Carteri RB, Marroni CA, Ferreira LF, Pinto LP, Czermainski J, Tovo CV, Fernandes SA. Do Child–Turcotte–Pugh and nutritional assessments predict survival in cirrhosis: A longitudinal study. World J Hepatol 2025; 17(1): 99183 [DOI: 10.4254/wjh.v17.i1.99183]
Corresponding Author of This Article
Sabrina A Fernandes, PhD, Postdoc, Professor, Researcher, Postgraduate in Hepatology, Universidade Federal de Ciências da Saúde de Porto Alegre, Sarmento Leite 245, Porto Alegre 90050-170, Brazil. sabrinaafernandes@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Cohort Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Hepatol. Jan 27, 2025; 17(1): 99183 Published online Jan 27, 2025. doi: 10.4254/wjh.v17.i1.99183
Do Child–Turcotte–Pugh and nutritional assessments predict survival in cirrhosis: A longitudinal study
Randhall B Carteri, Claudio A Marroni, Luis F Ferreira, Letícia P Pinto, Juliana Czermainski, Cristiane V Tovo, Sabrina A Fernandes
Randhall B Carteri, Department of Nutrition, Centro Universitário CESUCA, Cachoeirinha 94935-630, Brazil
Randhall B Carteri, Claudio A Marroni, Luis F Ferreira, Letícia P Pinto, Juliana Czermainski, Cristiane V Tovo, Sabrina A Fernandes, Postgraduate in Hepatology, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre 90050-170, Brazil
Luis F Ferreira, School of Electronics, Electrical Engineering and Computer Science, Queen’s University Belfast, Belfast BT9 5BN, Northern Ireland, United Kingdom
Author contributions: Carteri RB contributed to the methodological development and material support, collected data, interpreted results, conducted data analysis, wrote and revised the manuscript; Tovo CV and Marroni CA contributed to the conception and critical review of the manuscript; Pinto LP collected data and interpreted the results; Czermainski J contributed to the methodological development and material support; Ferreira LF conducted data analysis and interpreted the results; Fernandes SA designed the research project, collaborated in writing, and critically reviewed the manuscript; All authors have read and approved the final manuscript.
Institutional review board statement: This study was conducted in accordance with the Helsinki Declaration and was approved by the ethics and research committee of the Federal University of Health Sciences of Porto Alegre, under the number: 5203619. All participants signed the Informed Consent Form (TCLE) in advance.
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: No additional data is available for sharing.
STROBE statement: The authors have read the STROBE Statement—a checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-a checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sabrina A Fernandes, PhD, Postdoc, Professor, Researcher, Postgraduate in Hepatology, Universidade Federal de Ciências da Saúde de Porto Alegre, Sarmento Leite 245, Porto Alegre 90050-170, Brazil. sabrinaafernandes@gmail.com
Received: July 16, 2024 Revised: October 23, 2024 Accepted: December 6, 2024 Published online: January 27, 2025 Processing time: 174 Days and 8.9 Hours
Abstract
BACKGROUND
Cirrhotic patients face heightened energy demands, leading to rapid glycogen depletion, protein degradation, oxidative stress, and inflammation, which drive disease progression and complications. These disruptions cause cellular damage and parenchymal changes, resulting in vascular alterations, portal hypertension, and liver dysfunction, significantly affecting patient prognosis.
AIM
To analyze the association between Child–Turcotte–Pugh (CTP) scores and different nutritional indicators with survival in a 15-year follow-up cohort.
METHODS
This was a retrospective cohort study with 129 cirrhotic patients of both sexes aged > 18 years. Diagnosis of cirrhosis was made by liver biopsy. The first year of data collection was 2007, and data regarding outcomes were collected in 2023. Data were gathered from medical records, and grouped by different methods, including CTP, handgrip strength, and triceps skinfold cutoffs. The prognostic values for mortality were assessed using Kaplan–Meier curves and multivariate binary logistic regression models.
RESULTS
The coefficient for CTP was the only statistically significant variable (Wald = 5.193, P = 0.023). This suggests that with a negative change in CTP classification score, the odds of survival decrease 52.6%. The other evaluated variables did not significantly predict survival outcomes in the model. Kaplan–Meier survival curves also indicated that CTP classification was the only significant predictor.
CONCLUSION
Although different classifications showed specific differences in stratification, only CTP showed significant predictive potential. CTP score remains a simple and effective predictive tool for cirrhotic patients even after longer follow-up.
Core Tip: Cirrhosis involves destroying hepatic cells, leading to metabolic changes that disrupt the body’s homeostasis. These alterations adversely affect the patient’s clinical condition and prognosis. Identifying a parameter that can predict significant events is crucial for a more precise approach, reducing mortality and enhancing the quality of life. This study reinforces the predictive value of Child–Turcotte–Pugh for predicting the clinical status of those with chronic liver disease.
