Diagnosis of Acute-on-Chronic Liver Failure in Critically Ill Patients With Cirrhosis Using Administrative Data.

Abstract

We evaluated the positive predictive value (PPV) of International Classification of Diseases, Tenth Revision ( ICD-10 ) codes used to identify organ failures in critically ill patients with cirrhosis. A cohort of 315 hospitalized cirrhosis patients was analyzed. PPVs were calculated using chart review as the reference standard. Three hundred four patients had an ICD-10 code for cirrhosis. The PPV for liver failure was 33.0%, kidney failure 71.4%, respiratory failure 79.9%, circulatory failure 84.0%, and brain failure 33.3%. Adding laboratory thresholds increased PPVs. ICD-10 codes accurately identify organ failures in critically ill patients with cirrhosis and may be helpful for identifying cases of acute-on-chronic liver failure within administrative data.