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-00020: Florian Thorne

50M · MRN76486977 · Cardiology · admitted Mon Nov 02, 2026 11:23 AM · discharged Thu Nov 05, 2026 04:44 PM · attending Dr. Jalen Carrow · resident Dr. Greta Kowalczyk · 168 cm, 104.1 kg

Documented diagnoses (current)

“class 2 obesity” · E66.812 Obesity, class 2
“CKD stage 3b” · N18.32 Chronic kidney disease, stage 3b
“acute kidney injury” · N17.9 Acute kidney failure, unspecified
Principal: “acute diastolic heart failure” · I50.31 Acute diastolic (congestive) heart failure
“hyperlipidemia” · E78.5 Hyperlipidemia, unspecified

Illustrative grouping now: MS-DRG 292 Heart failure and shock with CC. If every open specificity/validation gap were answered as the criteria suggest: MS-DRG 292.

Queries and events

No queries yet.

All rules applied

Rule Criteria Finding Outcome

Acute kidney injury

Criteria not met

Clinical validation gap

Documented “acute kidney injury” (N17.9) but the criteria are not met: KDIGO creatinine and urine-output criteria not met.

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=1.042, t.ratio_s1=1.5, creat_rise_48h=0.05, t.rise_abs=0.3, uo_hours_lt_0_5=unknown, t.uo_s1_h=6	false
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=False, creat_ratio=1.042, t.ratio_s3=3.0, creat_peak=2.23, t.scr_s3=4.0, rrt_started=False, uo_hours_lt_0_3=unknown, t.uo_s3_h=24, anuria_hours=unknown, t.anuria_h=12	false
derived: stage2	`creat_ratio >= t.ratio_s2 or coalesce(uo_hours_lt_0_5 >= t.uo_s2_h, false)`	creat_ratio=1.042, t.ratio_s2=2.0, uo_hours_lt_0_5=unknown, t.uo_s2_h=12	false
derived: stage	`case(stage3, 3, stage2, 2, meets_definition, 1, 0)`	stage3=False, stage2=False, meets_definition=False	0
derived: baseline_independent	`creat_baseline_known or creat_rise_48h >= t.rise_abs or rrt_started`	creat_baseline_known=True, creat_rise_48h=0.05, t.rise_abs=0.3, rrt_started=False	true
outcome: aki_staged	`stage >= 1 and baseline_independent`	stage=0, baseline_independent=True	false
outcome: aki_presumed_baseline	`stage >= 1`	stage=0	false
outcome: not_met	`stage == 0`	stage=0	true

Acute blood loss anaemia

Criteria met

Specificity gap

Criteria support Acute blood loss anemia (D62); no corresponding diagnosis is documented.

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=M, hgb_nadir=9.54, 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=3.5, t.drop_major=2.0, prbc_units=2, t.prbc_major=2	true
outcome: met	`bleeding_documented and anaemic and acute_fall`	bleeding_documented=True, anaemic=True, acute_fall=True	true

Chronic kidney disease

Criteria met

No gap

Supported as documented (N18.32).

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=250, t.chronic_days=90	true
derived: staging_egfr	`max(egfr_early, egfr_late)`	egfr_early=32.6, egfr_late=36.8	36.8
derived: both_below_60	`egfr_early < t.g2 and egfr_late < t.g2`	egfr_early=32.6, t.g2=60, egfr_late=36.8	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=36.8, t.g2=60, t.g3a=45, t.g3b=30, t.g4=15	G3b
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=32.6, egfr_late=36.8, t.g2=60	false
outcome: g1_g2	`staging_egfr >= t.g2`	staging_egfr=36.8, t.g2=60	false
outcome: g3a	`category == 'G3a'`	category=G3b	false
outcome: g3b	`category == 'G3b'`	category=G3b	true

Heart failure

Criteria met

No gap

Supported as documented (I50.31).

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=1424.0, t.bnp=100, ntprobnp_max=unknown, t.ntprobnp=300	true
derived: acute_count	`count(iv_loop_diuretic, np_elevated, new_o2)`	iv_loop_diuretic=True, np_elevated=True, new_o2=False	2
derived: hf_type	`case(lvef <= t.ref, 'systolic', lvef >= t.pres, 'diastolic', 'midrange')`	lvef=57.0, t.ref=40, t.pres=50	diastolic
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=57.0, 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=2, hf_history=False	acute
outcome: improved_ef	`improved`	improved=False	false
outcome: midrange	`hf_type == 'midrange'`	hf_type=diastolic	false
outcome: sys_aoc	`hf_type == 'systolic' and acuity == 'acute on chronic'`	hf_type=diastolic, acuity=acute	false
outcome: sys_acute	`hf_type == 'systolic' and acuity == 'acute'`	hf_type=diastolic, acuity=acute	false
outcome: sys_chronic	`hf_type == 'systolic' and acuity == 'chronic'`	hf_type=diastolic, acuity=acute	false
outcome: dia_aoc	`hf_type == 'diastolic' and acuity == 'acute on chronic'`	hf_type=diastolic, acuity=acute	false
outcome: dia_acute	`hf_type == 'diastolic' and acuity == 'acute'`	hf_type=diastolic, acuity=acute	true

Hyponatraemia

Criteria not met

No gap

Not documented and not supported.

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=136.0, t.profound=125, t.moderate=130, t.low=135	none
outcome: met	`na_min < t.low and na_low_count >= t.repeat and na_treated`	na_min=136.0, t.low=135, na_low_count=0, t.repeat=2, na_treated=False	false
outcome: untreated	`na_min < t.low`	na_min=136.0, t.low=135	false
outcome: not_met	`na_min >= t.low`	na_min=136.0, t.low=135	true

Malnutrition

Criteria not met

No gap

Not documented and not supported.

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=100.0, t.a_sev_intake_pct=50, intake_days=unknown, t.a_sev_intake_days=5	false
derived: a_mod_intake	`intake_pct < t.a_mod_intake_pct and intake_days > t.a_mod_intake_days`	intake_pct=100.0, t.a_mod_intake_pct=75, intake_days=unknown, t.a_mod_intake_days=7	false
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=100.0, t.c_intake_pct=75, intake_days=unknown, t.c_intake_days=30	false
derived: c_mod_intake	`intake_pct < t.c_intake_pct and intake_days >= t.c_intake_days`	intake_pct=100.0, t.c_intake_pct=75, intake_days=unknown, t.c_intake_days=30	false
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=100.0, wt_loss_pct=unknown, fat_loss=0, muscle_loss=0, fluid=0, grip_reduced=unknown	4
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=acute, a_sev_intake=False, a_sev_wt=unknown, fat_loss=0, muscle_loss=0, fluid=0, grip_reduced=unknown, c_sev_intake=False, c_sev_wt=unknown	0
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=acute, a_sev_intake=False, a_mod_intake=False, a_sev_wt=unknown, a_mod_wt=unknown, fat_loss=0, muscle_loss=0, fluid=0, grip_reduced=unknown, c_sev_intake=False, c_mod_intake=False, c_sev_wt=unknown, c_mod_wt=unknown	0
outcome: severe	`n_severe >= 2`	n_severe=0	false
outcome: moderate	`n_moderate >= 2`	n_moderate=0	false
outcome: one_characteristic	`n_moderate == 1`	n_moderate=0	false
outcome: not_met	`n_moderate == 0 and n_assessed >= 2`	n_moderate=0, n_assessed=4	true

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=50, t.adult=20	false
outcome: class3	`bmi >= t.c3`	bmi=36.9, t.c3=40	false
outcome: class2	`bmi >= t.c2`	bmi=36.9, t.c2=35	true

Pressure injury

Insufficient data

No gap

Insufficient data: the criteria could not be applied.

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=unknown	unknown
outcome: no_wound_note	`not present(wound_stage)`	wound_stage=unknown	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 not met

No gap

Not documented and not supported.

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=37.1, t.t_hi=38, temp_min_48h=36.6, t.t_lo=36	false
derived: sirs_hr	`coalesce(hr_max_48h > t.hr, false)`	hr_max_48h=88.0, t.hr=90	false
derived: sirs_rr	`coalesce(rr_max_48h > t.rr, false) or coalesce(paco2_min_48h < t.paco2, false)`	rr_max_48h=19.0, 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=10.64, t.wbc_hi=12, wbc_min_48h=9.48, t.wbc_lo=4, bands_max_48h=unknown, t.bands=10	false
derived: sirs_count	`count(sirs_temp, sirs_hr, sirs_rr, sirs_wbc)`	sirs_temp=False, sirs_hr=False, sirs_rr=False, sirs_wbc=False	0
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=225.0	0
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=0.95	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=74.0	0
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=2.23	2
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=2.14	2
derived: sofa_delta	`sofa_resp + sofa_coag + sofa_liver + sofa_cardio + sofa_cns + sofa_renal - sofa_renal_baseline`	sofa_resp=0, sofa_coag=0, sofa_liver=0, sofa_cardio=0, sofa_cns=0, sofa_renal=2, sofa_renal_baseline=2	0
derived: sepsis3	`infection_documented and sofa_delta >= t.sofa_delta`	infection_documented=False, sofa_delta=0, t.sofa_delta=2	false
derived: sepsis2	`infection_documented and sirs_count >= t.sirs_min`	infection_documented=False, sirs_count=0, t.sirs_min=2	false
derived: shock	`sepsis3 and norepi_max_48h > 0 and coalesce(lactate_max_48h > t.lactate, false)`	sepsis3=False, norepi_max_48h=0.0, lactate_max_48h=unknown, t.lactate=2	false
outcome: no_infection	`not infection_documented`	infection_documented=False	true

Structured data

Labs (24)

Labs (pre-admission rows are outpatient values)
Row	When	Test	Value
LAB-000668	Wed Jan 14, 2026 09:15 AM	creatinine	2.37 mg/dL
LAB-000669	Tue Sep 22, 2026 10:05 AM	creatinine	2.14 mg/dL
LAB-000670	Mon Nov 02, 2026 12:23 PM	creatinine	2.23 mg/dL
LAB-000674	Mon Nov 02, 2026 12:23 PM	bnp	1424.0 pg/mL
LAB-000675	Mon Nov 02, 2026 12:23 PM	sodium	140.0 mmol/L
LAB-000679	Mon Nov 02, 2026 12:23 PM	hemoglobin	12.99 g/dL
LAB-000683	Mon Nov 02, 2026 12:23 PM	wbc	10.64 x10^3/uL
LAB-000684	Mon Nov 02, 2026 12:23 PM	platelets	278.0 x10^3/uL
LAB-000691	Mon Nov 02, 2026 12:23 PM	bilirubin	0.95 mg/dL
LAB-000671	Tue Nov 03, 2026 05:00 AM	creatinine	2.15 mg/dL
LAB-000676	Tue Nov 03, 2026 05:00 AM	sodium	140.0 mmol/L
LAB-000680	Tue Nov 03, 2026 05:00 AM	hemoglobin	10.92 g/dL
LAB-000685	Tue Nov 03, 2026 05:00 AM	wbc	9.75 x10^3/uL
LAB-000686	Tue Nov 03, 2026 05:00 AM	platelets	308.0 x10^3/uL
LAB-000672	Wed Nov 04, 2026 05:00 AM	creatinine	2.2 mg/dL
LAB-000677	Wed Nov 04, 2026 05:00 AM	sodium	136.0 mmol/L
LAB-000681	Wed Nov 04, 2026 05:00 AM	hemoglobin	9.54 g/dL
LAB-000687	Wed Nov 04, 2026 05:00 AM	wbc	9.48 x10^3/uL
LAB-000688	Wed Nov 04, 2026 05:00 AM	platelets	225.0 x10^3/uL
LAB-000673	Thu Nov 05, 2026 05:00 AM	creatinine	2.2 mg/dL
LAB-000678	Thu Nov 05, 2026 05:00 AM	sodium	136.0 mmol/L
LAB-000682	Thu Nov 05, 2026 05:00 AM	hemoglobin	10.34 g/dL
LAB-000689	Thu Nov 05, 2026 05:00 AM	wbc	8.68 x10^3/uL
LAB-000690	Thu Nov 05, 2026 05:00 AM	platelets	250.0 x10^3/uL

Vitals (60)

Vitals
Row	When	Kind	Value	Detail
VIT-001908	Mon Nov 02, 2026 11:43 AM	spo2	98.0	room air
VIT-001909	Mon Nov 02, 2026 11:43 AM	rr	16.0
VIT-001928	Mon Nov 02, 2026 11:43 AM	temp_c	37.1
VIT-001929	Mon Nov 02, 2026 11:43 AM	hr	80.0
VIT-001930	Mon Nov 02, 2026 11:43 AM	map	86.0
VIT-001931	Mon Nov 02, 2026 11:43 AM	gcs	15.0
VIT-001910	Mon Nov 02, 2026 07:43 PM	spo2	94.0	room air
VIT-001911	Mon Nov 02, 2026 07:43 PM	rr	19.0
VIT-001932	Mon Nov 02, 2026 07:43 PM	temp_c	36.9
VIT-001933	Mon Nov 02, 2026 07:43 PM	hr	76.0
VIT-001934	Mon Nov 02, 2026 07:43 PM	map	90.0
VIT-001935	Mon Nov 02, 2026 07:43 PM	gcs	15.0
VIT-001912	Tue Nov 03, 2026 03:43 AM	spo2	94.0	room air
VIT-001913	Tue Nov 03, 2026 03:43 AM	rr	14.0
VIT-001936	Tue Nov 03, 2026 03:43 AM	temp_c	36.6
VIT-001937	Tue Nov 03, 2026 03:43 AM	hr	84.0
VIT-001938	Tue Nov 03, 2026 03:43 AM	map	80.0
VIT-001939	Tue Nov 03, 2026 03:43 AM	gcs	15.0
VIT-001914	Tue Nov 03, 2026 11:43 AM	spo2	99.0	room air
VIT-001915	Tue Nov 03, 2026 11:43 AM	rr	15.0
VIT-001940	Tue Nov 03, 2026 11:43 AM	temp_c	37.0
VIT-001941	Tue Nov 03, 2026 11:43 AM	hr	70.0
VIT-001942	Tue Nov 03, 2026 11:43 AM	map	90.0
VIT-001943	Tue Nov 03, 2026 11:43 AM	gcs	15.0
VIT-001916	Tue Nov 03, 2026 07:43 PM	spo2	98.0	room air
VIT-001917	Tue Nov 03, 2026 07:43 PM	rr	15.0
VIT-001944	Tue Nov 03, 2026 07:43 PM	temp_c	36.8
VIT-001945	Tue Nov 03, 2026 07:43 PM	hr	88.0
VIT-001946	Tue Nov 03, 2026 07:43 PM	map	74.0
VIT-001947	Tue Nov 03, 2026 07:43 PM	gcs	15.0
VIT-001918	Wed Nov 04, 2026 03:43 AM	spo2	95.0	room air
VIT-001919	Wed Nov 04, 2026 03:43 AM	rr	14.0
VIT-001948	Wed Nov 04, 2026 03:43 AM	temp_c	36.9
VIT-001949	Wed Nov 04, 2026 03:43 AM	hr	79.0
VIT-001950	Wed Nov 04, 2026 03:43 AM	map	79.0
VIT-001951	Wed Nov 04, 2026 03:43 AM	gcs	15.0
VIT-001920	Wed Nov 04, 2026 11:43 AM	spo2	95.0	room air
VIT-001921	Wed Nov 04, 2026 11:43 AM	rr	18.0
VIT-001952	Wed Nov 04, 2026 11:43 AM	temp_c	36.9
VIT-001953	Wed Nov 04, 2026 11:43 AM	hr	85.0
VIT-001954	Wed Nov 04, 2026 11:43 AM	map	82.0
VIT-001955	Wed Nov 04, 2026 11:43 AM	gcs	15.0
VIT-001922	Wed Nov 04, 2026 07:43 PM	spo2	95.0	room air
VIT-001923	Wed Nov 04, 2026 07:43 PM	rr	20.0
VIT-001956	Wed Nov 04, 2026 07:43 PM	temp_c	37.1
VIT-001957	Wed Nov 04, 2026 07:43 PM	hr	84.0
VIT-001958	Wed Nov 04, 2026 07:43 PM	map	84.0
VIT-001959	Wed Nov 04, 2026 07:43 PM	gcs	15.0
VIT-001924	Thu Nov 05, 2026 03:43 AM	spo2	99.0	room air
VIT-001925	Thu Nov 05, 2026 03:43 AM	rr	15.0
VIT-001960	Thu Nov 05, 2026 03:43 AM	temp_c	37.1
VIT-001961	Thu Nov 05, 2026 03:43 AM	hr	84.0
VIT-001962	Thu Nov 05, 2026 03:43 AM	map	92.0
VIT-001963	Thu Nov 05, 2026 03:43 AM	gcs	15.0
VIT-001926	Thu Nov 05, 2026 11:43 AM	spo2	96.0	room air
VIT-001927	Thu Nov 05, 2026 11:43 AM	rr	16.0
VIT-001964	Thu Nov 05, 2026 11:43 AM	temp_c	36.6
VIT-001965	Thu Nov 05, 2026 11:43 AM	hr	88.0
VIT-001966	Thu Nov 05, 2026 11:43 AM	map	86.0
VIT-001967	Thu Nov 05, 2026 11:43 AM	gcs	15.0

Medications, orders, echo, history (8)

MED-000069 11-02 08:00 furosemide 40 mg IV
MED-000070 11-02 20:00 furosemide 40 mg IV
MED-000071 11-03 08:00 furosemide 40 mg IV
MED-000072 11-03 20:00 furosemide 40 mg IV
MED-000073 11-04 08:00 furosemide 40 mg IV
MED-000074 11-04 20:00 furosemide 40 mg IV
ORD-000016 11-03 09:00 transfusion_prbc: transfuse PRBC
ECH-000008 2026-11-03 echo LVEF 57.0%

Notes

History and physical · DOC-000065 · Dr. Greta Kowalczyk (resident) · Mon Nov 02, 2026 02:23 PM

Cited facts from this note (1)

bleeding_source: black tarry stools · cited p. 1, line 5 · confidence 0.85

Show source for bleeding_source

… rdiology Attending: Dr. Jalen Carrow History of present illness: 50-year-old man admitted with acute diastolic heart failure. Hospital course complicated by black tarry stools. Past medical history: hyperlipidemia. Review of systems otherwise negative. Exam: Lungs: scattered crackles at the bases, no distress. Assessment and plan: 1. …

Source document DOC-000065: History and physical (synthetic)

HISTORY AND PHYSICAL
Patient: Florian Thorne   MRN: MRN76486977   Admitted: 2026-11-02 11:23
Service: Cardiology   Attending: Dr. Jalen Carrow

History of present illness: 50-year-old man admitted with acute diastolic heart failure. Hospital course complicated by black tarry stools.
Past medical history: hyperlipidemia.
Review of systems otherwise negative.
Exam: Lungs: scattered crackles at the bases, no distress.
Assessment and plan:
1. CKD stage 3b: renally dose medications.
2. Acute diastolic heart failure: diuresis and daily weights; monitor electrolytes.

Nutrition assessment · DOC-000064 · Vera Pemberton, RD (dietitian) · Tue Nov 03, 2026 01:23 PM

Cited facts from this note (5)

fat_loss: none · cited p. 1, line 7 · confidence 0.90

Show source for fat_loss

… MRN: MRN76486977 Context: acute illness Intake: eating 100% of meals. Weight history: weight stable over the past 3 months. Nutrition-focused physical exam: no loss of subcutaneous fat; no muscle wasting; no fluid accumulation. Assessment: well nourished; no malnutrition identified.
fluid_accumulation: none · cited p. 1, line 7 · confidence 0.90

Show source for fluid_accumulation

… e: eating 100% of meals. Weight history: weight stable over the past 3 months. Nutrition-focused physical exam: no loss of subcutaneous fat; no muscle wasting; no fluid accumulation. Assessment: well nourished; no malnutrition identified.
intake_pct: 100 · cited p. 1, line 5 · confidence 0.90

Show source for intake_pct

NUTRITION ASSESSMENT (Registered Dietitian) Patient: Florian Thorne MRN: MRN76486977 Context: acute illness Intake: eating 100% of meals. Weight history: weight stable over the past 3 months. Nutrition-focused physical exam: no loss of subcutaneous fat; no muscle wasting; no fluid accumulation. …
muscle_loss: none · cited p. 1, line 7 · confidence 0.90

Show source for muscle_loss

… acute illness Intake: eating 100% of meals. Weight history: weight stable over the past 3 months. Nutrition-focused physical exam: no loss of subcutaneous fat; no muscle wasting; no fluid accumulation. Assessment: well nourished; no malnutrition identified.
nutrition_context: acute · cited p. 1, line 4 · confidence 0.95

Show source for nutrition_context

NUTRITION ASSESSMENT (Registered Dietitian) Patient: Florian Thorne MRN: MRN76486977 Context: acute illness Intake: eating 100% of meals. Weight history: weight stable over the past 3 months. Nutrition-focused physical exam: no loss of subcutaneous fat; no muscle was …

Source document DOC-000064: Nutrition assessment (synthetic)

NUTRITION ASSESSMENT (Registered Dietitian)
Patient: Florian Thorne   MRN: MRN76486977

Context: acute illness
Intake: eating 100% of meals.
Weight history: weight stable over the past 3 months.
Nutrition-focused physical exam: no loss of subcutaneous fat; no muscle wasting; no fluid accumulation.
Assessment: well nourished; no malnutrition identified.

Progress note · DOC-000066 · Dr. Greta Kowalczyk (resident) · Wed Nov 04, 2026 01:23 PM

Source document DOC-000066: Progress note (synthetic)

PROGRESS NOTE (Resident)
Patient: Florian Thorne   MRN: MRN76486977   Hospital day 3

Subjective: resting, tolerating diet.
Objective: vitals and labs reviewed in the flowsheet.
Assessment and plan:
1. Acute diastolic heart failure: continue current management.
2. Class 2 obesity: counsel on weight.
3. Acute kidney injury: trend creatinine, hold nephrotoxins, strict intake and output.

Resident: Dr. Greta Kowalczyk   Attending cosign: completed

Discharge summary · DOC-000067 · Dr. Jalen Carrow (attending) · Thu Nov 05, 2026 04:44 PM

Source document DOC-000067: Discharge summary (synthetic)

DISCHARGE SUMMARY
Patient: Florian Thorne   MRN: MRN76486977
Admitted 2026-11-02; discharged 2026-11-05.

Discharge diagnoses:
- class 2 obesity
- CKD stage 3b
- acute kidney injury
- acute diastolic heart failure
- hyperlipidemia

Disposition: home with follow-up.