Cirrhosis is a liver condition with a variety of causes and clinical manifestations. Patients can display no symptoms at all or very severe and life-threatening problems. It all depends on the degree of liver insufficiency associated with cirrhosis and the extension of the disease. It also depends on the treatment, the patient’s lifestyle, and if he is following advice and taking care of his condition.
In this article, we will review a topic that concerns patients as soon as they are diagnosed with cirrhosis: what is the life expectancy? Given the variability of the disease and its causes, the prognosis after the diagnosis depends on different factors in continuous change. So, instead of taking these estimates as the final word, it is essential to ask for your doctor’s opinion in every follow-up to get a more accurate assessment of the disease.
Assessment of cirrhosis severity
There are many ways and different tools to evaluate cirrhosis’s severity and extent, but one of the most widely used is the Child-Turcotte-Pugh scoring system. It is a system initially devised by Child and Turcotte back in 1964 and later reviewed and improved by Pugh in 1973. Since that time, other revisions have been made, but they have not been added to the original name.
According to this scoring system and after giving each patient a number, their life expectancy was measured, and researchers showed that it is not only useful to make clinical decisions. It is also helpful to give a prognosis and predict life expectancy.
So, if a patient gets a CTP score equal to or greater than 10, the disease is advanced and life-threatening. These patients are more likely to be short-lived and have multiple and overlapping complications.
To get a patient’s CTP score, doctors add 1, 2, or 3 points in each of the items above depending on the characteristics of the disease:
- Does the patient have encephalopathy? No encephalopathy is 1 point. Patients with encephalopathy grade 1 or 2 get 2 points. And encephalopathy grade 3 or 4 gets 3 points.
- Does the patient have ascites? No ascites is 1 point. Patients with slight ascites get 2 points. And moderate or large ascites gets 3 points.
- What is the level of bilirubin in the blood? Lower levels than 2 mg/dL get 1 point. When bilirubin levels are between 2 and 3 mg/dL, the patient receives 2 points. More than 3 mg/dL in bilirubin level gets 3 points (if the patient has associated primary sclerosing cholangitis or primary biliary cholangitis, these levels rise to 4, 4-10, and 10 mg/dL, respectively)
- What is the level of albumin in the blood? Higher levels than 3.5 g/dL get 1 point. When albumin levels are between 2.8 and 3.5 g/dL, the patient receives 2 points. Less than 2.8 g/dL in albumin level gets 3 points.
- What is the prothrombin time? A prothrombin time lower than 4 seconds gets 1 point. When prothrombin time is between 4 and 6 seconds, the patient receives 2 points. More than 6 seconds in prothrombin time gets 3 points.
In severe cirrhosis, there is also a scoring program called Model for End-Stage Liver Disease, which uses a complex score calculator that you can find online, and the patient gets a score point of 6-40. This score is useful to decide which patient needs a liver transplant and how urgent it is, and it also measures mortality in the next 3 months. The higher the score, the higher the mortality rate there will be in 3 months.
