Validation of Child-Turcotte-Pugh-Kumar (CTPK) Score in Predicting Short Term Mortality in Patients With Liver Cirrhosis

NCT ID: NCT01863121

Last Updated: 2017-04-28

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

UNKNOWN

Total Enrollment

500 participants

Study Classification

OBSERVATIONAL

Study Start Date

2013-05-31

Study Completion Date

2018-01-31

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

The CTP score is one of the best proved severity score in predicting mortality in patients with cirrhosis. Portal hypertension and variceal bleed are significant causes of morbidity and mortality in patients with cirrhosis. The recently published CTPK score included variceal variceal bleed status to the CTP score which improved the accuracy of CTP score in predicting short term mortality. CTPK score needs prospective validation.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Once patients with cirrhosis experience decompensation, early mortality risk increases sharply. Child-Pugh score has been the reference for many years for assessing the prognosis of cirrhosis. The model for end-stage liver disease (MELD) score, which was originally designed for assessing the prognosis of cirrhotic patients undergoing transjugular intrahepatic portosystemic shunt (TIPS), is a continuous score relying on three objective variables. Both CTP and MELD scores do not have portal hypertension as one of the parameters. The investigators already know that portal hypertension is also an independent prediction of mortality in patients of cirrhosis, however, both these scores fail to include portal hypertension component in prediction of mortality.

A new severity score was devised by us by modifying existing CTP Score adding to it the endoscopy parameter. The investigators modified the CTP score by adding the points for variceal bleed status of the patients as follows: history of variceal bleed present - 3 points; no history of variceal bleed but large (grade III-IV) varices present - 2 points; and no history of variceal bleed with small (grade I-II) or absent varices - 1 point. These points were added to the conventional CTP score to obtain the CTPK score (maximum score 18, minimum 6). CTPK score is a simple clinical tool and can be calculated at the bedside. It includes the component of portal hypertension, which is not present in the CTP score.

In a retrospective study conducted by the Principal Investigator the CTPK score was found to better predict the short term mortality (1 week, 2 week mortality regardless of treatment) in patients of cirrhosis. It performs significantly better than the CTP score in predicting early mortality, especially at 1 and 2 weeks in cirrhotics. Further prospective validation of this score was warranted. Hence this study aims to prospectively validate the CTPK score for predicting short term mortality in a cohort study of cirrhosis admitted in Sir Ganga Ram Hospital.

STUDY OBJECTIVE

Comparison of CTP score, MELD score with new CTPK score in predicting the mortality at 1 week (primary objective), and at 2 weeks, 1 month, 2 months, 3 months and 6 months (secondary objectives), regardless of the treatment offered.

Primary objective Prediction of short term mortality (1 week)

Secondary objective Prediction of long term mortality 2 weeks, 1 month, 2 months, 3 months and 6 months

All patients of cirrhosis of liver who are admitted in department of gastroenterology \& hepatology (Unit - 1, either as inpatient or day care), Sir Ganga Ram Hospital for any reason will be enrolled in study after taking consent \& who fit in inclusion criterion. The patients will be subjected to routine evaluation for etiology of cirrhosis and its complications. Severity assessment of cirrhosis will be done by CTP score, MELD score and in addition by new CTPK score. Patients will be treated as per discretion of treating physician. Then patients will be followed up for 6 months at defined intervals. The follow up will be taken as per following time intervals: 1 week, 2 week, 1 month, 2 months 3 months and 6 months. The only parameter assessed in follow up will be their survival.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Cirrhosis

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Cirrhotic Patients

Patients of cirrhosis

No interventions assigned to this group

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Patient of cirrhosis
* Age between 18 - 75 years
* Admitted in Unit 1 Department of Gastroenterology \& Hepatology
* Patients/ LAR who are willing to give written informed consent

Exclusion Criteria

* Patients with significant cardiopulmonary illness
* Any malignancy including HCC (Hepatocellular Carcinoma)
* Patients who refuse to give consent
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Sir Ganga Ram Hospital

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Dr. Ashish Kumar

Associate professor & Consultant

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Ashish kumar, M..D

Role: PRINCIPAL_INVESTIGATOR

Department of Gastroenterology & Hepatology, Sir Ganga Ram Hospital

Anil Arora, M.D

Role: PRINCIPAL_INVESTIGATOR

Department of Gatroenterology & Hepatology, Sir Gnaga Ram Hospital

Praveen Sharma, M.D

Role: PRINCIPAL_INVESTIGATOR

Department of Gastroenterology & Hepatology, Sir Ganga Ram Hospital

Pankaj tyagi, M.D

Role: PRINCIPAL_INVESTIGATOR

Department of Gastroenterology & Hepatology, Sir Ganga Ram Hospital

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Department of Gastroenterology & Hepatology, Sir Ganga Ram Hospital

New Delhi, , India

Site Status RECRUITING

Countries

Review the countries where the study has at least one active or historical site.

India

Central Contacts

Reach out to these primary contacts for questions about participation or study logistics.

Ashish Kumar, M.D

Role: CONTACT

091-9312792573

Praveen Sharma, M.D

Role: CONTACT

091-9540951004

Facility Contacts

Find local site contact details for specific facilities participating in the trial.

Ashish kumar, M.D

Role: primary

091-9312792573

Praveen Sharma, M.D

Role: backup

091-9540951004

References

Explore related publications, articles, or registry entries linked to this study.

Kumar A, Sharma P, Sarin SK. Adding variceal status to Child-Turcotte-Pugh score improves its performance in predicting early mortality in cirrhosis: the Child-Turcotte-Pugh-Kumar score. Eur J Gastroenterol Hepatol. 2012 Nov;24(11):1348-9. doi: 10.1097/MEG.0b013e3283579475. No abstract available.

Reference Type BACKGROUND
PMID: 23022921 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

EC/04/13/503

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.

Objective Scores in Variceal Bleeding
NCT06325436 NOT_YET_RECRUITING