Diagnosis of Acute on Chronic Liver Failure in critically ill patients with cirrhosis using administrative data

Objectives: We evaluated the positive predictive value (PPV) of 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: 304 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. Conclusions: ICD-10 codes accurately identify organ failures in critically ill patients with cirrhosis and may be helpful for identifying cases of ACLF within administrative data