title: Application of the BAR score as a predictor of short- and long-term survival in liver transplantation patients.
abstract: BACKGROUND
  The balance of risk (BAR) is a prediction system after liver transplantation.
  
  
  METHODS
  To assess the BAR system, a retrospective observational study was performed in 402 patients who had transplant surgery between 1997 and 2012. The BAR score was computed for each patient. Receiver operating characteristic curve analysis with the Hosmer-Lemeshow test was used to calculate sensitivity, specificity, and model calibration. The cutoff value with the best Youden index was selected. Statistical analysis employed the Kaplan-Meier method (log-rank test) for survival, the Mann-Whitney test for group comparison, and multiple logistic regression analysis.
  
  
  RESULTS
  3-month survival was 46% for BAR ≥ 11 and 77% for BAR <11 (p = 0.001); 12-month survival was 44% for BAR ≥ 11 and 69% for BAR <11 (p = 0.001). Factors of survival <3 months were BAR ≥ 11 [odds ratio (OR) 3.08; 95% confidence interval (CI) 1.75-5.42; p = 0.001] and intrasurgical use of packed red blood cells (RBC) above 6 units (OR 4.49; 95% CI 2.73-7.39; p = 0.001). For survival <12 months, factors were BAR ≥ 11 (OR 2.94; 95% CI 1.67-5.16; p = 0.001) and RBC >6 units (OR 2.99; 95% CI 1.92-4.64; p = 0.001).
  
  
  CONCLUSIONS
  Our study contributes to the incorporation of the BAR system into Brazilian transplantation centers.
authors: Faculty of Medical Science, State University of Campinas, Campinas, Brazil, idcjr@yahoo.com.br.
authors: Ivan Dias
authors: ID
authors: de Campos Junior
authors: Raquel Silveira Bello
authors: RS
authors: Stucchi
authors: Elisabete Yoko
authors: EY
authors: Udo
authors: Ilka de Fátima Santana Ferreira
authors: Ide F
authors: Boin
mesh_terms: D000328:Adult; D019540:Area Under Curve; D001938:Brazil / Q000453:epidemiology; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000401:mortality* / Q000601:surgery*; D016031:Liver Transplantation / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012372:ROC Curve; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods; D015996:Survival Rate; D013997:Time Factors