The Child-Pugh-Turcot (CTP) score consists of 5 clinical features and is used to assess the prognosis of chronic liver disease and cirrhosis.
Mnemonic: A BEAP
- Albumin (gm/dl)
- Bilirubin (mg/dl)
- Encephalopathy (Based on West Haven Criteria)
- Prothrombin Time (PT) Prolonged or INR
|Factor||1 point||2 points||3 points|
|Bilirubin (mg/dl)||< 2||2 – 3||< 3|
|Albumin (g/dl)||> 3.5||2.8 – 3.5||< 2.8|
|INR or (Prothrombin time [seconds prolonged])||< 1.7 (< 4)||1.7 – 2.3 (4 – 6)||> 2.3 (> 6)|
|Ascites||None||Mild (Diuretic responsive)||Moderate or Severe (Diuretic refractory)|
|Hepatic encephalopathy||None||Grade I – II||Grade III – IV|
West Haven Criteria for Hepatic Encephalopathy
Interpretation of Child Pugh Turcot Score
|Points||Class||One year survival||Two year survival||Operative mortality|
|5 – 6||A||100%||85%||Low (<5%)|
|7 – 9||B||81%||57%||Moderate (~25%)|
|10 – 15||C||45%||35%||High (>50%)|
MELD (Model For End Stage Liver Disease) Score
Model for End-Stage Liver Disease (MELD) is a numerical scale, ranging from 6 (less ill) to 40 (gravely ill), used for liver transplant candidates age 12 and older. It gives each person a ‘score’ (number) based on how urgently he or she needs a liver transplant within the next three months. The number is calculated by a formula using three routine lab test results:
- INR (prothrombin time)
For Pediatric population (<12 years), there is PELD (Pediatric End Stage Liver Disease) Score which uses Albumin, Growth failure and Age <1 year instead of Creatinine.
Calculate MELD score.