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-00033: Priya Whitlock

81F · MRN49356760 · Hospital Medicine · admitted Sat Nov 07, 2026 10:42 PM · in hospital · attending Dr. Cyrus Ellingham · resident Dr. Noor Halvorsen · 166 cm, 56.7 kg

Documented diagnoses (current)

Principal: “sepsis” · A41.9 Sepsis, unspecified organism
“urinary tract infection” · N39.0 Urinary tract infection, site not specified
“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 not met

No gap

Not documented and not supported.

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=1.053, t.ratio_s1=1.5, creat_rise_48h=0.03, 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=1.053, t.ratio_s3=3.0, creat_peak=0.8, 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=1.053, 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=0.03, 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 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=F, hgb_nadir=13.69, 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=0.3, 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=0.3, t.drop_min=1.0, prbc_units=0	false
outcome: not_anaemic	`present(hgb_nadir) and not anaemic`	hgb_nadir=13.69, 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=312, t.chronic_days=90	true
derived: staging_egfr	`max(egfr_early, egfr_late)`	egfr_early=76.3, egfr_late=78.7	78.7
derived: both_below_60	`egfr_early < t.g2 and egfr_late < t.g2`	egfr_early=76.3, t.g2=60, egfr_late=78.7	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=78.7, 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=76.3, egfr_late=78.7, t.g2=60	false
outcome: g1_g2	`staging_egfr >= t.g2`	staging_egfr=78.7, t.g2=60	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 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 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=81, t.adult=20	false
outcome: class3	`bmi >= t.c3`	bmi=20.6, t.c3=40	false
outcome: class2	`bmi >= t.c2`	bmi=20.6, t.c2=35	false
outcome: class1	`bmi >= t.c1`	bmi=20.6, t.c1=30	false
outcome: not_met	`bmi < t.c1`	bmi=20.6, 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 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=39.3, 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=120.0, 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=17.53, t.wbc_hi=12, wbc_min_48h=15.45, 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=85.0	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=0.41	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=0.8	0
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=0.76	0
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=0, sofa_renal_baseline=0	3
derived: sepsis3	`infection_documented and sofa_delta >= t.sofa_delta`	infection_documented=True, sofa_delta=3, 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=2.78, 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 (39)

Labs (pre-admission rows are outpatient values)
Row	When	Test	Value
LAB-001108	Mon Nov 17, 2025 09:15 AM	creatinine	0.78 mg/dL
LAB-001109	Sat Sep 26, 2026 10:05 AM	creatinine	0.76 mg/dL
LAB-001110	Sat Nov 07, 2026 11:42 PM	creatinine	0.8 mg/dL
LAB-001117	Sat Nov 07, 2026 11:42 PM	sodium	142.0 mmol/L
LAB-001124	Sat Nov 07, 2026 11:42 PM	hemoglobin	13.95 g/dL
LAB-001131	Sat Nov 07, 2026 11:42 PM	wbc	17.53 x10^3/uL
LAB-001132	Sat Nov 07, 2026 11:42 PM	platelets	88.0 x10^3/uL
LAB-001145	Sat Nov 07, 2026 11:42 PM	bilirubin	0.41 mg/dL
LAB-001146	Sat Nov 07, 2026 11:42 PM	lactate	2.78 mmol/L
LAB-001111	Sun Nov 08, 2026 05:00 AM	creatinine	0.77 mg/dL
LAB-001118	Sun Nov 08, 2026 05:00 AM	sodium	137.0 mmol/L
LAB-001125	Sun Nov 08, 2026 05:00 AM	hemoglobin	13.94 g/dL
LAB-001133	Sun Nov 08, 2026 05:00 AM	wbc	16.72 x10^3/uL
LAB-001134	Sun Nov 08, 2026 05:00 AM	platelets	87.0 x10^3/uL
LAB-001112	Mon Nov 09, 2026 05:00 AM	creatinine	0.78 mg/dL
LAB-001119	Mon Nov 09, 2026 05:00 AM	sodium	137.0 mmol/L
LAB-001126	Mon Nov 09, 2026 05:00 AM	hemoglobin	13.85 g/dL
LAB-001135	Mon Nov 09, 2026 05:00 AM	wbc	15.45 x10^3/uL
LAB-001136	Mon Nov 09, 2026 05:00 AM	platelets	85.0 x10^3/uL
LAB-001113	Tue Nov 10, 2026 05:00 AM	creatinine	0.8 mg/dL
LAB-001120	Tue Nov 10, 2026 05:00 AM	sodium	136.0 mmol/L
LAB-001127	Tue Nov 10, 2026 05:00 AM	hemoglobin	13.77 g/dL
LAB-001137	Tue Nov 10, 2026 05:00 AM	wbc	10.42 x10^3/uL
LAB-001138	Tue Nov 10, 2026 05:00 AM	platelets	191.0 x10^3/uL
LAB-001114	Wed Nov 11, 2026 05:00 AM	creatinine	0.8 mg/dL
LAB-001121	Wed Nov 11, 2026 05:00 AM	sodium	137.0 mmol/L
LAB-001128	Wed Nov 11, 2026 05:00 AM	hemoglobin	13.77 g/dL
LAB-001139	Wed Nov 11, 2026 05:00 AM	wbc	6.64 x10^3/uL
LAB-001140	Wed Nov 11, 2026 05:00 AM	platelets	225.0 x10^3/uL
LAB-001115	Thu Nov 12, 2026 05:00 AM	creatinine	0.78 mg/dL
LAB-001122	Thu Nov 12, 2026 05:00 AM	sodium	142.0 mmol/L
LAB-001129	Thu Nov 12, 2026 05:00 AM	hemoglobin	13.95 g/dL
LAB-001141	Thu Nov 12, 2026 05:00 AM	wbc	7.55 x10^3/uL
LAB-001142	Thu Nov 12, 2026 05:00 AM	platelets	286.0 x10^3/uL
LAB-001116	Fri Nov 13, 2026 05:00 AM	creatinine	0.77 mg/dL
LAB-001123	Fri Nov 13, 2026 05:00 AM	sodium	138.0 mmol/L
LAB-001130	Fri Nov 13, 2026 05:00 AM	hemoglobin	13.69 g/dL
LAB-001143	Fri Nov 13, 2026 05:00 AM	wbc	6.12 x10^3/uL
LAB-001144	Fri Nov 13, 2026 05:00 AM	platelets	260.0 x10^3/uL

Vitals (108)

Vitals
Row	When	Kind	Value	Detail
VIT-003179	Sat Nov 07, 2026 11:02 PM	spo2	98.0	room air
VIT-003180	Sat Nov 07, 2026 11:02 PM	rr	18.0
VIT-003215	Sat Nov 07, 2026 11:02 PM	temp_c	38.6
VIT-003216	Sat Nov 07, 2026 11:02 PM	hr	106.0
VIT-003217	Sat Nov 07, 2026 11:02 PM	map	67.0
VIT-003218	Sat Nov 07, 2026 11:02 PM	gcs	15.0
VIT-003181	Sun Nov 08, 2026 07:02 AM	spo2	98.0	room air
VIT-003182	Sun Nov 08, 2026 07:02 AM	rr	16.0
VIT-003219	Sun Nov 08, 2026 07:02 AM	temp_c	39.3
VIT-003220	Sun Nov 08, 2026 07:02 AM	hr	109.0
VIT-003221	Sun Nov 08, 2026 07:02 AM	map	68.0
VIT-003222	Sun Nov 08, 2026 07:02 AM	gcs	15.0
VIT-003183	Sun Nov 08, 2026 03:02 PM	spo2	96.0	room air
VIT-003184	Sun Nov 08, 2026 03:02 PM	rr	16.0
VIT-003223	Sun Nov 08, 2026 03:02 PM	temp_c	39.3
VIT-003224	Sun Nov 08, 2026 03:02 PM	hr	119.0
VIT-003225	Sun Nov 08, 2026 03:02 PM	map	68.0
VIT-003226	Sun Nov 08, 2026 03:02 PM	gcs	15.0
VIT-003185	Sun Nov 08, 2026 11:02 PM	spo2	99.0	room air
VIT-003186	Sun Nov 08, 2026 11:02 PM	rr	20.0
VIT-003227	Sun Nov 08, 2026 11:02 PM	temp_c	38.9
VIT-003228	Sun Nov 08, 2026 11:02 PM	hr	119.0
VIT-003229	Sun Nov 08, 2026 11:02 PM	map	64.0
VIT-003230	Sun Nov 08, 2026 11:02 PM	gcs	15.0
VIT-003187	Mon Nov 09, 2026 07:02 AM	spo2	98.0	room air
VIT-003188	Mon Nov 09, 2026 07:02 AM	rr	16.0
VIT-003231	Mon Nov 09, 2026 07:02 AM	temp_c	38.7
VIT-003232	Mon Nov 09, 2026 07:02 AM	hr	120.0
VIT-003233	Mon Nov 09, 2026 07:02 AM	map	66.0
VIT-003234	Mon Nov 09, 2026 07:02 AM	gcs	15.0
VIT-003189	Mon Nov 09, 2026 03:02 PM	spo2	98.0	room air
VIT-003190	Mon Nov 09, 2026 03:02 PM	rr	17.0
VIT-003235	Mon Nov 09, 2026 03:02 PM	temp_c	39.2
VIT-003236	Mon Nov 09, 2026 03:02 PM	hr	109.0
VIT-003237	Mon Nov 09, 2026 03:02 PM	map	66.0
VIT-003238	Mon Nov 09, 2026 03:02 PM	gcs	15.0
VIT-003191	Mon Nov 09, 2026 11:02 PM	spo2	95.0	room air
VIT-003192	Mon Nov 09, 2026 11:02 PM	rr	14.0
VIT-003239	Mon Nov 09, 2026 11:02 PM	temp_c	36.8
VIT-003240	Mon Nov 09, 2026 11:02 PM	hr	71.0
VIT-003241	Mon Nov 09, 2026 11:02 PM	map	79.0
VIT-003242	Mon Nov 09, 2026 11:02 PM	gcs	15.0
VIT-003193	Tue Nov 10, 2026 07:02 AM	spo2	99.0	room air
VIT-003194	Tue Nov 10, 2026 07:02 AM	rr	19.0
VIT-003243	Tue Nov 10, 2026 07:02 AM	temp_c	37.5
VIT-003244	Tue Nov 10, 2026 07:02 AM	hr	76.0
VIT-003245	Tue Nov 10, 2026 07:02 AM	map	76.0
VIT-003246	Tue Nov 10, 2026 07:02 AM	gcs	15.0
VIT-003195	Tue Nov 10, 2026 03:02 PM	spo2	95.0	room air
VIT-003196	Tue Nov 10, 2026 03:02 PM	rr	17.0
VIT-003247	Tue Nov 10, 2026 03:02 PM	temp_c	36.5
VIT-003248	Tue Nov 10, 2026 03:02 PM	hr	68.0
VIT-003249	Tue Nov 10, 2026 03:02 PM	map	88.0
VIT-003250	Tue Nov 10, 2026 03:02 PM	gcs	15.0
VIT-003197	Tue Nov 10, 2026 11:02 PM	spo2	99.0	room air
VIT-003198	Tue Nov 10, 2026 11:02 PM	rr	20.0
VIT-003251	Tue Nov 10, 2026 11:02 PM	temp_c	37.2
VIT-003252	Tue Nov 10, 2026 11:02 PM	hr	86.0
VIT-003253	Tue Nov 10, 2026 11:02 PM	map	92.0
VIT-003254	Tue Nov 10, 2026 11:02 PM	gcs	15.0
VIT-003199	Wed Nov 11, 2026 07:02 AM	spo2	98.0	room air
VIT-003200	Wed Nov 11, 2026 07:02 AM	rr	19.0
VIT-003255	Wed Nov 11, 2026 07:02 AM	temp_c	37.3
VIT-003256	Wed Nov 11, 2026 07:02 AM	hr	82.0
VIT-003257	Wed Nov 11, 2026 07:02 AM	map	88.0
VIT-003258	Wed Nov 11, 2026 07:02 AM	gcs	15.0
VIT-003201	Wed Nov 11, 2026 03:02 PM	spo2	99.0	room air
VIT-003202	Wed Nov 11, 2026 03:02 PM	rr	16.0
VIT-003259	Wed Nov 11, 2026 03:02 PM	temp_c	36.9
VIT-003260	Wed Nov 11, 2026 03:02 PM	hr	78.0
VIT-003261	Wed Nov 11, 2026 03:02 PM	map	89.0
VIT-003262	Wed Nov 11, 2026 03:02 PM	gcs	15.0
VIT-003203	Wed Nov 11, 2026 11:02 PM	spo2	97.0	room air
VIT-003204	Wed Nov 11, 2026 11:02 PM	rr	16.0
VIT-003263	Wed Nov 11, 2026 11:02 PM	temp_c	37.2
VIT-003264	Wed Nov 11, 2026 11:02 PM	hr	73.0
VIT-003265	Wed Nov 11, 2026 11:02 PM	map	91.0
VIT-003266	Wed Nov 11, 2026 11:02 PM	gcs	15.0
VIT-003205	Thu Nov 12, 2026 07:02 AM	spo2	99.0	room air
VIT-003206	Thu Nov 12, 2026 07:02 AM	rr	16.0
VIT-003267	Thu Nov 12, 2026 07:02 AM	temp_c	36.7
VIT-003268	Thu Nov 12, 2026 07:02 AM	hr	89.0
VIT-003269	Thu Nov 12, 2026 07:02 AM	map	89.0
VIT-003270	Thu Nov 12, 2026 07:02 AM	gcs	15.0
VIT-003207	Thu Nov 12, 2026 03:02 PM	spo2	95.0	room air
VIT-003208	Thu Nov 12, 2026 03:02 PM	rr	16.0
VIT-003271	Thu Nov 12, 2026 03:02 PM	temp_c	37.1
VIT-003272	Thu Nov 12, 2026 03:02 PM	hr	78.0
VIT-003273	Thu Nov 12, 2026 03:02 PM	map	83.0
VIT-003274	Thu Nov 12, 2026 03:02 PM	gcs	15.0
VIT-003209	Thu Nov 12, 2026 11:02 PM	spo2	99.0	room air
VIT-003210	Thu Nov 12, 2026 11:02 PM	rr	19.0
VIT-003275	Thu Nov 12, 2026 11:02 PM	temp_c	37.0
VIT-003276	Thu Nov 12, 2026 11:02 PM	hr	75.0
VIT-003277	Thu Nov 12, 2026 11:02 PM	map	87.0
VIT-003278	Thu Nov 12, 2026 11:02 PM	gcs	15.0
VIT-003211	Fri Nov 13, 2026 07:02 AM	spo2	94.0	room air
VIT-003212	Fri Nov 13, 2026 07:02 AM	rr	19.0
VIT-003279	Fri Nov 13, 2026 07:02 AM	temp_c	37.2
VIT-003280	Fri Nov 13, 2026 07:02 AM	hr	88.0
VIT-003281	Fri Nov 13, 2026 07:02 AM	map	78.0
VIT-003282	Fri Nov 13, 2026 07:02 AM	gcs	15.0
VIT-003213	Fri Nov 13, 2026 03:02 PM	spo2	96.0	room air
VIT-003214	Fri Nov 13, 2026 03:02 PM	rr	20.0
VIT-003283	Fri Nov 13, 2026 03:02 PM	temp_c	36.8
VIT-003284	Fri Nov 13, 2026 03:02 PM	hr	82.0
VIT-003285	Fri Nov 13, 2026 03:02 PM	map	75.0
VIT-003286	Fri Nov 13, 2026 03:02 PM	gcs	15.0

Medications, orders, echo, history (4)

MED-000121 11-07 23:42 piperacillin-tazobactam per protocol IV
MED-000122 11-08 05:00 ceftriaxone per protocol IV
MED-000123 11-09 05:00 piperacillin-tazobactam per protocol IV
ORD-000027 11-07 23:12 blood_culture: blood cultures x2

Notes

History and physical · DOC-000112 · Dr. Noor Halvorsen (resident) · Sun Nov 08, 2026 01:42 AM

Cited facts from this note (1)

infection_source: acute pyelonephritis · cited p. 1, line 5 · confidence 0.85

Show source for infection_source

… ce: Hospital Medicine Attending: Dr. Cyrus Ellingham History of present illness: 81-year-old woman admitted with sepsis. Urinalysis with pyuria; treated for acute pyelonephritis with cefepime. Past medical history: type 2 diabetes. Review of systems otherwise negative. Exam: Lungs: scattered crackles at the bases, no distress. Assessme …

Source document DOC-000112: History and physical (synthetic)

HISTORY AND PHYSICAL
Patient: Priya Whitlock   MRN: MRN49356760   Admitted: 2026-11-07 22:42
Service: Hospital Medicine   Attending: Dr. Cyrus Ellingham

History of present illness: 81-year-old woman admitted with sepsis. Urinalysis with pyuria; treated for acute pyelonephritis with cefepime.
Past medical history: type 2 diabetes.
Review of systems otherwise negative.
Exam: Lungs: scattered crackles at the bases, no distress.
Assessment and plan:
1. Sepsis: antibiotics, fluids.
2. Urinary tract infection: antibiotics.

Nutrition assessment · DOC-000111 · Dario Larkspur, RD (dietitian) · Mon Nov 09, 2026 03:42 AM

Cited facts from this note (5)

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

Show source for fat_loss

… MRN: MRN49356760 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: Priya Whitlock MRN: MRN49356760 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: Priya Whitlock MRN: MRN49356760 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-000111: Nutrition assessment (synthetic)

NUTRITION ASSESSMENT (Registered Dietitian)
Patient: Priya Whitlock   MRN: MRN49356760

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-000113 · Dr. Noor Halvorsen (resident) · Fri Nov 13, 2026 10:55 AM · awaiting cosign

Source document DOC-000113: Progress note (synthetic)

PROGRESS NOTE (Resident)
Patient: Priya Whitlock   MRN: MRN49356760   Hospital day 6

Subjective: resting, tolerating diet.
Objective: vitals and labs reviewed in the flowsheet.
Assessment and plan:
1. Sepsis: continue current management.

Resident: Dr. Noor Halvorsen   Attending cosign: pending