Campbell et al evaluated the Child-Turcotte criteria for cirrhosis in patients with a portocaval shunt. The authors are from Yale University and the University of Oklahoma.
Original Child-Turcotte parameters:
(1) serum bilirubin in mg/dL
(2) serum albumin
(3) ascites
(4) neurologic disorder
(5) prothrombin time
Grading for Each Criteria |
Function |
Points |
A |
good |
1 |
B |
fair |
2 |
C |
poor |
3 |
Parameter |
Finding |
Points |
serum bilirubin |
< 2 mg/dL |
1 |
|
2 - 3 mg/dL |
2 |
|
> 3 mg/dL |
3 |
serum albumin |
> 3.5 g/dL |
1 |
|
3.0 - 3.5 g/dL |
2 |
|
< 3.0 g/dL |
3 |
ascites |
none |
1 |
|
easily controlled |
2 |
|
difficult to control |
3 |
neurologic disorder |
none |
1 |
|
minimal |
2 |
|
advanced |
3 |
nutrition |
excellent |
1 |
|
good |
2 |
|
poor, with wasting |
3 |
where:
• Campbell et al evaluated the addition of age, number of preoperative bleeding episodes and preoperative ammonia level to the Child-Turcotte score but these factors did not improve the score performance.
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 5
• maximum score: 15
• The higher the score the more severe the cirrhosis.
Total Score |
Classification by Campbell et al |
5 - 8 |
good hepatic function |
9 - 11 |
moderately impaired hepatic function |
12 - 15 |
advanced hepatic function |
Performance:
• The criteria can help distinguish short from long term survivors in patients undergoing portocaval shunt. However, the total efficiency was only about 62%.
• The criteria are more accurate in patients with postnecrotic cirrhosis than in those with nutritional cirrhosis.
Specialty: Gastroenterology