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Liver Function CTP Grading Method

Hepatic Encephalopathy
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Hepatic Encephalopathy
None
Ⅰ~Ⅱ (Medication Control)
Ⅲ~Ⅳ (Refractory)
Ascites
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Ascites
None
Mild
Moderate to Severe
Serum Bilirubin, μmol/L(mg/dL)
Please select
Serum Bilirubin, μmol/L(mg/dL)
<34(<2)
34~50(2~3)
>50(>3)
[<68(<4)]
[68~170(4~10)]
[>170(>10)]
Albumin, g/L
Please select
Albumin, g/L
>35
28~35
<28
INR, PT Prolongation, Seconds
Please select
INR, PT Prolongation, Seconds
<1.7
1.7~2.30
>2.30
<4
4~6
>6
Score:

Result Interpretation

Result Interpretation
Grade Grade A Grade B Grade C
Total Score 5-6 points 7-9 points 10-15 points
Morbidity Rate for Shunt Surgery 0~5% 10~15% >25%
1-Year Survival Rate 100% 81% 45%
2-Year Survival Rate 85% 57% 35%

The Child grading standard is a commonly used clinical grading standard for quantifying the liver reserve function in patients with liver cirrhosis. This standard was first proposed by Child and Turcotte in 1964 (including bilirubin, albumin, ascites, hepatic encephalopathy, and nutrition as five indicators). However, as it is often difficult to score the nutritional status of patients, Pugh proposed in 1972 to use INR or PT prolongation time instead of nutritional status, while also staging the degree of hepatic encephalopathy, and separately indicating the serum bilirubin for cholestatic liver cirrhosis. This is now the most commonly used Child-Pugh grading method in clinical practice, also known as the Child-Turcotte-Pugh (CTP) grading method.

Note: PBC: Primary Biliary Cirrhosis; PSC: Primary Sclerosing Cholangitis.

References

Research Paper 1. Child CG, Turcotte JG. Surgery and portal hypertension. In: The liver and portal hypertension. Edited by CG Child. Philadelphia: Saunders 1964:50-64. Research Paper 2. Pugh RN, Murray-Lyon IM, Dawson JL, Pietroni MC, Williams R (1973). Transection of the esophagus for bleeding esophageal varices. The British Journal of Surgery 60 (8).
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