[
  {
    "phenotype_id": "PH3716",
    "phenotype_version_id": 8840,
    "name": "Severe Liver Disease",
    "definition": "This codelist was taken from [OpenCodelists](https://www.opencodelists.org/), created by [OpenSAFELY](https://www.opensafely.org/). We recommend viewing this Phenotype on the OpenCodelist website to view the most recent version.\n\n\nThis codelist aims to identify patients with severe liver disease.\n\n\n© University of Oxford for the Bennett Institute for Applied Data Science 2025\\. This work may be copied freely for non\\-commercial research and study.\n\n",
    "implementation": null,
    "publications": null,
    "validation": null,
    "citation_requirements": null,
    "created": "2026-01-26T23:31:15.441917Z",
    "author": "OpenSAFELY",
    "collections": [
      {
        "name": "OpenCodelist",
        "value": 31
      },
      {
        "name": "Phenotype Library",
        "value": 18
      }
    ],
    "tags": null,
    "organisation": {
      "id": 1,
      "slug": "opensafely",
      "name": "OpenSAFELY"
    },
    "world_access": 1,
    "updated": "2026-01-26T23:31:15.436767Z",
    "references": [
      {
        "url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6334027/pdf/clinmed-18-2s-s60.pdf",
        "title": "British Society of Gastroenterology Guidelines"
      },
      {
        "url": "https://github.com/opensafely/codelist-development/issues/378",
        "title": "GitHub Discussion"
      }
    ],
    "signed_off": [],
    "methodology": "**Search Terms:**\nCirrhosis / \nCirrhosis of the liver / \nDecompensated / \nDecompensated liver /\nChild pugh C /\nAscites /\nOesophageal varices /\nPortal Hypertension / \nHepatic encephalopathy /\n\n\n**Inclusion Criteria for Codes:**\nCodes which when applied in clinical records, are expected to refer to severe liver disease in \\>90% cases.\n\n\n**Borderline cases which were excluded:**\n\\- Hepatocellular cancers \\- a serious but not necessarily a severe liver disease.\n\\- Primary biliary cirrhosis \\- unlikely to consistently reflect severe liver disease.\n\\- Fetal ascites \\- causes of fetal ascites are more diverse and less likely to related to liver disease.\n\n\n**Borderline cases which were included:**\n\\- Cirrhosis of liver (and other non\\-specific codes that don't indicate severity) \\- debatable how consistently they would reflect severe liver disease.\n \\- Ascites \\- debateable how consistently a code for ascites in isolation would reflect severe liver disease.\n \\- Portal hypertension \\- non\\-hepatic causes of portal hypertension do exist, so debatable how consistently it would reflect severe liver disease.\n\n",
    "coding_system": [
      {
        "name": "SNOMED  CT codes",
        "value": 9
      }
    ],
    "open_codelist_id": "opensafely/severe-liver-disease",
    "source_reference": "https://www.opencodelists.org/codelist/opensafely/severe-liver-disease/5a033839",
    "concept_information": [
      {
        "concept_id": 9017,
        "concept_version_id": 16502,
        "concept_name": "opensafely/severe-liver-disease/5a033839",
        "coding_system": {
          "id": 9,
          "name": "SNOMED  CT codes",
          "description": "SNOMED CT codes"
        },
        "phenotype_id": "PH3716",
        "phenotype_version_id": 8840,
        "phenotype_name": "Severe Liver Disease",
        "code_attribute_header": [],
        "codes": [
          {
            "code": "1010616001",
            "description": "Cirrhosis of liver due to classical cystic fibrosis",
            "attributes": null
          },
          {
            "code": "103611000119102",
            "description": "Cirrhosis of liver due to hepatitis B",
            "attributes": null
          },
          {
            "code": "103931000119102",
            "description": "Hepatic coma due to hepatitis",
            "attributes": null
          },
          {
            "code": "1082511000119102",
            "description": "Hepatic coma due to acute hepatic failure",
            "attributes": null
          },
          {
            "code": "1082601000119104",
            "description": "Ascites due to alcoholic cirrhosis",
            "attributes": null
          },
          {
            "code": "1082611000119101",
            "description": "Ascites due to alcoholic hepatitis",
            "attributes": null
          },
          {
            "code": "1082621000119108",
            "description": "Hepatic coma due to alcoholic liver failure",
            "attributes": null
          },
          {
            "code": "1085021000119106",
            "description": "Hepatic ascites due to chronic alcoholic hepatitis",
            "attributes": null
          },
          {
            "code": "1085091000119108",
            "description": "Hepatic coma due to chronic hepatic failure",
            "attributes": null
          },
          {
            "code": "1092691000119109",
            "description": "Hepatic coma due to subacute liver failure",
            "attributes": null
          },
          {
            "code": "1092801000119102",
            "description": "Hepatic ascites co-occurrent with chronic active hepatitis due to toxic liver disease",
            "attributes": null
          },
          {
            "code": "109819003",
            "description": "Obstructive biliary cirrhosis",
            "attributes": null
          },
          {
            "code": "111370006",
            "description": "Cirrhosis of liver not due to alcohol",
            "attributes": null
          },
          {
            "code": "1137357005",
            "description": "Hepatic coma due to viral hepatitis D",
            "attributes": null
          },
          {
            "code": "1148573000",
            "description": "Hepatic failure following surgical procedure",
            "attributes": null
          },
          {
            "code": "1187643003",
            "description": "Acute infantile liver failure, cerebellar ataxia, peripheral sensory motor neuropathy syndrome",
            "attributes": null
          },
          {
            "code": "1197661009",
            "description": "Esophageal varices with bleeding due to schistosomiasis",
            "attributes": null
          },
          {
            "code": "1197664001",
            "description": "Secondary portal hypertension",
            "attributes": null
          },
          {
            "code": "1197694007",
            "description": "Esophageal varices with bleeding due to toxic liver disease",
            "attributes": null
          },
          {
            "code": "1197695008",
            "description": "Esophageal varices with bleeding due to viral hepatitis",
            "attributes": null
          },
          {
            "code": "1197696009",
            "description": "Esophageal varices with bleeding due to hepatic fibrosis",
            "attributes": null
          },
          {
            "code": "1197697000",
            "description": "Esophageal varices with bleeding due to primary biliary cholangitis",
            "attributes": null
          },
          {
            "code": "1197698005",
            "description": "Esophageal varices with bleeding due to alcoholic liver disease",
            "attributes": null
          },
          {
            "code": "1197700001",
            "description": "Esophageal varices with bleeding due to autoimmune hepatitis",
            "attributes": null
          },
          {
            "code": "1197736003",
            "description": "Chronic hepatic failure due to portosystemic shunt",
            "attributes": null
          },
          {
            "code": "12074006",
            "description": "Ligation of gastric varices",
            "attributes": null
          },
          {
            "code": "1208726006",
            "description": "Fever-associated acute infantile liver failure syndrome",
            "attributes": null
          },
          {
            "code": "123604002",
            "description": "Toxic cirrhosis",
            "attributes": null
          },
          {
            "code": "123605001",
            "description": "Nutritional cirrhosis",
            "attributes": null
          },
          {
            "code": "123606000",
            "description": "Cholangiolitic cirrhosis",
            "attributes": null
          },
          {
            "code": "12368000",
            "description": "Secondary biliary cirrhosis",
            "attributes": null
          },
          {
            "code": "123716002",
            "description": "Latent cirrhosis",
            "attributes": null
          },
          {
            "code": "123717006",
            "description": "Advanced cirrhosis",
            "attributes": null
          },
          {
            "code": "125921000119106",
            "description": "Hepatic coma due to acute hepatitis C",
            "attributes": null
          },
          {
            "code": "1259465009",
            "description": "Dementia due to hepatic failure",
            "attributes": null
          },
          {
            "code": "1263507006",
            "description": "Myoclonic disorder due to hepatic failure",
            "attributes": null
          },
          {
            "code": "128072003",
            "description": "Acquired portal-systemic shunt due to cirrhosis",
            "attributes": null
          },
          {
            "code": "1285574007",
            "description": "Hepatorenal syndrome with acute kidney injury",
            "attributes": null
          },
          {
            "code": "13124004",
            "description": "Ascites",
            "attributes": null
          },
          {
            "code": "13920009",
            "description": "Hepatic encephalopathy",
            "attributes": null
          },
          {
            "code": "140519000",
            "description": "O/E - ascites",
            "attributes": null
          },
          {
            "code": "140521005",
            "description": "O/E - ascites - dipping shown",
            "attributes": null
          },
          {
            "code": "140522003",
            "description": "O/E-ascites-fluid thrill shown",
            "attributes": null
          },
          {
            "code": "140523008",
            "description": "O/E -ascites-shifting dullness",
            "attributes": null
          },
          {
            "code": "140524002",
            "description": "O/E - ascites NOS",
            "attributes": null
          },
          {
            "code": "14223005",
            "description": "Esophageal varices without bleeding",
            "attributes": null
          },
          {
            "code": "146371000119104",
            "description": "Hepatic coma due to chronic hepatitis C",
            "attributes": null
          },
          {
            "code": "149322009",
            "description": "Oesophagus operation: [other] or [varices]",
            "attributes": null
          },
          {
            "code": "149326007",
            "description": "Sclerotherapy of oesophageal varices",
            "attributes": null
          },
          {
            "code": "149327003",
            "description": "Local ligation of oesophageal varices",
            "attributes": null
          },
          {
            "code": "150557006",
            "description": "Ascites tap",
            "attributes": null
          },
          {
            "code": "153091000119109",
            "description": "Hepatic coma due to chronic hepatitis B with delta agent",
            "attributes": null
          },
          {
            "code": "155479001",
            "description": "Oesophageal varices",
            "attributes": null
          },
          {
            "code": "155808003",
            "description": "(Acute/subacute necrosis of liver) or (acute liver failure)",
            "attributes": null
          },
          {
            "code": "155809006",
            "description": "(Cirrhosis &/or chronic liver dis) or (alcoholic liver disease)",
            "attributes": null
          },
          {
            "code": "155811002",
            "description": "Alcoholic cirrhosis of liver",
            "attributes": null
          },
          {
            "code": "155814005",
            "description": "Cirrhosis - non-alcoholic",
            "attributes": null
          },
          {
            "code": "155821005",
            "description": "Portal hypertension",
            "attributes": null
          },
          {
            "code": "158530005",
            "description": "[D]Ascites",
            "attributes": null
          },
          {
            "code": "15999000",
            "description": "Mixed micro and macronodular cirrhosis",
            "attributes": null
          },
          {
            "code": "16060001",
            "description": "Hepatic coma due to viral hepatitis A",
            "attributes": null
          },
          {
            "code": "16070004",
            "description": "Syphilitic cirrhosis",
            "attributes": null
          },
          {
            "code": "16093661000119105",
            "description": "History of esophageal varices",
            "attributes": null
          },
          {
            "code": "163309001",
            "description": "On examination - ascites",
            "attributes": null
          },
          {
            "code": "163311005",
            "description": "On examination - ascites - dipping shown",
            "attributes": null
          },
          {
            "code": "163312003",
            "description": "On examination - ascites-fluid thrill shown",
            "attributes": null
          },
          {
            "code": "163313008",
            "description": "On examination - ascites-shifting dullness",
            "attributes": null
          },
          {
            "code": "163314002",
            "description": "On examination - ascites NOS",
            "attributes": null
          },
          {
            "code": "16446101000119108",
            "description": "Ultrasonography of abdomen for ascites",
            "attributes": null
          },
          {
            "code": "173617001",
            "description": "Open operations on esophageal varices",
            "attributes": null
          },
          {
            "code": "173618006",
            "description": "Disconnection of azygos vein",
            "attributes": null
          },
          {
            "code": "173621008",
            "description": "Open injection sclerotherapy to esophageal varices",
            "attributes": null
          },
          {
            "code": "173622001",
            "description": "Oesophageal varices operation: [OS open] or [Tanner]",
            "attributes": null
          },
          {
            "code": "173623006",
            "description": "Open operation on esophageal varices NOS",
            "attributes": null
          },
          {
            "code": "173639004",
            "description": "Fiberoptic esophagoscopy and injection sclerotherapy of varices",
            "attributes": null
          },
          {
            "code": "173641003",
            "description": "Fiberoptic esophagoscopy and banding of esophageal varices",
            "attributes": null
          },
          {
            "code": "173660005",
            "description": "Rigid esophagoscopy and injection sclerotherapy of varices",
            "attributes": null
          },
          {
            "code": "173661009",
            "description": "Rigid esophagoscopy and banding of esophageal varices",
            "attributes": null
          },
          {
            "code": "173679008",
            "description": "Balloon tamponade of esophagus",
            "attributes": null
          },
          {
            "code": "175802001",
            "description": "Peritoneal to venous drainage of ascites",
            "attributes": null
          },
          {
            "code": "1761006",
            "description": "Biliary cirrhosis",
            "attributes": null
          },
          {
            "code": "176411000000108",
            "description": "Acute hepatic failure due to drugs",
            "attributes": null
          },
          {
            "code": "17709002",
            "description": "Bleeding esophageal varices",
            "attributes": null
          },
          {
            "code": "178012008",
            "description": "Percutaneous drainage of ascites",
            "attributes": null
          },
          {
            "code": "178013003",
            "description": "Peritoneovenous shunt for ascites (& [LeVeen] or [Denver])",
            "attributes": null
          },
          {
            "code": "178014009",
            "description": "Drainage of ascites NEC",
            "attributes": null
          },
          {
            "code": "186624004",
            "description": "Hepatic coma due to acute hepatitis B with delta agent",
            "attributes": null
          },
          {
            "code": "186628001",
            "description": "Hepatic coma due to viral hepatitis C",
            "attributes": null
          },
          {
            "code": "195473005",
            "description": "(Oesophageal varices) or (other varicose veins)",
            "attributes": null
          },
          {
            "code": "195474004",
            "description": "Esophageal varices associated with another disorder",
            "attributes": null
          },
          {
            "code": "195475003",
            "description": "Esophageal varices with bleeding, associated with another disorder",
            "attributes": null
          },
          {
            "code": "195476002",
            "description": "Esophageal varices without bleeding, associated with another disorder",
            "attributes": null
          },
          {
            "code": "195477006",
            "description": "Oesophageal varices in cirrhosis of the liver",
            "attributes": null
          },
          {
            "code": "195478001",
            "description": "Oesophageal varices in alcoholic cirrhosis of the liver",
            "attributes": null
          },
          {
            "code": "195479009",
            "description": "Esophageal varices in diseases EC NOS",
            "attributes": null
          },
          {
            "code": "195483009",
            "description": "Oesophageal varices NOS",
            "attributes": null
          },
          {
            "code": "195643006",
            "description": "[X]Esophageal varices in diseases classified elsewhere",
            "attributes": null
          },
          {
            "code": "196121006",
            "description": "Lung: [cirrhosis of] or [postinflammatory pulmonary fibrosis]",
            "attributes": null
          },
          {
            "code": "197270009",
            "description": "Acute hepatic failure",
            "attributes": null
          },
          {
            "code": "197275004",
            "description": "Subacute hepatic failure",
            "attributes": null
          },
          {
            "code": "197279005",
            "description": "Cirrhosis and chronic liver disease",
            "attributes": null
          },
          {
            "code": "197280008",
            "description": "Cirrhosis: [florid] or [alcoholic]",
            "attributes": null
          },
          {
            "code": "197283005",
            "description": "Alcoholic hepatic failure",
            "attributes": null
          },
          {
            "code": "197290000",
            "description": "(Cirrhosis - non alcoholic) or (portal cirrhosis)",
            "attributes": null
          },
          {
            "code": "197291001",
            "description": "Unilobular portal cirrhosis",
            "attributes": null
          },
          {
            "code": "197292008",
            "description": "Cirrhosis of liver: [multilobular portal] or [postnecrotic]",
            "attributes": null
          },
          {
            "code": "197293003",
            "description": "Diffuse nodular cirrhosis",
            "attributes": null
          },
          {
            "code": "197294009",
            "description": "Fatty portal cirrhosis",
            "attributes": null
          },
          {
            "code": "197295005",
            "description": "Macronodular cirrhosis",
            "attributes": null
          },
          {
            "code": "197296006",
            "description": "Capsular portal cirrhosis",
            "attributes": null
          },
          {
            "code": "197297002",
            "description": "Cirrhosis: [cardiac portal] or [congestive]",
            "attributes": null
          },
          {
            "code": "197298007",
            "description": "Cirrhosis: [juvenile portal] or [childhood function] or [Indian childhood]",
            "attributes": null
          },
          {
            "code": "197299004",
            "description": "Pigmentary portal cirrhosis",
            "attributes": null
          },
          {
            "code": "197300007",
            "description": "Pipestem portal cirrhosis",
            "attributes": null
          },
          {
            "code": "197301006",
            "description": "Toxic portal cirrhosis",
            "attributes": null
          },
          {
            "code": "197302004",
            "description": "Cirrhosis secondary to cholestasis",
            "attributes": null
          },
          {
            "code": "197303009",
            "description": "Bacterial portal cirrhosis",
            "attributes": null
          },
          {
            "code": "197304003",
            "description": "Cardituberculous cirrhosis",
            "attributes": null
          },
          {
            "code": "197305002",
            "description": "Syphilitic portal cirrhosis",
            "attributes": null
          },
          {
            "code": "197306001",
            "description": "Zooparasitic portal cirrhosis",
            "attributes": null
          },
          {
            "code": "197307005",
            "description": "Infectious cirrhosis NOS",
            "attributes": null
          },
          {
            "code": "197308000",
            "description": "Portal cirrhosis unspecified",
            "attributes": null
          },
          {
            "code": "197309008",
            "description": "(Liver cirrhosis: [named variants] or [NOS]) or (hepatic fibrosis)",
            "attributes": null
          },
          {
            "code": "197310003",
            "description": "Biliary cirrhosis of children",
            "attributes": null
          },
          {
            "code": "197311004",
            "description": "Biliary cirrhosis NOS",
            "attributes": null
          },
          {
            "code": "197316009",
            "description": "Portal fibrosis without cirrhosis",
            "attributes": null
          },
          {
            "code": "197332007",
            "description": "Hepatic: [coma] or [encephalopathy]",
            "attributes": null
          },
          {
            "code": "197334008",
            "description": "Hepatic failure",
            "attributes": null
          },
          {
            "code": "197335009",
            "description": "(Hepatic failure (& [NOS]) or (other sequelae of chronic liver disease)",
            "attributes": null
          },
          {
            "code": "197362001",
            "description": "Toxic liver disease with fibrosis and cirrhosis of liver",
            "attributes": null
          },
          {
            "code": "197553002",
            "description": "[X]Other and unspecified cirrhosis of liver",
            "attributes": null
          },
          {
            "code": "19943007",
            "description": "Cirrhosis of liver",
            "attributes": null
          },
          {
            "code": "2053831000122108",
            "description": "Acute on chronic liver failure",
            "attributes": null
          },
          {
            "code": "207252009",
            "description": "[D]Ascites",
            "attributes": null
          },
          {
            "code": "207254005",
            "description": "[D]Ascites NOS",
            "attributes": null
          },
          {
            "code": "213230009",
            "description": "Hepatic failure as a complication of care",
            "attributes": null
          },
          {
            "code": "213231008",
            "description": "Hepatorenal syndrome as a complication of care",
            "attributes": null
          },
          {
            "code": "21861000",
            "description": "Micronodular cirrhosis",
            "attributes": null
          },
          {
            "code": "22508003",
            "description": "Hepatic failure due to a procedure",
            "attributes": null
          },
          {
            "code": "22846003",
            "description": "Hepatorenal syndrome following delivery",
            "attributes": null
          },
          {
            "code": "232534061000119102",
            "description": "Delirium due to hepatic encephalopathy",
            "attributes": null
          },
          {
            "code": "235184005",
            "description": "Operation on esophageal varices",
            "attributes": null
          },
          {
            "code": "235201007",
            "description": "Sclerotherapy of esophageal varices",
            "attributes": null
          },
          {
            "code": "235212007",
            "description": "Balloon tamponade of esophagus using Sengstaken-Blakemore tube",
            "attributes": null
          },
          {
            "code": "235213002",
            "description": "Balloon tamponade of esophagus using Minnesota tube",
            "attributes": null
          },
          {
            "code": "235236006",
            "description": "Sclerotherapy of gastric varices",
            "attributes": null
          },
          {
            "code": "235247004",
            "description": "Balloon tamponade of stomach",
            "attributes": null
          },
          {
            "code": "235881000",
            "description": "Alcoholic hepatic failure",
            "attributes": null
          },
          {
            "code": "235882007",
            "description": "Liver failure NOS",
            "attributes": null
          },
          {
            "code": "235883002",
            "description": "Hepatic failure NOS",
            "attributes": null
          },
          {
            "code": "235884008",
            "description": "Fulminant hepatic failure",
            "attributes": null
          },
          {
            "code": "235885009",
            "description": "Subfulminant hepatic failure",
            "attributes": null
          },
          {
            "code": "235886005",
            "description": "Chronic hepatic failure",
            "attributes": null
          },
          {
            "code": "235891006",
            "description": "Cirrhosis of liver NOS",
            "attributes": null
          },
          {
            "code": "235892004",
            "description": "Florid cirrhosis",
            "attributes": null
          },
          {
            "code": "235894003",
            "description": "Portal cirrhosis",
            "attributes": null
          },
          {
            "code": "235895002",
            "description": "Laennec's cirrhosis, non-alcoholic",
            "attributes": null
          },
          {
            "code": "235896001",
            "description": "Infectious cirrhosis",
            "attributes": null
          },
          {
            "code": "235897005",
            "description": "Hypoxia-associated cirrhosis",
            "attributes": null
          },
          {
            "code": "236004002",
            "description": "Ascites co-occurrent and due to hepatic disorder",
            "attributes": null
          },
          {
            "code": "236067006",
            "description": "Bleeding oesophageal varices",
            "attributes": null
          },
          {
            "code": "238310002",
            "description": "Intraperitoneal reinfusion of ascites",
            "attributes": null
          },
          {
            "code": "24807004",
            "description": "Bleeding gastric varices",
            "attributes": null
          },
          {
            "code": "26206000",
            "description": "Hepatic coma due to viral hepatitis B",
            "attributes": null
          },
          {
            "code": "264974007",
            "description": "Peritoneal to venous drainage of ascites",
            "attributes": null
          },
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