TreatmentUpdate
215

May/June 2016 

Child-Turcotte-Pugh – Grading severe liver disease and the likelihood of survival

In cases of cirrhosis (severe liver injury and scarring of the liver), it is useful for doctors to know the likelihood of patient survival in the short- and medium-term so that interventions can be prioritized. Doctors have developed a scoring system called Child-Turcotte-Pugh (CTP) for this purpose. CTP takes into account cirrhosis-related symptoms and certain lab test results. The more severe the symptoms and the greater the abnormality in lab test results, the greater the CTP score. Entering these into an equation or calculator produces a score that has a relatively high predictive value.

CTP takes into account the following factors:

  • HCV brain-related problems (encephalopathy)
  • whether or not fluid is accumulating in the abdomen (ascites)
  • analyses of lab tests focusing on the concentrations of bilirubin and albumin
  • the time it takes for blood to clot

CTP scores are graded and have the following implications:

  • CTP category A (5 to 6 points) – people have a 100% chance of surviving for one year and an 80% chance of surviving for a subsequent year
  • CTP category B (7 to 9 points) – people have an 81% chance of surviving for one year and a 57% chance of surviving for a subsequent year
  • CTP category C (10 to 15 points) – people have a 45% chance of surviving for one year and a 35% chance of surviving for a subsequent year

We will refer to CTP categories (A, B, C) later in this issue of TreatmentUpdate.

—Sean R. Hosein