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Diagnosis of Acute-on-Chronic Liver Failure in Critically Ill Patients With Cirrhosis Using Administrative Data
Luis Garrido-Trevino1, Soongjin Ahn2, Elliot B Tapper3
1Baylor Scott & White Research Institute, Dallas, Texas, USA.
Introduction:
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.
Methods:
A cohort of 315 hospitalized cirrhosis patients was analyzed. PPVs were calculated using chart review as the reference standard.
Results:
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.
Discussion:
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.
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