Usefulness of an index score as a predictor of hepatic fibrosis in obese patients undergoing bariatric surgery.
OBJECTIVE
To evaluate the usefulness of a non-invasive clinical score to predict liver fibrosis in the steatosis associated with morbid obesity.


METHODS
We included 88 patients, who underwent bariatric surgery in the Sanitary Area of León, Spain, and who showed a liver biopsy with steatosis greater than 5%. This is a retrospective study in which the rate of fibrosis is calculated from tests performed during the preoperative period, and is then compared to data from intraoperative hepatic biopsies. The analysis population was grouped according to the presence of advanced fibrosis in the liver biopsy (grade 3-4) or its absence (grade 0-2). The cutoff used for diagnosing advanced fibrosis was 0.676 (high cutoff point), and the cutoff point to exclude advanced fibrosis was -1.455 (low cutoff).


RESULTS
The prevalence of advanced fibrosis in the histological samples was 5.5%, and 65.9% of patients had no fibrosis. The cutoff for a low negative predictive value was 100%, and sensitivity was 100%. The cutoff point for a high positive predictive value was 1.7%, and specificity was 31.3%.


CONCLUSIONS
This scoring system for morbidly obese patients eligible for bariatric surgery allows to identify those without advanced fibrosis, but cannot predict who may have advanced fibrosis.
Service of Digestive Diseases, Complejo Asistencial de León, Spain. rudiro@msn.com
R Díez
RD
Rodríguez
M D Ballesteros
MD
Pomar
A Calleja
AC
Fernández
T González
TG
de Francisco
J L Olcoz
JL
Goñi
D000328:Adult; D050110:Bariatric Surgery; D001706:Biopsy; D015992:Body Mass Index; D003627:Data Interpretation, Statistical; D005234:Fatty Liver / Q000150:complications* / Q000473:pathology; D006801:Humans; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000150:complications / Q000175:diagnosis*; D009767:Obesity, Morbid / Q000150:complications* / Q000601:surgery; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012680:Sensitivity and Specificity