A Validated Algorithm to Identify Hepatic Decompensation in the Veterans Health Administration Electronic Health Record System.

PURPOSE: Accurate identification of hepatic decompensation is essential for pharmacoepidemiologic research among patients with chronic liver disease.

METHODS

An algorithm using ≥ 1 inpatient or ≥ 2 outpatient International Classification of Diseases, 10th revision (ICD-10) codes for hepatic decompensation was developed in Veterans Health Administration data from October 2015 through July 2019. Medical records were reviewed by hepatologists to confirm cases. The positive predictive value (PPV) of the coding algorithm for confirmed hepatic decompensation was calculated.

RESULTS

Hepatic decompensation was confirmed in 149/185 records meeting the algorithm (PPV 81%; 95% CI, 70%, 90%). The most common hepatic decompensation diagnosis was ascites. Only 56% of confirmed cases had an accompanying diagnosis code for cirrhosis.

CONCLUSIONS

Our ICD-10-based coding algorithm identified hepatic decompensation with high PPV in Veterans Health Administration data.