Department of Digestive Surgery & Gastroenterology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Región Metropolitana, Chile.
Department of Digestive Surgery & Gastroenterology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Región Metropolitana, Chile.
Ann Hepatol. 2019 Mar-Apr;18(2):386-392. doi: 10.1016/j.aohep.2019.01.002. Epub 2019 Apr 17.
The Balance of Risk (BAR) Score, a simple scoring system that combines six independent donor and recipient variables to predict outcome after liver transplantation (LT), was validated in a large U.S./European cohort of patients. This study aims to assess the performance of the BAR score to predict survival after liver transplantation and determine the factors associated with short and long-term survival in Latin-American patients.
A retrospective cohort study was performed in 194 patients [112 (55.4%) males; mean age 52±14 years] who underwent 202 LT during the period 2003-2015. Demographic, clinical, pathological and surgical variables, as well as mortality and survival rates, were analyzed. The BAR score was investigated through a receiver operating characteristics (ROC) curve with the calculation of the area under the curve (AUC) to evaluate the predictive score power for 3-month, 1 and 5-year mortality in a matched donor-recipient cohort. Youden index was calculated to identify optimal cutoff points.
The AUC of BAR score in predicting 3-month, 1-year and 5-year mortality were 0.755 (CI95% 0.689-0.812), 0.702 (CI95% 0.634-0.764) and 0.610 (CI95% 0.539-0.678) respectively. The best cut-off point was a BAR score ≥15 points. In the multivariate analysis BAR score <15 was associated with higher survival rates at 3 months and 1 and 5-years.
BAR score <15 points is an independent predictor of better short and long-term survival in Latin-American patients undergoing LT. The BAR scoring system has an adequate diagnostic capacity allowing to predict 3 and 12-month mortality.
风险平衡（BAR）评分是一种简单的评分系统，它结合了六个独立的供体和受体变量，以预测肝移植（LT）后的结果。该评分系统在美国/欧洲的大型患者队列中得到了验证。本研究旨在评估 BAR 评分预测肝移植后生存率的表现，并确定与拉丁美洲患者短期和长期生存率相关的因素。
对 194 例患者（112 例男性，55.4%；平均年龄 52±14 岁）进行回顾性队列研究，这些患者在 2003 年至 2015 年期间接受了 202 例 LT。分析了人口统计学、临床、病理和手术变量以及死亡率和生存率。通过计算曲线下面积（AUC）来评估 3 个月、1 年和 5 年死亡率的预测评分能力，对 BAR 评分进行了接受者操作特征（ROC）曲线分析。计算了约登指数以确定最佳截断点。
BAR 评分预测 3 个月、1 年和 5 年死亡率的 AUC 分别为 0.755（95%CI95%为 0.689-0.812）、0.702（95%CI95%为 0.634-0.764）和 0.610（95%CI95%为 0.539-0.678）。最佳截断点为 BAR 评分≥15 分。在多变量分析中，BAR 评分<15 与 3 个月和 1 年和 5 年的生存率较高相关。
BAR 评分<15 分是拉丁美洲患者 LT 后短期和长期生存的独立预测因子。BAR 评分系统具有足够的诊断能力，可以预测 3 个月和 12 个月的死亡率。
