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Clinical calculator summary

Child-Turcotte-Pugh (CTP) Score: PT or INR Variant

This route implements the standard-bilirubin Child-Turcotte-Pugh score for an adult with established chronic liver disease or cirrhosis.

Evidence-based context for fast calculator use

Purpose:
Calculates the standard-bilirubin Child-Turcotte-Pugh total and class from a contemporaneous adult chronic-liver-disease assessment using either PT prolongation or INR.
Population:
patients undergoing liver-function, hepatocellular carcinoma staging, imaging, or transplant assessment
Factors:
CTP applicability, Coagulation variant, Total bilirubin, Albumin, INR, PT prolongation above laboratory control, Ascites source category, Hepatic encephalopathy source category
HomeChild-Turcotte-Pugh (CTP) Score: PT or INR Variant
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Child-Turcotte-Pugh (CTP) Score: PT or INR Variant

Clinical Context & Background

This route implements the standard-bilirubin Child-Turcotte-Pugh score for an adult with established chronic liver disease or cirrhosis. It requires one explicit coagulation variant: INR, or prothrombin-time prolongation in seconds above the laboratory control. PT prolongation is not raw PT, and the two variants are not silently interchanged.
The five components are total bilirubin, albumin, the selected coagulation measure, clinician-assigned ascites category, and clinician-assigned West Haven encephalopathy category. All components must be contemporaneous. Anticoagulation or another nonhepatic coagulation disorder, recent component-altering intervention, or discordant collection times withhold the numeric interpretation rather than produce an unqualified class.
This is the standard bilirubin table only. PBC, PSC, and other cholestatic threshold variants are not implemented. Acute liver failure, pediatric use, and use without established chronic liver disease are outside scope. The output is a severity class, not a fixed survival estimate, transplant-priority rule, surgery rule, treatment recommendation, or drug-dose instruction.
Primary Source Evidences: Child and Turcotte 1964 (PMID 4950264); Pugh et al. 1973 (PMID 4541913); Merck Manual and U.S. Department of Veterans Affairs CTP tables.
Formula Logic
Total = bilirubin points + albumin points + selected INR or PT-prolongation points + ascites points + encephalopathy points; Class A 5-6, B 7-9, C 10-15.

Reference Data

CTP classTotalNeutral interpretation
Class A5-6Standard CTP severity class; management remains separate
Class B7-9Standard CTP severity class; management remains separate
Class C10-15Standard CTP severity class; management remains separate

Clinical Workflow

Use, Interpret, And Continue The Patient Pathway

Expand for workflow guidance, limitations, examples, and related next steps.

When To Use

  • Use Child-Turcotte-Pugh (CTP) Score: PT or INR Variant when calculates the standard-bilirubin Child-Turcotte-Pugh total and class from a contemporaneous adult chronic-liver-disease assessment using either PT prolongation or INR.
  • Confirm that the patient, diagnosis, disease phase, and available inputs match the cited model before calculation.

How To Interpret

  • Interpret the displayed result using the calculator-specific formula and reference table, spanning Class A through Class C.
  • A boundary result should prompt input verification and clinical review rather than false precision.

What To Do Next

  • Integrate liver reserve, portal hypertension, tumor burden, vascular invasion, extrahepatic disease, performance status, and transplant policy.
  • Document the inputs, result, timing, and clinical context so the assessment can be reproduced.

Limitations

  • Liver function, HCC stage, imaging category, and transplant criteria are complementary but not interchangeable.
  • The result supports clinician judgment and does not independently determine treatment.

Validated Population

patients undergoing liver-function, hepatocellular carcinoma staging, imaging, or transplant assessment

How to apply this result

For a representative case, verify CTP applicability, Coagulation variant, Total bilirubin, calculate the result, and confirm that its classification matches the highlighted reference band before continuing the disease-specific pathway.

Liver / HCC hubContinue to related calculators and clinical workflow resources.

Calculation verification history

Verified

  1. : Production browser revalidation

    • Three source-backed Child-Pugh cases passed through visible production controls across the outside-scope gate and Class A/Class C extremes.
    • No unexpected N/A, literal undefined value, stale control, unsupported gauge, or browser-console error was observed.
    Download latest production check (Excel)

    Case-level evidence is retained in validation/browser-revalidation/child-pugh-liver-cirrhosis-severity-score-2026-08-03.json.

  2. : Production browser validation

    • Ten source-backed cases were exercised on the public production route through visible browser controls; 10/10 case records passed their expected-versus-observed assertions across 11 visible submissions.
    • Overall browser status: failed-console. medium: Production emitted minified React error #418 during route loads/reloads used by this run.
    • Case-level inputs, expected and observed results, reset/repeat behavior, failure reproductions, and console evidence are retained in the production-browser evidence record.

    Case-level production evidence is retained in validation/browser-production/child-pugh-liver-cirrhosis-severity-score.json.

  3. : Full validation

    • 665/665 independently expected engine, boundary, malformed-input, scope, panel, UI, trace, content, registry, history, and report assertions passed.
    • This is implementation verification, not independent clinical validation. The master liver panel remains In review.

  4. : Calculation/input correction

    • Removed ascites and encephalopathy defaults, Number coercion, unsupported fallthrough, the 50/51 bilirubin boundary error, and fixed survival output.
    • Added an exact ten-key immutable contract, explicit INR versus PT-prolongation variants, exact raw boundaries, and enforceable population, coagulation, and timing gates.
    • Invalid, incomplete, outside-scope, confounded, and noncontemporaneous inputs return no total or class.

    Included in the current validation report.

  5. : Content reconciliation

    • Replaced fixed survival, transplant urgency, surgery, treatment, and drug-dose claims with neutral class-only interpretation.
    • Corrected direct article, glossary, blog metadata, video metadata, and liver-panel dependency wording.
    • The panel now consumes the canonical class and blocks BCLC/HKLC when Child-Pugh is not interpreted; no panel-wide verification was claimed.

    Included in the current validation report.

  6. : Public form simplified

    • Combined the separate population, coagulation-confounder, and component-timing questions into one early applicability confirmation.
    • Preserved bilirubin, albumin, ascites, encephalopathy, coagulation-variant selection, and the selected raw INR or PT-prolongation value.
    • The compact adapter projects confirmed applicability into the unchanged strict ten-key engine; declined or uncertain applicability stops before component entry.

    Public-form parity is covered by the calculator entry-burden audit; the verified scoring engine and report remain unchanged.

Verification confirms the calculator implementation against the cited model; it is not independent clinical validation, regulatory approval, or medical advice.

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Frequently Asked Questions

When should Child-Turcotte-Pugh (CTP) Score: PT or INR Variant be used?

Use it for patients undergoing liver-function, hepatocellular carcinoma staging, imaging, or transplant assessment when all required inputs and the intended clinical setting are confirmed.

Can Child-Turcotte-Pugh (CTP) Score: PT or INR Variant determine treatment by itself?

No. Interpret the result with the cited evidence, complete clinical assessment, current guidelines, and patient-specific goals.

Evidence-based oncology decision support. Verify with clinical guidelines.