Related Experiment Video
Updated: Jun 4, 2025
Histological Quantification of Chronic Myocardial Infarct in Rats
Published on: December 11, 2016
Relationship Between Left Ventricular Ejection Fraction and ICD-10 Codes Among Patients Hospitalized With Heart
Ty J Gluckman1, Shih-Ting Chiu1, Deanna Rider2
1Center for Cardiovascular Analytics, Research, and Data Science (CARDS), Providence Heart Institute, Providence Health System, Portland, Oregon, USA.
Insights
Left ventricular ejection fraction (LVEF) distribution varies by heart failure (HF) type. While systolic HF patients typically have low LVEF, diastolic HF patients often have preserved LVEF, highlighting classification nuances.
Area of Science:
- Cardiology
- Heart Failure Research
- Clinical Informatics
Background:
- Left ventricular ejection fraction (LVEF) is crucial for classifying heart failure (HF).
- Limited data exists on LVEF distribution across different HF classifications based on ICD-10 codes.
- Understanding this distribution is vital for accurate patient stratification and management.
Purpose of the Study:
- To analyze the distribution of LVEF in hospitalized heart failure patients.
- To correlate LVEF with specific International Classification of Disease (ICD)-10 codes for heart failure types.
- To assess the concordance between ICD-10 defined HF types and measured LVEF.
Main Methods:
- Retrospective cross-sectional analysis of 61,238 HF hospitalizations from January 2018 to October 2022.
- Included patients with principal HF diagnosis using specific ICD-10 codes (systolic, diastolic, combined, hypertensive heart disease).
- Analyzed LVEF data from echocardiography within 3 months prior to hospitalization for 49,772 patients.
Main Results:
- High concordance observed between LVEF and ICD-10 codes for systolic HF (LVEF ≤ 40%) and diastolic HF (LVEF ≥ 50%).
- Systolic HF: 86.2% had LVEF ≤ 40%; Diastolic HF: 94.0% had LVEF ≥ 50%.
- Hypertensive heart disease with HF and CKD showed a wider range of LVEF values.
Conclusions:
- ICD-10 codes show good concordance with LVEF for distinct HF types (systolic, diastolic, combined).
- However, these specific HF codes represent a small fraction (~10%) of total HF hospitalizations.
- Further research is needed to understand LVEF distribution in broader HF populations.
Introduction:
While left ventricular ejection fraction (LVEF) represents an important means by which to classify patients with heart failure (HF), relatively little is known about the distribution of LVEFs among patients hospitalized for HF based on their International Classification of Disease (ICD)-10 code.
Methods:
We performed a retrospective cross-sectional analysis of patients admitted to a large integrated health system within the western US between January 1, 2018 and October 1, 2022 with a principal diagnosis of HF (defined by ICD-10 codes: I50.2, systolic HF; I50.3, diastolic HF; I50.4, combined systolic and diastolic HF; I11.0, hypertensive heart disease with HF; and I13.0 and I13.2, hypertensive heart disease with HF and chronic kidney disease).
Results:
Over nearly 5 years, 61,238 HF hospitalizations occurred, of which 49,772 (81%) had a LVEF available by echocardiography within the preceding 3 months. Whereas most patients hospitalized with systolic HF (n = 2220) as well as systolic and diastolic heart failure (n = 1582) had an LVEF ≤ 40% (86.2% and 74.8%, respectively), most patients hospitalized with diastolic HF (n = 1542) had an LVEF ≥ 50% (94.0%) (Figure). A much greater range of LVEFs were noted for those with hypertensive heart disease with HF (n = 18,092) and hypertensive heart disease with HF and CKD (n = 26,336) (Figure).
Conclusion:
While there was relatively good concordance between LVEF and the ICD-10 code-defined HF type for systolic HF, diastolic HF, and systolic and diastolic HF, these codes represent a small subset (~10%) of total HF hospitalizations.
Related Concept Videos
01:17Pathophysiology of Heart Failure
01:26Imbalances in Cardiac Output
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
01:26Heart Failure Drugs: Inotropic Agents
01:22Heart Failure Drugs: β-Blockers
01:22Heart Failure Drugs: Diuretics
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System