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.
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