My Sick Liver
CTP Scoring
_
Child-Turcotte-Pugh (CTP) scoring helps determine how severe cirrhosis is. You will need to know some basic labs:
There is also an excellent CTP calculator at the MDCalc website.
Child-Turcotte-Pugh (CTP) scoring helps determine how severe cirrhosis is. You will need to know some basic labs:
- Bilirubin
- Albumin
- INR
- Do you have hepatic encephalopathy (mental confusion , memory problems, agitation, excessive sleeping)? If so how is it being treated?
- Do you have ascites (free fluid in the abdominal cavity)? If so how are they treating it?
There is also an excellent CTP calculator at the MDCalc website.
|
|
1 point
|
2 points
|
3 points
|
|
Billirubin
|
< 2
|
2 - 3
|
> 3
|
|
Albumin
|
> 3.5
|
2.8 - 3.5
|
< 2.8
|
|
INR
|
< 1.7
|
1.7 - 2.2
|
> 2.2
|
|
Encephalopathy |
Not present |
_Grade I-II
Treated with lactulose Grade I: Sleep disturbances; impaired concentration; depression; anxiety; or irritability Grade II: Drowsiness, disorientation, poor short-term memory, uninhibited behavior |
_Grade III-IV
Treatment ineffective Grade III: Somnolence; confusion; amnesia; anger, paranoia, or other bizarre behavior Grade IV: Coma |
|
Ascites
|
Not present
|
_Mild
Treated with diuretics and low sodium diet |
_Severe or Moderate even with treatment
|
_Total points:
5-6 this is called compensated cirrhosis (any score greater than 6 is called decompensated
cirrhosis). You are not very sick right now. Most transplant centers would not evaluate you
for transplant yet. Most cirrhosis patients will stay at this level for many years. Many will
live out a normal life without ever leaving this group.
7-9 this is the time when most doctors will refer you to a transplant center. You are starting to see complications and your labs are a little worse but you are still a long way from needing a
transplant. After complications are treated most patients return to a compensated level and
will bounce between the two levels sometimes for years.
10-15 you are very sick and having difficulty controlling complications. You are actively waiting
for transplant and may be in the hospital.
5-6 this is called compensated cirrhosis (any score greater than 6 is called decompensated
cirrhosis). You are not very sick right now. Most transplant centers would not evaluate you
for transplant yet. Most cirrhosis patients will stay at this level for many years. Many will
live out a normal life without ever leaving this group.
7-9 this is the time when most doctors will refer you to a transplant center. You are starting to see complications and your labs are a little worse but you are still a long way from needing a
transplant. After complications are treated most patients return to a compensated level and
will bounce between the two levels sometimes for years.
10-15 you are very sick and having difficulty controlling complications. You are actively waiting
for transplant and may be in the hospital.
