Emerson et al modified the Child-Turcotte-Pugh score for patients with cirrhosis in the intensive care unit (ICU). The authors are from the University of Glasgow and the Royal Infirmary Glasgow.
Patient selection: patient with cirrhosis in the ICU
Parameters for basic Child-Turcotte-Pugh score:
(1) serum total bilirubin
(2) serum albumin
(5) hepatic encephalopathy
serum total bilirubin
< 34 µmol/L
> 50 µmol/L
> 35 g/L
< 28 g/L
Grade I or II
Grade III or IV
The CTP-L score adds additional points for lactate
admission serum lactate
<= 2.00 mmol/L
2.01 to 4.0 mmol/L
>= 4.01 mmol/L
= SUM(points for CTP score) + (points for admission serum lactate)
The CTP+L score adds the actual serum lactate value in mmol/L to the CTP score.
= SUM(points for CTP score) + (serum lactate in mmol/L)
• minimum CTP score: 5
• maximum CTP score: 15
• minimum CTP-L score: 6
• maximum CTP-L score: 18
• minimum CTP+L score: 5
• maximum CTP+L score: 15 plus maximum serum lactate value
• A CTP-L >= 11.5 was associated with ICU mortality.
• A CTP+L >= 14 was associated with ICU mortality.
• The AUC for the CTP-L score was 0.78. The sensitivity was 72% and specificity 68%.
• The AUC for the CTP+L score was 0.86. The sensitivity was 79% and specificity 90%.
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Purpose: To evaluate a patient with cirrhosis in the ICU using the CTP-L and CTP+L scores of Emerson et al.
Specialty: Critical Care, Emergency Medicine, Gastroenterology
Objective: severity, prognosis, stage