Prognostic Value of Child-Turcotte Criteria in Medically Treated Cirrhosis
Corresponding Author
Erik Christensen
Medical Department A, Division of Hepatology, Rigshospitalet; Medical Department, Division of Hepatology, Department of Pathology, Hvidovre Hospital, University of Copenhagen; Statistical Research Unit, Danish Medical and Social Science Research Councils; Medical Departments B and C, Bispebjerg Hospital; Medical Department B, Frederiksberg Hospital; Medical Departments II, III and VII, Kommunehospitalet, Copenhagen, Denmark; University Institute of Pathological Anatomy, Århus, Denmark
Erik Christensen, M.D., Department of Hepatology 233, University of Copenhagen, Hvidovre Hospital, 30 Kettegaard Alle, DK-2650 Copenhagen, Denmark.===Search for more papers by this authorPoul Schlichting
Medical Department A, Division of Hepatology, Rigshospitalet; Medical Department, Division of Hepatology, Department of Pathology, Hvidovre Hospital, University of Copenhagen; Statistical Research Unit, Danish Medical and Social Science Research Councils; Medical Departments B and C, Bispebjerg Hospital; Medical Department B, Frederiksberg Hospital; Medical Departments II, III and VII, Kommunehospitalet, Copenhagen, Denmark; University Institute of Pathological Anatomy, Århus, Denmark
Search for more papers by this authorLis Fauerholdt
Medical Department A, Division of Hepatology, Rigshospitalet; Medical Department, Division of Hepatology, Department of Pathology, Hvidovre Hospital, University of Copenhagen; Statistical Research Unit, Danish Medical and Social Science Research Councils; Medical Departments B and C, Bispebjerg Hospital; Medical Department B, Frederiksberg Hospital; Medical Departments II, III and VII, Kommunehospitalet, Copenhagen, Denmark; University Institute of Pathological Anatomy, Århus, Denmark
Search for more papers by this authorChristian Gluud
Medical Department A, Division of Hepatology, Rigshospitalet; Medical Department, Division of Hepatology, Department of Pathology, Hvidovre Hospital, University of Copenhagen; Statistical Research Unit, Danish Medical and Social Science Research Councils; Medical Departments B and C, Bispebjerg Hospital; Medical Department B, Frederiksberg Hospital; Medical Departments II, III and VII, Kommunehospitalet, Copenhagen, Denmark; University Institute of Pathological Anatomy, Århus, Denmark
Search for more papers by this authorPer Kragh Andersen
Medical Department A, Division of Hepatology, Rigshospitalet; Medical Department, Division of Hepatology, Department of Pathology, Hvidovre Hospital, University of Copenhagen; Statistical Research Unit, Danish Medical and Social Science Research Councils; Medical Departments B and C, Bispebjerg Hospital; Medical Department B, Frederiksberg Hospital; Medical Departments II, III and VII, Kommunehospitalet, Copenhagen, Denmark; University Institute of Pathological Anatomy, Århus, Denmark
Search for more papers by this authorErik Juhl
Medical Department A, Division of Hepatology, Rigshospitalet; Medical Department, Division of Hepatology, Department of Pathology, Hvidovre Hospital, University of Copenhagen; Statistical Research Unit, Danish Medical and Social Science Research Councils; Medical Departments B and C, Bispebjerg Hospital; Medical Department B, Frederiksberg Hospital; Medical Departments II, III and VII, Kommunehospitalet, Copenhagen, Denmark; University Institute of Pathological Anatomy, Århus, Denmark
Search for more papers by this authorHemming Poulsen
Medical Department A, Division of Hepatology, Rigshospitalet; Medical Department, Division of Hepatology, Department of Pathology, Hvidovre Hospital, University of Copenhagen; Statistical Research Unit, Danish Medical and Social Science Research Councils; Medical Departments B and C, Bispebjerg Hospital; Medical Department B, Frederiksberg Hospital; Medical Departments II, III and VII, Kommunehospitalet, Copenhagen, Denmark; University Institute of Pathological Anatomy, Århus, Denmark
Search for more papers by this authorNiels Tygstrup
Medical Department A, Division of Hepatology, Rigshospitalet; Medical Department, Division of Hepatology, Department of Pathology, Hvidovre Hospital, University of Copenhagen; Statistical Research Unit, Danish Medical and Social Science Research Councils; Medical Departments B and C, Bispebjerg Hospital; Medical Department B, Frederiksberg Hospital; Medical Departments II, III and VII, Kommunehospitalet, Copenhagen, Denmark; University Institute of Pathological Anatomy, Århus, Denmark
Search for more papers by this authorThe Copenhagen Study Group For Liver Diseases
Medical Department A, Division of Hepatology, Rigshospitalet; Medical Department, Division of Hepatology, Department of Pathology, Hvidovre Hospital, University of Copenhagen; Statistical Research Unit, Danish Medical and Social Science Research Councils; Medical Departments B and C, Bispebjerg Hospital; Medical Department B, Frederiksberg Hospital; Medical Departments II, III and VII, Kommunehospitalet, Copenhagen, Denmark; University Institute of Pathological Anatomy, Århus, Denmark
Members of the Copenhagen Study Group for Liver Diseases are: J. T. Balslev; M. Bjørneboe; P. Christoffersen; K. Eghøje; V. Faber; S. Gjørup; B. Harvald; K. Iversen; O. Jessen; E. Juhl; H. E. Jørgensen; A. R. Krogsgaard; S. A. Nørregaard; T. Steen Olsen; H. Poulsen; F. Quaade; L. Ranek; F. Raaschou; K. Schmidt; Å. C. Thomsen; N. Tygstrup; and P. Winkel.
Search for more papers by this authorCorresponding Author
Erik Christensen
Medical Department A, Division of Hepatology, Rigshospitalet; Medical Department, Division of Hepatology, Department of Pathology, Hvidovre Hospital, University of Copenhagen; Statistical Research Unit, Danish Medical and Social Science Research Councils; Medical Departments B and C, Bispebjerg Hospital; Medical Department B, Frederiksberg Hospital; Medical Departments II, III and VII, Kommunehospitalet, Copenhagen, Denmark; University Institute of Pathological Anatomy, Århus, Denmark
Erik Christensen, M.D., Department of Hepatology 233, University of Copenhagen, Hvidovre Hospital, 30 Kettegaard Alle, DK-2650 Copenhagen, Denmark.===Search for more papers by this authorPoul Schlichting
Medical Department A, Division of Hepatology, Rigshospitalet; Medical Department, Division of Hepatology, Department of Pathology, Hvidovre Hospital, University of Copenhagen; Statistical Research Unit, Danish Medical and Social Science Research Councils; Medical Departments B and C, Bispebjerg Hospital; Medical Department B, Frederiksberg Hospital; Medical Departments II, III and VII, Kommunehospitalet, Copenhagen, Denmark; University Institute of Pathological Anatomy, Århus, Denmark
Search for more papers by this authorLis Fauerholdt
Medical Department A, Division of Hepatology, Rigshospitalet; Medical Department, Division of Hepatology, Department of Pathology, Hvidovre Hospital, University of Copenhagen; Statistical Research Unit, Danish Medical and Social Science Research Councils; Medical Departments B and C, Bispebjerg Hospital; Medical Department B, Frederiksberg Hospital; Medical Departments II, III and VII, Kommunehospitalet, Copenhagen, Denmark; University Institute of Pathological Anatomy, Århus, Denmark
Search for more papers by this authorChristian Gluud
Medical Department A, Division of Hepatology, Rigshospitalet; Medical Department, Division of Hepatology, Department of Pathology, Hvidovre Hospital, University of Copenhagen; Statistical Research Unit, Danish Medical and Social Science Research Councils; Medical Departments B and C, Bispebjerg Hospital; Medical Department B, Frederiksberg Hospital; Medical Departments II, III and VII, Kommunehospitalet, Copenhagen, Denmark; University Institute of Pathological Anatomy, Århus, Denmark
Search for more papers by this authorPer Kragh Andersen
Medical Department A, Division of Hepatology, Rigshospitalet; Medical Department, Division of Hepatology, Department of Pathology, Hvidovre Hospital, University of Copenhagen; Statistical Research Unit, Danish Medical and Social Science Research Councils; Medical Departments B and C, Bispebjerg Hospital; Medical Department B, Frederiksberg Hospital; Medical Departments II, III and VII, Kommunehospitalet, Copenhagen, Denmark; University Institute of Pathological Anatomy, Århus, Denmark
Search for more papers by this authorErik Juhl
Medical Department A, Division of Hepatology, Rigshospitalet; Medical Department, Division of Hepatology, Department of Pathology, Hvidovre Hospital, University of Copenhagen; Statistical Research Unit, Danish Medical and Social Science Research Councils; Medical Departments B and C, Bispebjerg Hospital; Medical Department B, Frederiksberg Hospital; Medical Departments II, III and VII, Kommunehospitalet, Copenhagen, Denmark; University Institute of Pathological Anatomy, Århus, Denmark
Search for more papers by this authorHemming Poulsen
Medical Department A, Division of Hepatology, Rigshospitalet; Medical Department, Division of Hepatology, Department of Pathology, Hvidovre Hospital, University of Copenhagen; Statistical Research Unit, Danish Medical and Social Science Research Councils; Medical Departments B and C, Bispebjerg Hospital; Medical Department B, Frederiksberg Hospital; Medical Departments II, III and VII, Kommunehospitalet, Copenhagen, Denmark; University Institute of Pathological Anatomy, Århus, Denmark
Search for more papers by this authorNiels Tygstrup
Medical Department A, Division of Hepatology, Rigshospitalet; Medical Department, Division of Hepatology, Department of Pathology, Hvidovre Hospital, University of Copenhagen; Statistical Research Unit, Danish Medical and Social Science Research Councils; Medical Departments B and C, Bispebjerg Hospital; Medical Department B, Frederiksberg Hospital; Medical Departments II, III and VII, Kommunehospitalet, Copenhagen, Denmark; University Institute of Pathological Anatomy, Århus, Denmark
Search for more papers by this authorThe Copenhagen Study Group For Liver Diseases
Medical Department A, Division of Hepatology, Rigshospitalet; Medical Department, Division of Hepatology, Department of Pathology, Hvidovre Hospital, University of Copenhagen; Statistical Research Unit, Danish Medical and Social Science Research Councils; Medical Departments B and C, Bispebjerg Hospital; Medical Department B, Frederiksberg Hospital; Medical Departments II, III and VII, Kommunehospitalet, Copenhagen, Denmark; University Institute of Pathological Anatomy, Århus, Denmark
Members of the Copenhagen Study Group for Liver Diseases are: J. T. Balslev; M. Bjørneboe; P. Christoffersen; K. Eghøje; V. Faber; S. Gjørup; B. Harvald; K. Iversen; O. Jessen; E. Juhl; H. E. Jørgensen; A. R. Krogsgaard; S. A. Nørregaard; T. Steen Olsen; H. Poulsen; F. Quaade; L. Ranek; F. Raaschou; K. Schmidt; Å. C. Thomsen; N. Tygstrup; and P. Winkel.
Search for more papers by this authorAbstract
The Child-Turcotte criteria (CTC) (based on serum bilirubin and albumin, ascites, neurological disorder and nutrition) are established prognostic factors in patients with cirrhosis having portacaval shunt surgery. The objective of this study was to evaluate the prognostic value of CTC in conservatively treated cirrhosis. Patients (n = 245) with histologically verified cirrhosis from a control group of a controlled clinical trial were studied. Data at entry into the trial were used to classify patients according to CTC. Survival curves for up to 16 years were made, and survival rates were compared using the log-rank test. Survival decreased significantly with increasing degree of abnormality (A ± B ± C) of albumin (p < 0.001), ascites (p < 0.001), bilirubin (p = 0.02) and nutritional status (p = 0.03). Survival was insignificantly influenced by neurological status (p = 0.11) probably because none of the patients had hepatic coma at entry into the trial. The five variables in CTC were combined to a score. With increasing score, the median survival time decreased from 6.4 years (score 5) to 2 months (scores 12 or more). Furthermore, the mortality from hepatic failure, gastrointestinal bleeding or hepatocellular carcinoma increased significantly with increasing score. CTC provide valuable and easily obtainable prognostic information in cirrhosis. However, CTC are inferior to a prognostic index based on multivariate analysis of prognostic factors.
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