computes the published Sterling 2006 FIB-4 fibrosis index from age, AST, ALT, and platelets; pay per request with x402 USDC on Base.
West Haven — Return the Conn 1977 (West Haven / Conn score) hepatic encephalopathy grade 0-4 from a caller-assigned integer.

Payment

Unpaid requests return HTTP 402 even if query parameters or POST items are missing or invalid, so CDP and agents can index the path. After a PAYMENT-SIGNATURE, 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. Stdio MCP: /docs/mcp.

Guarantees

HTTP 402 is unpaid, including a missing query. After PAYMENT-SIGNATURE, invalid parameters return HTTP 400 before settlement. You are not charged. HTTP 402 never includes the tool JSON.
exact: settlement finishes before the tool (paymentFlow upfront). batch-settlement: verify/deposit before the tool; chargedCumulativeAmount commits after HTTP 2xx. 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.