Gastroenterology,  Liver,  Uncategorized

Child-Turcotte-Pugh (CTP) score

The CTP score is used to predict surgical risks in patients with cirrhosis when undergoing intra-abdominal operations. 

Child-Turcotte-Pugh (CTP) Score

Variable 1 point 2 points 3 points
Bilirubin < 2 mg/dL 2-3 mg/dL > 3 mg/dL
Albumin >3.5 g/dL 2.8-3.5 g/dL <2.8 g/dL
INR <1.7 1.7-2.2 >2.2
Encephalopathy None Controlled Uncontrolled
Ascites None Controlled Uncontrolled

Studies have shown that surgical mortality for a patient with class A cirrhosis is 10%, and for patients with class B cirrhosis is 30%, and for those with class C cirrhosis is 75-80%. 

Class Points Surgical mortality
Class A 5-6 points 10%
Class B 7-9 points 30%
Class C 10-15 points 75-80%

A 56 year old man with cirrhosis requires elective intra-abdominal surgery to remove a segment of the colon. To evaluate his surgical mortality risk, the Child-Turcotte-Pugh score is used. His labs reveal bilirubin 3.1 mg/dL, albumin 3.0 g/dL, and INR of 2.0. Further testing reveals no ascites or encephalopathy. 

What is the risk of him dying during surgery?

His gets 3+2+2 = 7 points which puts him in class B and gives him a 30% chance of dying during the colon resection.