Statistical
Child-Pugh spreadsheet arithmetic with validated inputs and class boundaries
Practice nested IF with a conventional non-cholestatic Child-Pugh scoring example using fictional data and explicit units.
Define the scoring convention and units
This fictional exercise demonstrates arithmetic, not drug dosing, surgical clearance or individual survival prediction. Clinical use requires an appropriately assessed patient, a specified scoring convention and the relevant medicine-specific guidance.
The example uses bilirubin in mg/dL, albumin in g/dL and INR. Its bilirubin thresholds are 2 and 3; albumin uses 3.5 and 2.8 in the opposite direction; INR uses 1.7 and 2.3. Ascites and encephalopathy enter as independently assessed 1–3 point subscores, not raw diagnostic grades.
Some disease-specific conventions use different bilirubin thresholds, particularly for cholestatic disease. Class alone does not establish compensated versus decompensated status or mandate a universal dose reduction. The worksheet deliberately returns only the point class.
| Child-Pugh Parameter | 1 pt / 2 pts / 3 pts Cutoffs | Fictional input | Points Awarded |
|---|---|---|---|
| Total Bilirubin (B2) | <2.0 | 2.0–3.0 | >3.0 mg/dL | 2.5 mg/dL | 2 pts |
| Serum Albumin (B3) | >3.5 | 2.8–3.5 | <2.8 g/dL | 3.0 g/dL (Inverted!) | 2 pts |
| INR (B4) | <1.7 | 1.7–2.3 | >2.3 | 1.9 | 2 pts |
| Ascites (B5) & Enceph (B6) | Pre-assessed component points:1,2or3 | Mild Ascites (2), No Enc (1) | 3 pts -> Total 9 (Class B) |
Total Child-Pugh Score (5 to 15 points)
Notice Albumin B3 uses > 3.5 -> 1 and < 2.8 -> 3 because hypoalbuminemia reflects impaired hepatic synthesis.
=IF(COUNT(B2:B6)<>5,"Invalid inputs",IF(OR(MIN(B2:B4)<=0,B5<1,B5>3,B6<1,B6>3,B5<>INT(B5),B6<>INT(B6)),"Invalid inputs",IF(B2 < 2, 1, IF(B2 <= 3, 2, 3)) + IF(B3 > 3.5, 1, IF(B3 >= 2.8, 2, 3)) + IF(B4 < 1.7, 1, IF(B4 <= 2.3, 2, 3)) + B5 + B6))Child-Pugh Hepatic Impairment Class (A, B, or C)
Maps total score in B7 onto Class A (5–6), Class B (7–9), or Class C (10–15).
=IF(COUNT(B7)<>1,"Invalid inputs",IF(OR(B7<5,B7>15,B7<>INT(B7)),"Invalid inputs",IF(B7<=6,"Class A (5-6)",IF(B7<=9,"Class B (7-9)","Class C (10-15)"))))Try the example
Use the original values or change them to test your understanding.