Performance of the Bard Scoring System in Bariatric Surgery Patients with Nonalcoholic Fatty Liver Disease

Nonalcoholic fatty liver disease incidence is related to the presence of obesity and insulin resistance. A treatment of this disease in patients with morbid obesity is bariatric surgery and its diagnosis is extremely important due to the possible progression to cirrhosis or hepatocellular carcinoma. The development of clinical-laboratorial analysis tools to this disease and its complications is necessary as the gold standard for its diagnosis is an invasive procedure. The objective of the study is to evaluate the use of BARD score in the selection of patients who should undergo liver biopsy during bariatric surgery.

It was a retrospective analysis of patients with hepatic disease who were biopsied between 2012 and 2013. Their clinical and laboratory data were analyzed by BARD score. The results of those who presented score >2 were compared to the rest.

Two hundred ninety-eight patients with hepatic disease were analyzed and among them 70.27 % had score >2. Of the 76 patients with score <1, 1 was diagnosed with liver fibrosis, determining a negative predictive value of 98.68 % for the test (p < 0.05).

The BARD score is still not ideal for the diagnosis of nonalcoholic fatty liver disease, hepatitis, and fibrosis, but it was proved to be effective in the detection of absence of liver fibrosis in a bariatric population.