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-00025: Nico Elsworth

83M · MRN22161213 · Cardiology · admitted Sat Nov 07, 2026 06:36 PM · discharged Tue Nov 10, 2026 04:36 PM · attending Dr. Rosalind Quillan · 167 cm, 64.9 kg

Documented diagnoses (current)

“AKI” · N17.9 Acute kidney failure, unspecified
Principal: “congestive heart failure” · I50.9 Heart failure, unspecified
“hypoxia” · R09.02 Hypoxemia
“hypertension” · I10 Essential (primary) hypertension
“hyperlipidemia” · E78.5 Hyperlipidemia, unspecified
“GERD” · K21.9 Gastro-esophageal reflux disease without esophagitis

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 291.

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=3.363, t.ratio_s1=1.5, creat_rise_48h=0.68, 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=3.363, t.ratio_s3=3.0, creat_peak=3.06, t.scr_s3=4.0, rrt_started=True, 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=3.363, 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=0.68, t.rise_abs=0.3, rrt_started=True	true
outcome: aki_staged	`stage >= 1 and baseline_independent`	stage=3, baseline_independent=True	true

Acute blood loss anaemia

Criteria not met

No gap

Not documented and not supported.

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=14.04, t.hb_m=13, t.hb_f=12	false
derived: acute_fall	`hgb_drop >= t.drop_major or prbc_units >= t.prbc_major`	hgb_drop=0.4, 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=False, acute_fall=False	false
outcome: anaemia_only	`anaemic and hgb_drop < t.drop_min and prbc_units == 0`	anaemic=False, hgb_drop=0.4, t.drop_min=1.0, prbc_units=0	false
outcome: not_anaemic	`present(hgb_nadir) and not anaemic`	hgb_nadir=14.04, anaemic=False	true

Chronic kidney disease

Clinical judgement required

No gap

Not documented; egfr 60 or above; ckd g1-g2 requires markers of kidney damage, which are not assessed here.

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=233, t.chronic_days=90	true
derived: staging_egfr	`max(egfr_early, egfr_late)`	egfr_early=83.6, egfr_late=83.6	83.6
derived: both_below_60	`egfr_early < t.g2 and egfr_late < t.g2`	egfr_early=83.6, t.g2=60, egfr_late=83.6	false
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=83.6, t.g2=60, t.g3a=45, t.g3b=30, t.g4=15	G1-G2
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=False, egfr_early=83.6, egfr_late=83.6, t.g2=60	false
outcome: g1_g2	`staging_egfr >= t.g2`	staging_egfr=83.6, t.g2=60	true

Heart failure

Criteria met

Specificity gap

Documented “congestive heart failure” (I50.9); criteria support the more specific Acute on chronic diastolic (HFpEF) heart failure (I50.33).

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=1299.0, 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=True	3
derived: hf_type	`case(lvef <= t.ref, 'systolic', lvef >= t.pres, 'diastolic', 'midrange')`	lvef=58.0, 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=58.0, 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=3, hf_history=True	acute on chronic
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 on chronic	false
outcome: sys_acute	`hf_type == 'systolic' and acuity == 'acute'`	hf_type=diastolic, acuity=acute on chronic	false
outcome: sys_chronic	`hf_type == 'systolic' and acuity == 'chronic'`	hf_type=diastolic, acuity=acute on chronic	false
outcome: dia_aoc	`hf_type == 'diastolic' and acuity == 'acute on chronic'`	hf_type=diastolic, acuity=acute on chronic	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=137.0, 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=137.0, t.low=135, na_low_count=0, t.repeat=2, na_treated=False	false
outcome: untreated	`na_min < t.low`	na_min=137.0, t.low=135	false
outcome: not_met	`na_min >= t.low`	na_min=137.0, t.low=135	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 not met

No gap

Not documented and not supported.

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=83, t.adult=20	false
outcome: class3	`bmi >= t.c3`	bmi=23.3, t.c3=40	false
outcome: class2	`bmi >= t.c2`	bmi=23.3, t.c2=35	false
outcome: class1	`bmi >= t.c1`	bmi=23.3, t.c1=30	false
outcome: not_met	`bmi < t.c1`	bmi=23.3, t.c1=30	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 met

Specificity gap

Documented “hypoxia” (R09.02); criteria support the more specific Acute respiratory failure with hypoxia (J96.01).

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=86.0, pao2_min_ra=55.0, pf_min=262	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=86.0, t.spo2_ra=88, pao2_min_ra=55.0, t.pao2=60, pf_min=262, t.pf=300	true
derived: distress	`coalesce(rr_max >= t.rr_distress, false) or coalesce(wob_increased, false) or adv_resp_support`	rr_max=28.0, t.rr_distress=28, wob_increased=True, adv_resp_support=False	true
outcome: chronic_baseline	`home_o2 and hypoxemia`	home_o2=False, hypoxemia=True	false
outcome: met	`hypoxemia and distress`	hypoxemia=True, distress=True	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=37.6, t.t_hi=38, temp_min_48h=36.7, t.t_lo=36	false
derived: sirs_hr	`coalesce(hr_max_48h > t.hr, false)`	hr_max_48h=90.0, 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=28.0, t.rr=20, paco2_min_48h=unknown, t.paco2=32	true
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=8.56, t.wbc_hi=12, wbc_min_48h=6.81, 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=True, sirs_wbc=False	1
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=262, adv_resp_support=False	2
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=195.0	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=0.96	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=76.0	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=3.06	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=0.91	0
derived: sofa_delta	`sofa_resp + sofa_coag + sofa_liver + sofa_cardio + sofa_cns + sofa_renal - sofa_renal_baseline`	sofa_resp=2, sofa_coag=0, sofa_liver=0, sofa_cardio=0, sofa_cns=0, sofa_renal=2, sofa_renal_baseline=0	4
derived: sepsis3	`infection_documented and sofa_delta >= t.sofa_delta`	infection_documented=False, sofa_delta=4, t.sofa_delta=2	false
derived: sepsis2	`infection_documented and sirs_count >= t.sirs_min`	infection_documented=False, sirs_count=1, 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 (26)

Labs (pre-admission rows are outpatient values)
Row	When	Test	Value
LAB-000847	Wed Dec 31, 2025 09:15 AM	creatinine	0.91 mg/dL
LAB-000848	Sat Aug 22, 2026 10:05 AM	creatinine	0.91 mg/dL
LAB-000854	Sat Nov 07, 2026 07:01 PM	pao2	55.0 mmHg
LAB-000855	Sat Nov 07, 2026 07:01 PM	fio2	21.0 %
LAB-000849	Sat Nov 07, 2026 07:36 PM	creatinine	2.38 mg/dL
LAB-000853	Sat Nov 07, 2026 07:36 PM	bnp	1299.0 pg/mL
LAB-000856	Sat Nov 07, 2026 07:36 PM	sodium	137.0 mmol/L
LAB-000860	Sat Nov 07, 2026 07:36 PM	hemoglobin	14.42 g/dL
LAB-000864	Sat Nov 07, 2026 07:36 PM	wbc	6.81 x10^3/uL
LAB-000865	Sat Nov 07, 2026 07:36 PM	platelets	230.0 x10^3/uL
LAB-000872	Sat Nov 07, 2026 07:36 PM	bilirubin	0.96 mg/dL
LAB-000850	Sun Nov 08, 2026 05:00 AM	creatinine	3.06 mg/dL
LAB-000857	Sun Nov 08, 2026 05:00 AM	sodium	142.0 mmol/L
LAB-000861	Sun Nov 08, 2026 05:00 AM	hemoglobin	14.13 g/dL
LAB-000866	Sun Nov 08, 2026 05:00 AM	wbc	8.56 x10^3/uL
LAB-000867	Sun Nov 08, 2026 05:00 AM	platelets	195.0 x10^3/uL
LAB-000851	Mon Nov 09, 2026 05:00 AM	creatinine	2.75 mg/dL
LAB-000858	Mon Nov 09, 2026 05:00 AM	sodium	138.0 mmol/L
LAB-000862	Mon Nov 09, 2026 05:00 AM	hemoglobin	14.04 g/dL
LAB-000868	Mon Nov 09, 2026 05:00 AM	wbc	6.9 x10^3/uL
LAB-000869	Mon Nov 09, 2026 05:00 AM	platelets	295.0 x10^3/uL
LAB-000852	Tue Nov 10, 2026 05:00 AM	creatinine	2.29 mg/dL
LAB-000859	Tue Nov 10, 2026 05:00 AM	sodium	138.0 mmol/L
LAB-000863	Tue Nov 10, 2026 05:00 AM	hemoglobin	14.19 g/dL
LAB-000870	Tue Nov 10, 2026 05:00 AM	wbc	8.4 x10^3/uL
LAB-000871	Tue Nov 10, 2026 05:00 AM	platelets	210.0 x10^3/uL

Vitals (71)

Vitals
Row	When	Kind	Value	Detail
VIT-002457	Sat Nov 07, 2026 06:56 PM	spo2	86.0	room air
VIT-002458	Sat Nov 07, 2026 06:56 PM	rr	28.0
VIT-002484	Sat Nov 07, 2026 06:56 PM	temp_c	37.3
VIT-002485	Sat Nov 07, 2026 06:56 PM	hr	68.0
VIT-002486	Sat Nov 07, 2026 06:56 PM	map	76.0
VIT-002487	Sat Nov 07, 2026 06:56 PM	gcs	15.0
VIT-002459	Sat Nov 07, 2026 07:06 PM	o2_lpm	5.0	nasal cannula
VIT-002449	Sun Nov 08, 2026 12:36 AM	urine_ml_6h	428.3
VIT-002460	Sun Nov 08, 2026 02:56 AM	spo2	94.0	nasal cannula
VIT-002461	Sun Nov 08, 2026 02:56 AM	rr	20.0
VIT-002462	Sun Nov 08, 2026 02:56 AM	o2_lpm	4.0	nasal cannula
VIT-002488	Sun Nov 08, 2026 02:56 AM	temp_c	37.1
VIT-002489	Sun Nov 08, 2026 02:56 AM	hr	86.0
VIT-002490	Sun Nov 08, 2026 02:56 AM	map	86.0
VIT-002491	Sun Nov 08, 2026 02:56 AM	gcs	15.0
VIT-002450	Sun Nov 08, 2026 06:36 AM	urine_ml_6h	85.7
VIT-002463	Sun Nov 08, 2026 10:56 AM	spo2	92.0	nasal cannula
VIT-002464	Sun Nov 08, 2026 10:56 AM	rr	22.0
VIT-002465	Sun Nov 08, 2026 10:56 AM	o2_lpm	2.0	nasal cannula
VIT-002492	Sun Nov 08, 2026 10:56 AM	temp_c	37.6
VIT-002493	Sun Nov 08, 2026 10:56 AM	hr	90.0
VIT-002494	Sun Nov 08, 2026 10:56 AM	map	88.0
VIT-002495	Sun Nov 08, 2026 10:56 AM	gcs	15.0
VIT-002451	Sun Nov 08, 2026 12:36 PM	urine_ml_6h	85.7
VIT-002452	Sun Nov 08, 2026 06:36 PM	urine_ml_6h	85.7
VIT-002466	Sun Nov 08, 2026 06:56 PM	spo2	95.0	nasal cannula
VIT-002467	Sun Nov 08, 2026 06:56 PM	rr	22.0
VIT-002468	Sun Nov 08, 2026 06:56 PM	o2_lpm	3.0	nasal cannula
VIT-002496	Sun Nov 08, 2026 06:56 PM	temp_c	36.7
VIT-002497	Sun Nov 08, 2026 06:56 PM	hr	70.0
VIT-002498	Sun Nov 08, 2026 06:56 PM	map	88.0
VIT-002499	Sun Nov 08, 2026 06:56 PM	gcs	15.0
VIT-002453	Mon Nov 09, 2026 12:36 AM	urine_ml_6h	85.7
VIT-002469	Mon Nov 09, 2026 02:56 AM	spo2	93.0	nasal cannula
VIT-002470	Mon Nov 09, 2026 02:56 AM	rr	20.0
VIT-002471	Mon Nov 09, 2026 02:56 AM	o2_lpm	3.0	nasal cannula
VIT-002500	Mon Nov 09, 2026 02:56 AM	temp_c	36.8
VIT-002501	Mon Nov 09, 2026 02:56 AM	hr	69.0
VIT-002502	Mon Nov 09, 2026 02:56 AM	map	82.0
VIT-002503	Mon Nov 09, 2026 02:56 AM	gcs	15.0
VIT-002454	Mon Nov 09, 2026 06:36 AM	urine_ml_6h	85.7
VIT-002472	Mon Nov 09, 2026 10:56 AM	spo2	95.0	nasal cannula
VIT-002473	Mon Nov 09, 2026 10:56 AM	rr	21.0
VIT-002474	Mon Nov 09, 2026 10:56 AM	o2_lpm	2.0	nasal cannula
VIT-002504	Mon Nov 09, 2026 10:56 AM	temp_c	37.5
VIT-002505	Mon Nov 09, 2026 10:56 AM	hr	75.0
VIT-002506	Mon Nov 09, 2026 10:56 AM	map	85.0
VIT-002507	Mon Nov 09, 2026 10:56 AM	gcs	15.0
VIT-002455	Mon Nov 09, 2026 12:36 PM	urine_ml_6h	428.3
VIT-002456	Mon Nov 09, 2026 06:36 PM	urine_ml_6h	428.3
VIT-002475	Mon Nov 09, 2026 06:56 PM	spo2	94.0	nasal cannula
VIT-002476	Mon Nov 09, 2026 06:56 PM	rr	21.0
VIT-002477	Mon Nov 09, 2026 06:56 PM	o2_lpm	3.0	nasal cannula
VIT-002508	Mon Nov 09, 2026 06:56 PM	temp_c	36.5
VIT-002509	Mon Nov 09, 2026 06:56 PM	hr	83.0
VIT-002510	Mon Nov 09, 2026 06:56 PM	map	82.0
VIT-002511	Mon Nov 09, 2026 06:56 PM	gcs	15.0
VIT-002478	Tue Nov 10, 2026 02:56 AM	spo2	94.0	nasal cannula
VIT-002479	Tue Nov 10, 2026 02:56 AM	rr	21.0
VIT-002480	Tue Nov 10, 2026 02:56 AM	o2_lpm	4.0	nasal cannula
VIT-002512	Tue Nov 10, 2026 02:56 AM	temp_c	37.0
VIT-002513	Tue Nov 10, 2026 02:56 AM	hr	68.0
VIT-002514	Tue Nov 10, 2026 02:56 AM	map	89.0
VIT-002515	Tue Nov 10, 2026 02:56 AM	gcs	15.0
VIT-002481	Tue Nov 10, 2026 10:56 AM	spo2	93.0	nasal cannula
VIT-002482	Tue Nov 10, 2026 10:56 AM	rr	22.0
VIT-002483	Tue Nov 10, 2026 10:56 AM	o2_lpm	3.0	nasal cannula
VIT-002516	Tue Nov 10, 2026 10:56 AM	temp_c	36.6
VIT-002517	Tue Nov 10, 2026 10:56 AM	hr	76.0
VIT-002518	Tue Nov 10, 2026 10:56 AM	map	85.0
VIT-002519	Tue Nov 10, 2026 10:56 AM	gcs	15.0

Medications, orders, echo, history (9)

MED-000091 11-07 08:00 furosemide 40 mg IV
MED-000092 11-07 20:00 furosemide 40 mg IV
MED-000093 11-08 08:00 furosemide 40 mg IV
MED-000094 11-08 20:00 furosemide 40 mg IV
MED-000095 11-09 08:00 furosemide 40 mg IV
MED-000096 11-09 20:00 furosemide 40 mg IV
ORD-000020 11-08 08:00 dialysis: hemodialysis catheter and session
ECH-000011 2026-11-08 echo LVEF 58.0%
HX-000007 history: heart failure with preserved ejection fraction

Notes

History and physical · DOC-000081 · Dr. Rosalind Quillan (attending) · Sat Nov 07, 2026 09:36 PM

Cited facts from this note (1)

work_of_breathing: increased · cited p. 1, line 8 · confidence 0.90

Show source for work_of_breathing

… . Past medical history: heart failure with preserved ejection fraction, hypertension, hyperlipidemia, GERD. Review of systems otherwise negative. Exam: Lungs: increased work of breathing with accessory muscle use. Assessment and plan: 1. Congestive heart failure: diuresis and daily weights; monitor electrolytes.

Source document DOC-000081: History and physical (synthetic)

HISTORY AND PHYSICAL
Patient: Nico Elsworth   MRN: MRN22161213   Admitted: 2026-11-07 18:36
Service: Cardiology   Attending: Dr. Rosalind Quillan

History of present illness: 83-year-old man admitted with congestive heart failure. 
Past medical history: heart failure with preserved ejection fraction, hypertension, hyperlipidemia, GERD.
Review of systems otherwise negative.
Exam: Lungs: increased work of breathing with accessory muscle use.
Assessment and plan:
1. Congestive heart failure: diuresis and daily weights; monitor electrolytes.

Progress note · DOC-000082 · Dr. Rosalind Quillan (attending) · Mon Nov 09, 2026 07:36 PM

Source document DOC-000082: Progress note (synthetic)

PROGRESS NOTE (Attending)
Patient: Nico Elsworth   MRN: MRN22161213   Hospital day 3

Subjective: resting, tolerating diet.
Objective: vitals and labs reviewed in the flowsheet.
Assessment and plan:
1. Congestive heart failure: continue current management.
2. AKI: trend creatinine, hold nephrotoxins, strict intake and output.
3. Hypoxia: supplemental oxygen, wean as tolerated.

Attending: Dr. Rosalind Quillan

Discharge summary · DOC-000083 · Dr. Rosalind Quillan (attending) · Tue Nov 10, 2026 04:36 PM

Source document DOC-000083: Discharge summary (synthetic)

DISCHARGE SUMMARY
Patient: Nico Elsworth   MRN: MRN22161213
Admitted 2026-11-07; discharged 2026-11-10.

Discharge diagnoses:
- AKI
- congestive heart failure
- hypoxia
- hypertension
- hyperlipidemia
- GERD

Disposition: home with follow-up.