Extended criteria (experimental). This is the broader ten-condition engine, kept as a secondary area. It shows ICD-10-CM codes and illustrative grouping effects for CDI staff. The primary surface is Before you sign (kidney, measurement only). All extended pages.

ENC-00018: Rosalind Upfield

89F · MRN70259788 · Hospital Medicine · admitted Sun Nov 08, 2026 02:09 PM · in hospital · attending Dr. Jalen Carrow · resident Dr. Camila Oyelaran · 164 cm, 96.0 kg

Documented diagnoses (current)

Principal: “sepsis” · A41.9 Sepsis, unspecified organism
“urinary tract infection” · N39.0 Urinary tract infection, site not specified
“class 2 obesity” · E66.812 Obesity, class 2
“CKD” · N18.9 Chronic kidney disease, unspecified
“AKI” · N17.9 Acute kidney failure, unspecified
“hyponatremia” · E87.1 Hypo-osmolality and hyponatremia
“acute blood loss anemia” · D62 Acute posthemorrhagic anemia
“sacral decubitus ulcer” · L89.159 Pressure ulcer of sacral region, unspecified stage
“GERD” · K21.9 Gastro-esophageal reflux disease without esophagitis
“hypertension” · I10 Essential (primary) hypertension
“type 2 diabetes” · E11.9 Type 2 diabetes mellitus without complications

Illustrative grouping now: MS-DRG 872 Septicemia or severe sepsis without MV >96 hours without MCC. If every open specificity/validation gap were answered as the criteria suggest: MS-DRG 872.

Queries and events

No queries yet.

All rules applied

Rule Criteria Finding Outcome

Acute kidney injury

Criteria met

No gap

Supported as documented (N17.9).

Trace

Rule trace (rule aki v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
Step	Expression	Inputs and thresholds read	Result
derived: meets_definition	`creat_ratio >= t.ratio_s1 or creat_rise_48h >= t.rise_abs or coalesce(uo_hours_lt_0_5 >= t.uo_s1_h, false)`	creat_ratio=3.133, t.ratio_s1=1.5, creat_rise_48h=1.71, t.rise_abs=0.3, uo_hours_lt_0_5=30, t.uo_s1_h=6	true
derived: stage3	`meets_definition and (creat_ratio >= t.ratio_s3 or creat_peak >= t.scr_s3 or rrt_started or coalesce(uo_hours_lt_0_3 >= t.uo_s3_h, false) or coalesce(anuria_hours >= t.anuria_h, false))`	meets_definition=True, creat_ratio=3.133, t.ratio_s3=3.0, creat_peak=7.77, t.scr_s3=4.0, rrt_started=False, uo_hours_lt_0_3=30, t.uo_s3_h=24, anuria_hours=0, t.anuria_h=12	true
derived: stage2	`creat_ratio >= t.ratio_s2 or coalesce(uo_hours_lt_0_5 >= t.uo_s2_h, false)`	creat_ratio=3.133, t.ratio_s2=2.0, uo_hours_lt_0_5=30, t.uo_s2_h=12	true
derived: stage	`case(stage3, 3, stage2, 2, meets_definition, 1, 0)`	stage3=True, stage2=True, meets_definition=True	3
derived: baseline_independent	`creat_baseline_known or creat_rise_48h >= t.rise_abs or rrt_started`	creat_baseline_known=True, creat_rise_48h=1.71, t.rise_abs=0.3, rrt_started=False	true
outcome: aki_staged	`stage >= 1 and baseline_independent`	stage=3, baseline_independent=True	true

Acute blood loss anaemia

Clinical judgement required

Clinical judgement required: Haemoglobin fell 1.4 g/dL without transfusion (between 1 and 2 g/dL).

Trace

Rule trace (rule blood_loss_anemia v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
Step	Expression	Inputs and thresholds read	Result
derived: anaemic	`case(sex == 'M', hgb_nadir < t.hb_m, sex == 'F', hgb_nadir < t.hb_f, null)`	sex=F, hgb_nadir=9.44, t.hb_m=13, t.hb_f=12	true
derived: acute_fall	`hgb_drop >= t.drop_major or prbc_units >= t.prbc_major`	hgb_drop=1.4, t.drop_major=2.0, prbc_units=0, t.prbc_major=2	false
outcome: met	`bleeding_documented and anaemic and acute_fall`	bleeding_documented=False, anaemic=True, acute_fall=False	false
outcome: anaemia_only	`anaemic and hgb_drop < t.drop_min and prbc_units == 0`	anaemic=True, hgb_drop=1.4, t.drop_min=1.0, prbc_units=0	false
outcome: not_anaemic	`present(hgb_nadir) and not anaemic`	hgb_nadir=9.44, anaemic=True	false
outcome: no_source	`anaemic and acute_fall`	anaemic=True, acute_fall=False	false
outcome: borderline	`anaemic`	anaemic=True	true

Chronic kidney disease

Criteria met

Specificity gap

Documented “CKD” (N18.9); criteria support the more specific Chronic kidney disease stage 4 (N18.4).

Trace

Rule trace (rule ckd v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
Step	Expression	Inputs and thresholds read	Result
derived: chronic	`egfr_n >= 2 and egfr_span_days >= t.chronic_days`	egfr_n=2, egfr_span_days=241, t.chronic_days=90	true
derived: staging_egfr	`max(egfr_early, egfr_late)`	egfr_early=18.9, egfr_late=18.1	18.9
derived: both_below_60	`egfr_early < t.g2 and egfr_late < t.g2`	egfr_early=18.9, t.g2=60, egfr_late=18.1	true
derived: category	`case(staging_egfr >= t.g2, 'G1-G2', staging_egfr >= t.g3a, 'G3a', staging_egfr >= t.g3b, 'G3b', staging_egfr >= t.g4, 'G4', 'G5')`	staging_egfr=18.9, t.g2=60, t.g3a=45, t.g3b=30, t.g4=15	G4
outcome: duration_not_shown	`not chronic`	chronic=True	false
outcome: straddles_60	`not both_below_60 and min(egfr_early, egfr_late) < t.g2`	both_below_60=True, egfr_early=18.9, egfr_late=18.1, t.g2=60	false
outcome: g1_g2	`staging_egfr >= t.g2`	staging_egfr=18.9, t.g2=60	false
outcome: g3a	`category == 'G3a'`	category=G4	false
outcome: g3b	`category == 'G3b'`	category=G4	false
outcome: g4	`category == 'G4'`	category=G4	true

Heart failure

Insufficient data

No gap

Insufficient data: the criteria could not be applied.

Trace

Rule trace (rule heart_failure v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
Step	Expression	Inputs and thresholds read	Result
derived: np_elevated	`coalesce(bnp_max >= t.bnp, false) or coalesce(ntprobnp_max >= t.ntprobnp, false)`	bnp_max=unknown, t.bnp=100, ntprobnp_max=unknown, t.ntprobnp=300	false
derived: acute_count	`count(iv_loop_diuretic, np_elevated, new_o2)`	iv_loop_diuretic=False, np_elevated=False, new_o2=False	0
derived: hf_type	`case(lvef <= t.ref, 'systolic', lvef >= t.pres, 'diastolic', 'midrange')`	lvef=unknown, t.ref=40, t.pres=50	unknown
derived: improved	`coalesce(lvef_prior_min <= t.ref and lvef > t.ref and lvef - lvef_prior_min >= t.improved_rise, false)`	lvef_prior_min=unknown, t.ref=40, lvef=unknown, t.improved_rise=10	false
derived: acuity	`case(acute_count >= 2 and hf_history, 'acute on chronic', acute_count >= 2, 'acute', acute_count == 0 and hf_history, 'chronic', null)`	acute_count=0, hf_history=False	unknown
outcome: improved_ef	`improved`	improved=False	false
outcome: midrange	`hf_type == 'midrange'`	hf_type=unknown	unknown
outcome: sys_aoc	`hf_type == 'systolic' and acuity == 'acute on chronic'`	hf_type=unknown, acuity=unknown	unknown
outcome: sys_acute	`hf_type == 'systolic' and acuity == 'acute'`	hf_type=unknown, acuity=unknown	unknown
outcome: sys_chronic	`hf_type == 'systolic' and acuity == 'chronic'`	hf_type=unknown, acuity=unknown	unknown
outcome: dia_aoc	`hf_type == 'diastolic' and acuity == 'acute on chronic'`	hf_type=unknown, acuity=unknown	unknown
outcome: dia_acute	`hf_type == 'diastolic' and acuity == 'acute'`	hf_type=unknown, acuity=unknown	unknown
outcome: dia_chronic	`hf_type == 'diastolic' and acuity == 'chronic'`	hf_type=unknown, acuity=unknown	unknown
outcome: one_indicator	`acute_count == 1`	acute_count=0	false

Hyponatraemia

Criteria met

No gap

Supported as documented (E87.1).

Trace

Rule trace (rule hyponatremia v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
Step	Expression	Inputs and thresholds read	Result
derived: severity	`case(na_min < t.profound, 'profound', na_min < t.moderate, 'moderate', na_min < t.low, 'mild', 'none')`	na_min=122.0, t.profound=125, t.moderate=130, t.low=135	profound
outcome: met	`na_min < t.low and na_low_count >= t.repeat and na_treated`	na_min=122.0, t.low=135, na_low_count=6, t.repeat=2, na_treated=True	true

Malnutrition

Insufficient data

No gap

Insufficient data: the criteria could not be applied.

Trace

Rule trace (rule malnutrition v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
Step	Expression	Inputs and thresholds read	Result
derived: a_sev_intake	`intake_pct <= t.a_sev_intake_pct and intake_days >= t.a_sev_intake_days`	intake_pct=unknown, t.a_sev_intake_pct=50, intake_days=unknown, t.a_sev_intake_days=5	unknown
derived: a_mod_intake	`intake_pct < t.a_mod_intake_pct and intake_days > t.a_mod_intake_days`	intake_pct=unknown, t.a_mod_intake_pct=75, intake_days=unknown, t.a_mod_intake_days=7	unknown
derived: a_sev_wt	`(wt_loss_days <= 7 and wt_loss_pct > 2) or (wt_loss_days <= 31 and wt_loss_pct > 5) or (wt_loss_days <= 92 and wt_loss_pct > 7.5)`	wt_loss_days=unknown, wt_loss_pct=unknown	unknown
derived: a_mod_wt	`(wt_loss_days <= 7 and wt_loss_pct >= 1) or (wt_loss_days <= 31 and wt_loss_pct >= 5) or (wt_loss_days <= 92 and wt_loss_pct >= 7.5)`	wt_loss_days=unknown, wt_loss_pct=unknown	unknown
derived: c_sev_intake	`intake_pct <= t.c_intake_pct and intake_days >= t.c_intake_days`	intake_pct=unknown, t.c_intake_pct=75, intake_days=unknown, t.c_intake_days=30	unknown
derived: c_mod_intake	`intake_pct < t.c_intake_pct and intake_days >= t.c_intake_days`	intake_pct=unknown, t.c_intake_pct=75, intake_days=unknown, t.c_intake_days=30	unknown
derived: c_sev_wt	`(wt_loss_days <= 31 and wt_loss_pct > 5) or (wt_loss_days <= 92 and wt_loss_pct > 7.5) or (wt_loss_days <= 183 and wt_loss_pct > 10) or (wt_loss_days <= 366 and wt_loss_pct > 20)`	wt_loss_days=unknown, wt_loss_pct=unknown	unknown
derived: c_mod_wt	`(wt_loss_days <= 31 and wt_loss_pct >= 5) or (wt_loss_days <= 92 and wt_loss_pct >= 7.5) or (wt_loss_days <= 183 and wt_loss_pct >= 10) or (wt_loss_days <= 366 and wt_loss_pct >= 20)`	wt_loss_days=unknown, wt_loss_pct=unknown	unknown
derived: n_assessed	`known(intake_pct, wt_loss_pct, fat_loss, muscle_loss, fluid, grip_reduced)`	intake_pct=unknown, wt_loss_pct=unknown, fat_loss=unknown, muscle_loss=unknown, fluid=unknown, grip_reduced=unknown	0
derived: n_severe	`case(nutr_context == 'acute', count(a_sev_intake, a_sev_wt, fat_loss >= 2, muscle_loss >= 2, fluid >= 2, grip_reduced), nutr_context == 'chronic', count(c_sev_intake, c_sev_wt, fat_loss >= 3, muscle_loss >= 3, fluid >= 3, grip_reduced), null)`	nutr_context=unknown, a_sev_intake=unknown, a_sev_wt=unknown, fat_loss=unknown, muscle_loss=unknown, fluid=unknown, grip_reduced=unknown, c_sev_intake=unknown, c_sev_wt=unknown	unknown
derived: n_moderate	`case(nutr_context == 'acute', count(a_sev_intake or a_mod_intake, a_sev_wt or a_mod_wt, fat_loss >= 1, muscle_loss >= 1, fluid >= 1, grip_reduced), nutr_context == 'chronic', count(c_sev_intake or c_mod_intake, c_sev_wt or c_mod_wt, fat_loss >= 1, muscle_loss >= 1, fluid >= 1, grip_reduced), null)`	nutr_context=unknown, a_sev_intake=unknown, a_mod_intake=unknown, a_sev_wt=unknown, a_mod_wt=unknown, fat_loss=unknown, muscle_loss=unknown, fluid=unknown, grip_reduced=unknown, c_sev_intake=unknown, c_mod_intake=unknown, c_sev_wt=unknown, c_mod_wt=unknown	unknown
outcome: severe	`n_severe >= 2`	n_severe=unknown	unknown
outcome: moderate	`n_moderate >= 2`	n_moderate=unknown	unknown
outcome: one_characteristic	`n_moderate == 1`	n_moderate=unknown	unknown
outcome: not_met	`n_moderate == 0 and n_assessed >= 2`	n_moderate=unknown, n_assessed=0	false

Obesity

Criteria met

No gap

Supported as documented (E66.812).

Trace

Rule trace (rule obesity v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
Step	Expression	Inputs and thresholds read	Result
outcome: not_adult	`age < t.adult`	age=89, t.adult=20	false
outcome: class3	`bmi >= t.c3`	bmi=35.7, t.c3=40	false
outcome: class2	`bmi >= t.c2`	bmi=35.7, t.c2=35	true

Pressure injury

Criteria met

Specificity gap

Documented “sacral decubitus ulcer” (L89.159); criteria support the more specific Pressure injury of sacral region, unstageable (L89.150).

Trace

Rule trace (rule pressure_injury v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
Step	Expression	Inputs and thresholds read	Result
derived: sacral	`wound_site == 'sacral'`	wound_site=sacral	true
outcome: no_wound_note	`not present(wound_stage)`	wound_stage=unstageable	false
outcome: other_site	`wound_site != 'sacral'`	wound_site=sacral	false
outcome: stage1	`sacral and wound_stage == '1'`	sacral=True, wound_stage=unstageable	false
outcome: stage2	`sacral and wound_stage == '2'`	sacral=True, wound_stage=unstageable	false
outcome: stage3	`sacral and wound_stage == '3'`	sacral=True, wound_stage=unstageable	false
outcome: stage4	`sacral and wound_stage == '4'`	sacral=True, wound_stage=unstageable	false
outcome: unstageable	`sacral and wound_stage == 'unstageable'`	sacral=True, wound_stage=unstageable	true

Acute respiratory failure

Criteria not met

No gap

Not documented and not supported.

Trace

Rule trace (rule respiratory_failure v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
Step	Expression	Inputs and thresholds read	Result
derived: measured	`present(spo2_min_ra) or present(pao2_min_ra) or present(pf_min)`	spo2_min_ra=94.0, pao2_min_ra=unknown, pf_min=unknown	true
derived: hypoxemia	`coalesce(spo2_min_ra < t.spo2_ra, false) or coalesce(pao2_min_ra < t.pao2, false) or coalesce(pf_min < t.pf, false)`	spo2_min_ra=94.0, t.spo2_ra=88, pao2_min_ra=unknown, t.pao2=60, pf_min=unknown, t.pf=300	false
derived: distress	`coalesce(rr_max >= t.rr_distress, false) or coalesce(wob_increased, false) or adv_resp_support`	rr_max=20.0, t.rr_distress=28, wob_increased=unknown, adv_resp_support=False	false
outcome: chronic_baseline	`home_o2 and hypoxemia`	home_o2=False, hypoxemia=False	false
outcome: met	`hypoxemia and distress`	hypoxemia=False, distress=False	false
outcome: hypoxemia_only	`hypoxemia`	hypoxemia=False	false
outcome: not_met	`measured and not hypoxemia and o2_max_lpm <= t.o2_low and not adv_resp_support`	measured=True, hypoxemia=False, o2_max_lpm=0.0, t.o2_low=2, adv_resp_support=False	true

Sepsis

Criteria met

No gap

Supported as documented (A41.9).

Trace

Rule trace (rule sepsis v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
Step	Expression	Inputs and thresholds read	Result
derived: sirs_temp	`coalesce(temp_max_48h > t.t_hi, false) or coalesce(temp_min_48h < t.t_lo, false)`	temp_max_48h=39.2, t.t_hi=38, temp_min_48h=38.6, t.t_lo=36	true
derived: sirs_hr	`coalesce(hr_max_48h > t.hr, false)`	hr_max_48h=121.0, t.hr=90	true
derived: sirs_rr	`coalesce(rr_max_48h > t.rr, false) or coalesce(paco2_min_48h < t.paco2, false)`	rr_max_48h=20.0, t.rr=20, paco2_min_48h=unknown, t.paco2=32	false
derived: sirs_wbc	`coalesce(wbc_max_48h > t.wbc_hi, false) or coalesce(wbc_min_48h < t.wbc_lo, false) or coalesce(bands_max_48h > t.bands, false)`	wbc_max_48h=18.49, t.wbc_hi=12, wbc_min_48h=15.43, t.wbc_lo=4, bands_max_48h=unknown, t.bands=10	true
derived: sirs_count	`count(sirs_temp, sirs_hr, sirs_rr, sirs_wbc)`	sirs_temp=True, sirs_hr=True, sirs_rr=False, sirs_wbc=True	3
derived: sofa_resp	`coalesce(case(pf_min_48h < 100 and adv_resp_support, 4, pf_min_48h < 200 and adv_resp_support, 3, pf_min_48h < 300, 2, pf_min_48h < 400, 1, 0), 0)`	pf_min_48h=unknown, adv_resp_support=False	0
derived: sofa_coag	`coalesce(case(platelets_min_48h < 20, 4, platelets_min_48h < 50, 3, platelets_min_48h < 100, 2, platelets_min_48h < 150, 1, 0), 0)`	platelets_min_48h=84.0	2
derived: sofa_liver	`coalesce(case(bili_max_48h >= 12, 4, bili_max_48h >= 6, 3, bili_max_48h >= 2, 2, bili_max_48h >= 1.2, 1, 0), 0)`	bili_max_48h=0.66	0
derived: sofa_cardio	`coalesce(case(norepi_max_48h > 0.1, 4, norepi_max_48h > 0, 3, map_min_48h < 70, 1, 0), 0)`	norepi_max_48h=0.0, map_min_48h=64.0	1
derived: sofa_cns	`coalesce(case(gcs_min_48h < 6, 4, gcs_min_48h < 10, 3, gcs_min_48h < 13, 2, gcs_min_48h < 15, 1, 0), 0)`	gcs_min_48h=15.0	0
derived: sofa_renal	`coalesce(case(creat_max_48h >= 5, 4, creat_max_48h >= 3.5, 3, creat_max_48h >= 2, 2, creat_max_48h >= 1.2, 1, 0), 0)`	creat_max_48h=7.77	4
derived: sofa_renal_baseline	`coalesce(case(creat_baseline >= 5, 4, creat_baseline >= 3.5, 3, creat_baseline >= 2, 2, creat_baseline >= 1.2, 1, 0), 0)`	creat_baseline=2.48	2
derived: sofa_delta	`sofa_resp + sofa_coag + sofa_liver + sofa_cardio + sofa_cns + sofa_renal - sofa_renal_baseline`	sofa_resp=0, sofa_coag=2, sofa_liver=0, sofa_cardio=1, sofa_cns=0, sofa_renal=4, sofa_renal_baseline=2	5
derived: sepsis3	`infection_documented and sofa_delta >= t.sofa_delta`	infection_documented=True, sofa_delta=5, t.sofa_delta=2	true
derived: sepsis2	`infection_documented and sirs_count >= t.sirs_min`	infection_documented=True, sirs_count=3, t.sirs_min=2	true
derived: shock	`sepsis3 and norepi_max_48h > 0 and coalesce(lactate_max_48h > t.lactate, false)`	sepsis3=True, norepi_max_48h=0.0, lactate_max_48h=2.63, t.lactate=2	false
outcome: no_infection	`not infection_documented`	infection_documented=True	false
outcome: septic_shock	`shock`	shock=False	false
outcome: both	`sepsis3 and sepsis2`	sepsis3=True, sepsis2=True	true

Structured data

Labs (34)

Labs (pre-admission rows are outpatient values)
Row	When	Test	Value
LAB-000591	Wed Nov 12, 2025 09:15 AM	creatinine	2.39 mg/dL
LAB-000592	Sun Jul 12, 2026 10:05 AM	creatinine	2.48 mg/dL
LAB-000593	Sun Nov 08, 2026 03:09 PM	creatinine	6.06 mg/dL
LAB-000599	Sun Nov 08, 2026 03:09 PM	sodium	124.0 mmol/L
LAB-000605	Sun Nov 08, 2026 03:09 PM	hemoglobin	10.84 g/dL
LAB-000611	Sun Nov 08, 2026 03:09 PM	wbc	18.49 x10^3/uL
LAB-000612	Sun Nov 08, 2026 03:09 PM	platelets	95.0 x10^3/uL
LAB-000623	Sun Nov 08, 2026 03:09 PM	bilirubin	0.66 mg/dL
LAB-000624	Sun Nov 08, 2026 03:09 PM	lactate	2.63 mmol/L
LAB-000594	Mon Nov 09, 2026 05:00 AM	creatinine	7.77 mg/dL
LAB-000600	Mon Nov 09, 2026 05:00 AM	sodium	122.0 mmol/L
LAB-000606	Mon Nov 09, 2026 05:00 AM	hemoglobin	10.04 g/dL
LAB-000613	Mon Nov 09, 2026 05:00 AM	wbc	16.25 x10^3/uL
LAB-000614	Mon Nov 09, 2026 05:00 AM	platelets	89.0 x10^3/uL
LAB-000595	Tue Nov 10, 2026 05:00 AM	creatinine	7.0 mg/dL
LAB-000601	Tue Nov 10, 2026 05:00 AM	sodium	123.0 mmol/L
LAB-000607	Tue Nov 10, 2026 05:00 AM	hemoglobin	9.44 g/dL
LAB-000615	Tue Nov 10, 2026 05:00 AM	wbc	15.43 x10^3/uL
LAB-000616	Tue Nov 10, 2026 05:00 AM	platelets	84.0 x10^3/uL
LAB-000596	Wed Nov 11, 2026 05:00 AM	creatinine	5.83 mg/dL
LAB-000602	Wed Nov 11, 2026 05:00 AM	sodium	126.0 mmol/L
LAB-000608	Wed Nov 11, 2026 05:00 AM	hemoglobin	9.54 g/dL
LAB-000617	Wed Nov 11, 2026 05:00 AM	wbc	10.06 x10^3/uL
LAB-000618	Wed Nov 11, 2026 05:00 AM	platelets	257.0 x10^3/uL
LAB-000597	Thu Nov 12, 2026 05:00 AM	creatinine	4.82 mg/dL
LAB-000603	Thu Nov 12, 2026 05:00 AM	sodium	128.0 mmol/L
LAB-000609	Thu Nov 12, 2026 05:00 AM	hemoglobin	9.64 g/dL
LAB-000619	Thu Nov 12, 2026 05:00 AM	wbc	9.6 x10^3/uL
LAB-000620	Thu Nov 12, 2026 05:00 AM	platelets	224.0 x10^3/uL
LAB-000598	Fri Nov 13, 2026 05:00 AM	creatinine	4.28 mg/dL
LAB-000604	Fri Nov 13, 2026 05:00 AM	sodium	134.0 mmol/L
LAB-000610	Fri Nov 13, 2026 05:00 AM	hemoglobin	9.64 g/dL
LAB-000621	Fri Nov 13, 2026 05:00 AM	wbc	7.41 x10^3/uL
LAB-000622	Fri Nov 13, 2026 05:00 AM	platelets	221.0 x10^3/uL

Vitals (104)

Vitals
Row	When	Kind	Value	Detail
VIT-001680	Sun Nov 08, 2026 02:29 PM	spo2	97.0	room air
VIT-001681	Sun Nov 08, 2026 02:29 PM	rr	14.0
VIT-001712	Sun Nov 08, 2026 02:29 PM	temp_c	39.2
VIT-001713	Sun Nov 08, 2026 02:29 PM	hr	108.0
VIT-001714	Sun Nov 08, 2026 02:29 PM	map	65.0
VIT-001715	Sun Nov 08, 2026 02:29 PM	gcs	15.0
VIT-001672	Sun Nov 08, 2026 08:09 PM	urine_ml_6h	633.6
VIT-001682	Sun Nov 08, 2026 10:29 PM	spo2	98.0	room air
VIT-001683	Sun Nov 08, 2026 10:29 PM	rr	20.0
VIT-001716	Sun Nov 08, 2026 10:29 PM	temp_c	39.1
VIT-001717	Sun Nov 08, 2026 10:29 PM	hr	120.0
VIT-001718	Sun Nov 08, 2026 10:29 PM	map	66.0
VIT-001719	Sun Nov 08, 2026 10:29 PM	gcs	15.0
VIT-001673	Mon Nov 09, 2026 02:09 AM	urine_ml_6h	126.7
VIT-001684	Mon Nov 09, 2026 06:29 AM	spo2	97.0	room air
VIT-001685	Mon Nov 09, 2026 06:29 AM	rr	14.0
VIT-001720	Mon Nov 09, 2026 06:29 AM	temp_c	39.0
VIT-001721	Mon Nov 09, 2026 06:29 AM	hr	121.0
VIT-001722	Mon Nov 09, 2026 06:29 AM	map	64.0
VIT-001723	Mon Nov 09, 2026 06:29 AM	gcs	15.0
VIT-001674	Mon Nov 09, 2026 08:09 AM	urine_ml_6h	126.7
VIT-001675	Mon Nov 09, 2026 02:09 PM	urine_ml_6h	126.7
VIT-001686	Mon Nov 09, 2026 02:29 PM	spo2	95.0	room air
VIT-001687	Mon Nov 09, 2026 02:29 PM	rr	16.0
VIT-001724	Mon Nov 09, 2026 02:29 PM	temp_c	38.6
VIT-001725	Mon Nov 09, 2026 02:29 PM	hr	114.0
VIT-001726	Mon Nov 09, 2026 02:29 PM	map	65.0
VIT-001727	Mon Nov 09, 2026 02:29 PM	gcs	15.0
VIT-001676	Mon Nov 09, 2026 08:09 PM	urine_ml_6h	126.7
VIT-001688	Mon Nov 09, 2026 10:29 PM	spo2	94.0	room air
VIT-001689	Mon Nov 09, 2026 10:29 PM	rr	18.0
VIT-001728	Mon Nov 09, 2026 10:29 PM	temp_c	38.9
VIT-001729	Mon Nov 09, 2026 10:29 PM	hr	121.0
VIT-001730	Mon Nov 09, 2026 10:29 PM	map	67.0
VIT-001731	Mon Nov 09, 2026 10:29 PM	gcs	15.0
VIT-001677	Tue Nov 10, 2026 02:09 AM	urine_ml_6h	126.7
VIT-001690	Tue Nov 10, 2026 06:29 AM	spo2	95.0	room air
VIT-001691	Tue Nov 10, 2026 06:29 AM	rr	18.0
VIT-001732	Tue Nov 10, 2026 06:29 AM	temp_c	39.2
VIT-001733	Tue Nov 10, 2026 06:29 AM	hr	121.0
VIT-001734	Tue Nov 10, 2026 06:29 AM	map	68.0
VIT-001735	Tue Nov 10, 2026 06:29 AM	gcs	15.0
VIT-001678	Tue Nov 10, 2026 08:09 AM	urine_ml_6h	633.6
VIT-001679	Tue Nov 10, 2026 02:09 PM	urine_ml_6h	633.6
VIT-001692	Tue Nov 10, 2026 02:29 PM	spo2	98.0	room air
VIT-001693	Tue Nov 10, 2026 02:29 PM	rr	18.0
VIT-001736	Tue Nov 10, 2026 02:29 PM	temp_c	37.5
VIT-001737	Tue Nov 10, 2026 02:29 PM	hr	76.0
VIT-001738	Tue Nov 10, 2026 02:29 PM	map	87.0
VIT-001739	Tue Nov 10, 2026 02:29 PM	gcs	15.0
VIT-001694	Tue Nov 10, 2026 10:29 PM	spo2	99.0	room air
VIT-001695	Tue Nov 10, 2026 10:29 PM	rr	15.0
VIT-001740	Tue Nov 10, 2026 10:29 PM	temp_c	37.0
VIT-001741	Tue Nov 10, 2026 10:29 PM	hr	78.0
VIT-001742	Tue Nov 10, 2026 10:29 PM	map	83.0
VIT-001743	Tue Nov 10, 2026 10:29 PM	gcs	15.0
VIT-001696	Wed Nov 11, 2026 06:29 AM	spo2	98.0	room air
VIT-001697	Wed Nov 11, 2026 06:29 AM	rr	18.0
VIT-001744	Wed Nov 11, 2026 06:29 AM	temp_c	37.3
VIT-001745	Wed Nov 11, 2026 06:29 AM	hr	73.0
VIT-001746	Wed Nov 11, 2026 06:29 AM	map	74.0
VIT-001747	Wed Nov 11, 2026 06:29 AM	gcs	15.0
VIT-001698	Wed Nov 11, 2026 02:29 PM	spo2	95.0	room air
VIT-001699	Wed Nov 11, 2026 02:29 PM	rr	20.0
VIT-001748	Wed Nov 11, 2026 02:29 PM	temp_c	36.7
VIT-001749	Wed Nov 11, 2026 02:29 PM	hr	80.0
VIT-001750	Wed Nov 11, 2026 02:29 PM	map	77.0
VIT-001751	Wed Nov 11, 2026 02:29 PM	gcs	15.0
VIT-001700	Wed Nov 11, 2026 10:29 PM	spo2	96.0	room air
VIT-001701	Wed Nov 11, 2026 10:29 PM	rr	20.0
VIT-001752	Wed Nov 11, 2026 10:29 PM	temp_c	36.8
VIT-001753	Wed Nov 11, 2026 10:29 PM	hr	73.0
VIT-001754	Wed Nov 11, 2026 10:29 PM	map	88.0
VIT-001755	Wed Nov 11, 2026 10:29 PM	gcs	15.0
VIT-001702	Thu Nov 12, 2026 06:29 AM	spo2	99.0	room air
VIT-001703	Thu Nov 12, 2026 06:29 AM	rr	17.0
VIT-001756	Thu Nov 12, 2026 06:29 AM	temp_c	36.6
VIT-001757	Thu Nov 12, 2026 06:29 AM	hr	77.0
VIT-001758	Thu Nov 12, 2026 06:29 AM	map	90.0
VIT-001759	Thu Nov 12, 2026 06:29 AM	gcs	15.0
VIT-001704	Thu Nov 12, 2026 02:29 PM	spo2	99.0	room air
VIT-001705	Thu Nov 12, 2026 02:29 PM	rr	20.0
VIT-001760	Thu Nov 12, 2026 02:29 PM	temp_c	37.2
VIT-001761	Thu Nov 12, 2026 02:29 PM	hr	80.0
VIT-001762	Thu Nov 12, 2026 02:29 PM	map	82.0
VIT-001763	Thu Nov 12, 2026 02:29 PM	gcs	15.0
VIT-001706	Thu Nov 12, 2026 10:29 PM	spo2	97.0	room air
VIT-001707	Thu Nov 12, 2026 10:29 PM	rr	17.0
VIT-001764	Thu Nov 12, 2026 10:29 PM	temp_c	37.0
VIT-001765	Thu Nov 12, 2026 10:29 PM	hr	85.0
VIT-001766	Thu Nov 12, 2026 10:29 PM	map	82.0
VIT-001767	Thu Nov 12, 2026 10:29 PM	gcs	15.0
VIT-001708	Fri Nov 13, 2026 06:29 AM	spo2	95.0	room air
VIT-001709	Fri Nov 13, 2026 06:29 AM	rr	16.0
VIT-001768	Fri Nov 13, 2026 06:29 AM	temp_c	37.3
VIT-001769	Fri Nov 13, 2026 06:29 AM	hr	85.0
VIT-001770	Fri Nov 13, 2026 06:29 AM	map	75.0
VIT-001771	Fri Nov 13, 2026 06:29 AM	gcs	15.0
VIT-001710	Fri Nov 13, 2026 02:29 PM	spo2	97.0	room air
VIT-001711	Fri Nov 13, 2026 02:29 PM	rr	17.0
VIT-001772	Fri Nov 13, 2026 02:29 PM	temp_c	37.5
VIT-001773	Fri Nov 13, 2026 02:29 PM	hr	82.0
VIT-001774	Fri Nov 13, 2026 02:29 PM	map	87.0
VIT-001775	Fri Nov 13, 2026 02:29 PM	gcs	15.0

Medications, orders, echo, history (6)

MED-000065 11-08 15:09 ceftriaxone per protocol IV
MED-000066 11-09 05:00 piperacillin-tazobactam per protocol IV
MED-000067 11-10 05:00 ceftriaxone per protocol IV
MED-000068 11-08 18:09 sodium chloride 3% 100 mL IV
ORD-000014 11-08 14:39 blood_culture: blood cultures x2
ORD-000015 11-08 17:09 fluid_restriction: fluid restriction 1.2 L/day

Notes

History and physical · DOC-000059 · Dr. Camila Oyelaran (resident) · Sun Nov 08, 2026 05:09 PM

Cited facts from this note (1)

infection_source: urinary tract infection · cited p. 1, line 5 · confidence 0.85

Show source for infection_source

… rvice: Hospital Medicine Attending: Dr. Jalen Carrow History of present illness: 89-year-old woman admitted with sepsis. Urinalysis with pyuria; treated for urinary tract infection with cefepime. Past medical history: GERD, hypertension, type 2 diabetes. Review of systems otherwise negative. Exam: Lungs: clear to auscultation bilaterally. …

Source document DOC-000059: History and physical (synthetic)

HISTORY AND PHYSICAL
Patient: Rosalind Upfield   MRN: MRN70259788   Admitted: 2026-11-08 14:09
Service: Hospital Medicine   Attending: Dr. Jalen Carrow

History of present illness: 89-year-old woman admitted with sepsis. Urinalysis with pyuria; treated for urinary tract infection with cefepime.
Past medical history: GERD, hypertension, type 2 diabetes.
Review of systems otherwise negative.
Exam: Lungs: clear to auscultation bilaterally.
Assessment and plan:
1. Sepsis: antibiotics, fluids.
2. Urinary tract infection: antibiotics.
3. CKD: renally dose medications.

Wound care note · DOC-000058 · Elena Jessup, RN, CWOCN (wound_nurse) · Mon Nov 09, 2026 09:09 PM

Cited facts from this note (2)

wound_site: sacral · cited p. 1, line 4 · confidence 0.95

Show source for wound_site

WOUND CARE NOTE Patient: Rosalind Upfield MRN: MRN70259788 Location: sacrum Stage: unstageable (NPIAP) Description: wound bed obscured by eschar. Size: 3.5 x 2.6 x 0.1 cm. Plan: offloading every 2 hours, foam dressing, nutrition consul …
wound_stage: unstageable · cited p. 1, line 5 · confidence 0.95

Show source for wound_stage

WOUND CARE NOTE Patient: Rosalind Upfield MRN: MRN70259788 Location: sacrum Stage: unstageable (NPIAP) Description: wound bed obscured by eschar. Size: 3.5 x 2.6 x 0.1 cm. Plan: offloading every 2 hours, foam dressing, nutrition consult.

Source document DOC-000058: Wound care note (synthetic)

WOUND CARE NOTE
Patient: Rosalind Upfield   MRN: MRN70259788

Location: sacrum
Stage: unstageable (NPIAP)
Description: wound bed obscured by eschar.
Size: 3.5 x 2.6 x 0.1 cm.
Plan: offloading every 2 hours, foam dressing, nutrition consult.

Progress note · DOC-000060 · Dr. Camila Oyelaran (resident) · Fri Nov 13, 2026 10:55 AM · awaiting cosign

Source document DOC-000060: Progress note (synthetic)

PROGRESS NOTE (Resident)
Patient: Rosalind Upfield   MRN: MRN70259788   Hospital day 5

Subjective: resting, tolerating diet.
Objective: vitals and labs reviewed in the flowsheet.
Assessment and plan:
1. Sepsis: continue current management.
2. Class 2 obesity: counsel on weight.
3. AKI: trend creatinine, hold nephrotoxins, strict intake and output.
4. Hyponatremia: trend sodium.
5. Acute blood loss anemia: trend hemoglobin, transfuse if needed.
6. Sacral decubitus ulcer: wound care following, offloading.

Resident: Dr. Camila Oyelaran   Attending cosign: pending