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 |
- Class A cirrhosis: 5-6 points
- Class B cirrhosis: 7-9 points
- Class C cirrhosis: 10-15 points
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.