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-00053: Amara Merriweather

53M · MRN35922532 · Pulmonology · admitted Sun Nov 01, 2026 10:14 PM · discharged Wed Nov 04, 2026 01:41 PM · attending Dr. Wes Merriweather · 177 cm, 78.7 kg

Documented diagnoses (current)

Principal: “COPD exacerbation” · J44.1 Chronic obstructive pulmonary disease with (acute) exacerbation
“chronic kidney disease” · N18.9 Chronic kidney disease, unspecified
“acute renal insufficiency” · N28.9 Disorder of kidney and ureter, unspecified (renal insufficiency)
“acute on chronic diastolic heart failure” · I50.33 Acute on chronic diastolic (congestive) heart failure
“acute blood loss anemia” · D62 Acute posthemorrhagic anemia
“hyperlipidemia” · E78.5 Hyperlipidemia, unspecified

Illustrative grouping now: MS-DRG 190 Chronic obstructive pulmonary disease with MCC. If every open specificity/validation gap were answered as the criteria suggest: MS-DRG 191.

Queries and events

No queries yet.

All rules applied

Rule Criteria Finding Outcome

Acute kidney injury

Criteria met

Specificity gap

Documented “acute renal insufficiency” (N28.9); criteria support the more specific Acute kidney injury (KDIGO stage 1) (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=1.69, t.ratio_s1=1.5, creat_rise_48h=0.85, t.rise_abs=0.3, uo_hours_lt_0_5=unknown, 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=1.69, t.ratio_s3=3.0, creat_peak=3.87, 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=1.69, 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=True	1
derived: baseline_independent	`creat_baseline_known or creat_rise_48h >= t.rise_abs or rrt_started`	creat_baseline_known=True, creat_rise_48h=0.85, t.rise_abs=0.3, rrt_started=False	true
outcome: aki_staged	`stage >= 1 and baseline_independent`	stage=1, baseline_independent=True	true

Acute blood loss anaemia

Criteria met

No gap

Supported as documented (D62).

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=8.74, 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=4.0, 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

Specificity gap

Documented “chronic kidney disease” (N18.9); criteria support the more specific Chronic kidney disease stage 3b (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=346, t.chronic_days=90	true
derived: staging_egfr	`max(egfr_early, egfr_late)`	egfr_early=40.4, egfr_late=33.3	40.4
derived: both_below_60	`egfr_early < t.g2 and egfr_late < t.g2`	egfr_early=40.4, t.g2=60, egfr_late=33.3	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=40.4, 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=40.4, egfr_late=33.3, t.g2=60	false
outcome: g1_g2	`staging_egfr >= t.g2`	staging_egfr=40.4, t.g2=60	false
outcome: g3a	`category == 'G3a'`	category=G3b	false
outcome: g3b	`category == 'G3b'`	category=G3b	true

Heart failure

Criteria met

Clinical validation gap

Documented “acute on chronic diastolic heart failure” (I50.33) is more specific than the criteria support (Chronic diastolic (HFpEF) heart failure, I50.32).

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=58.0, 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=62.0, 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=62.0, 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=0, hf_history=True	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=chronic	false
outcome: sys_acute	`hf_type == 'systolic' and acuity == 'acute'`	hf_type=diastolic, acuity=chronic	false
outcome: sys_chronic	`hf_type == 'systolic' and acuity == 'chronic'`	hf_type=diastolic, acuity=chronic	false
outcome: dia_aoc	`hf_type == 'diastolic' and acuity == 'acute on chronic'`	hf_type=diastolic, acuity=chronic	false
outcome: dia_acute	`hf_type == 'diastolic' and acuity == 'acute'`	hf_type=diastolic, acuity=chronic	false
outcome: dia_chronic	`hf_type == 'diastolic' and acuity == 'chronic'`	hf_type=diastolic, acuity=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=53, t.adult=20	false
outcome: class3	`bmi >= t.c3`	bmi=25.1, t.c3=40	false
outcome: class2	`bmi >= t.c2`	bmi=25.1, t.c2=35	false
outcome: class1	`bmi >= t.c1`	bmi=25.1, t.c1=30	false
outcome: not_met	`bmi < t.c1`	bmi=25.1, 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=95.0, 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=95.0, 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=37.4, 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=87.0, 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=10.96, t.wbc_hi=12, wbc_min_48h=6.38, 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=182.0	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=0.79	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=75.0	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=3.87	3
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=2.29	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=3, sofa_renal_baseline=2	1
derived: sepsis3	`infection_documented and sofa_delta >= t.sofa_delta`	infection_documented=False, sofa_delta=1, 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-001801	Tue Sep 30, 2025 09:15 AM	creatinine	1.95 mg/dL
LAB-001802	Fri Sep 11, 2026 10:05 AM	creatinine	2.29 mg/dL
LAB-001803	Sun Nov 01, 2026 11:14 PM	creatinine	3.02 mg/dL
LAB-001807	Sun Nov 01, 2026 11:14 PM	bnp	58.0 pg/mL
LAB-001808	Sun Nov 01, 2026 11:14 PM	sodium	142.0 mmol/L
LAB-001812	Sun Nov 01, 2026 11:14 PM	hemoglobin	12.71 g/dL
LAB-001816	Sun Nov 01, 2026 11:14 PM	wbc	10.96 x10^3/uL
LAB-001817	Sun Nov 01, 2026 11:14 PM	platelets	297.0 x10^3/uL
LAB-001824	Sun Nov 01, 2026 11:14 PM	bilirubin	0.79 mg/dL
LAB-001804	Mon Nov 02, 2026 05:00 AM	creatinine	3.87 mg/dL
LAB-001809	Mon Nov 02, 2026 05:00 AM	sodium	142.0 mmol/L
LAB-001813	Mon Nov 02, 2026 05:00 AM	hemoglobin	10.33 g/dL
LAB-001818	Mon Nov 02, 2026 05:00 AM	wbc	6.38 x10^3/uL
LAB-001819	Mon Nov 02, 2026 05:00 AM	platelets	190.0 x10^3/uL
LAB-001805	Tue Nov 03, 2026 05:00 AM	creatinine	3.49 mg/dL
LAB-001810	Tue Nov 03, 2026 05:00 AM	sodium	139.0 mmol/L
LAB-001814	Tue Nov 03, 2026 05:00 AM	hemoglobin	8.74 g/dL
LAB-001820	Tue Nov 03, 2026 05:00 AM	wbc	9.12 x10^3/uL
LAB-001821	Tue Nov 03, 2026 05:00 AM	platelets	182.0 x10^3/uL
LAB-001806	Wed Nov 04, 2026 05:00 AM	creatinine	2.9 mg/dL
LAB-001811	Wed Nov 04, 2026 05:00 AM	sodium	137.0 mmol/L
LAB-001815	Wed Nov 04, 2026 05:00 AM	hemoglobin	9.54 g/dL
LAB-001822	Wed Nov 04, 2026 05:00 AM	wbc	7.69 x10^3/uL
LAB-001823	Wed Nov 04, 2026 05:00 AM	platelets	252.0 x10^3/uL

Vitals (48)

Vitals
Row	When	Kind	Value	Detail
VIT-005185	Sun Nov 01, 2026 10:34 PM	spo2	99.0	room air
VIT-005186	Sun Nov 01, 2026 10:34 PM	rr	14.0
VIT-005201	Sun Nov 01, 2026 10:34 PM	temp_c	36.9
VIT-005202	Sun Nov 01, 2026 10:34 PM	hr	69.0
VIT-005203	Sun Nov 01, 2026 10:34 PM	map	77.0
VIT-005204	Sun Nov 01, 2026 10:34 PM	gcs	15.0
VIT-005187	Mon Nov 02, 2026 06:34 AM	spo2	95.0	room air
VIT-005188	Mon Nov 02, 2026 06:34 AM	rr	15.0
VIT-005205	Mon Nov 02, 2026 06:34 AM	temp_c	37.4
VIT-005206	Mon Nov 02, 2026 06:34 AM	hr	87.0
VIT-005207	Mon Nov 02, 2026 06:34 AM	map	88.0
VIT-005208	Mon Nov 02, 2026 06:34 AM	gcs	15.0
VIT-005189	Mon Nov 02, 2026 02:34 PM	spo2	96.0	room air
VIT-005190	Mon Nov 02, 2026 02:34 PM	rr	15.0
VIT-005209	Mon Nov 02, 2026 02:34 PM	temp_c	37.3
VIT-005210	Mon Nov 02, 2026 02:34 PM	hr	68.0
VIT-005211	Mon Nov 02, 2026 02:34 PM	map	84.0
VIT-005212	Mon Nov 02, 2026 02:34 PM	gcs	15.0
VIT-005191	Mon Nov 02, 2026 10:34 PM	spo2	98.0	room air
VIT-005192	Mon Nov 02, 2026 10:34 PM	rr	14.0
VIT-005213	Mon Nov 02, 2026 10:34 PM	temp_c	36.6
VIT-005214	Mon Nov 02, 2026 10:34 PM	hr	87.0
VIT-005215	Mon Nov 02, 2026 10:34 PM	map	92.0
VIT-005216	Mon Nov 02, 2026 10:34 PM	gcs	15.0
VIT-005193	Tue Nov 03, 2026 06:34 AM	spo2	99.0	room air
VIT-005194	Tue Nov 03, 2026 06:34 AM	rr	16.0
VIT-005217	Tue Nov 03, 2026 06:34 AM	temp_c	36.9
VIT-005218	Tue Nov 03, 2026 06:34 AM	hr	87.0
VIT-005219	Tue Nov 03, 2026 06:34 AM	map	75.0
VIT-005220	Tue Nov 03, 2026 06:34 AM	gcs	15.0
VIT-005195	Tue Nov 03, 2026 02:34 PM	spo2	97.0	room air
VIT-005196	Tue Nov 03, 2026 02:34 PM	rr	19.0
VIT-005221	Tue Nov 03, 2026 02:34 PM	temp_c	37.0
VIT-005222	Tue Nov 03, 2026 02:34 PM	hr	84.0
VIT-005223	Tue Nov 03, 2026 02:34 PM	map	78.0
VIT-005224	Tue Nov 03, 2026 02:34 PM	gcs	15.0
VIT-005197	Tue Nov 03, 2026 10:34 PM	spo2	96.0	room air
VIT-005198	Tue Nov 03, 2026 10:34 PM	rr	20.0
VIT-005225	Tue Nov 03, 2026 10:34 PM	temp_c	37.2
VIT-005226	Tue Nov 03, 2026 10:34 PM	hr	90.0
VIT-005227	Tue Nov 03, 2026 10:34 PM	map	81.0
VIT-005228	Tue Nov 03, 2026 10:34 PM	gcs	15.0
VIT-005199	Wed Nov 04, 2026 06:34 AM	spo2	95.0	room air
VIT-005200	Wed Nov 04, 2026 06:34 AM	rr	15.0
VIT-005229	Wed Nov 04, 2026 06:34 AM	temp_c	36.9
VIT-005230	Wed Nov 04, 2026 06:34 AM	hr	72.0
VIT-005231	Wed Nov 04, 2026 06:34 AM	map	79.0
VIT-005232	Wed Nov 04, 2026 06:34 AM	gcs	15.0

Medications, orders, echo, history (6)

MED-000191 11-01 09:14 furosemide 40 mg PO
MED-000192 11-02 09:00 furosemide 40 mg PO
MED-000193 11-03 09:00 furosemide 40 mg PO
ORD-000044 11-02 09:00 transfusion_prbc: transfuse PRBC
ECH-000024 2026-04-15 echo LVEF 62.0%
HX-000017 history: heart failure with preserved ejection fraction

Notes

History and physical · DOC-000185 · Dr. Wes Merriweather (attending) · Mon Nov 02, 2026 01:14 AM

Cited facts from this note (1)

bleeding_source: bleeding from the surgical drain · cited p. 1, line 5 · confidence 0.85

Show source for bleeding_source

… ice: Pulmonology Attending: Dr. Wes Merriweather History of present illness: 53-year-old man admitted with COPD exacerbation. Hospital course complicated by bleeding from the surgical drain. Past medical history: heart failure with preserved ejection fraction, hyperlipidemia. Review of systems otherwise negative. Exam: Lungs: scattered crackles at …

Source document DOC-000185: History and physical (synthetic)

HISTORY AND PHYSICAL
Patient: Amara Merriweather   MRN: MRN35922532   Admitted: 2026-11-01 22:14
Service: Pulmonology   Attending: Dr. Wes Merriweather

History of present illness: 53-year-old man admitted with COPD exacerbation. Hospital course complicated by bleeding from the surgical drain.
Past medical history: heart failure with preserved ejection fraction, hyperlipidemia.
Review of systems otherwise negative.
Exam: Lungs: scattered crackles at the bases, no distress.
Assessment and plan:
1. COPD exacerbation: bronchodilators and steroids.
2. Chronic kidney disease: renally dose medications.

Progress note · DOC-000186 · Dr. Wes Merriweather (attending) · Wed Nov 04, 2026 12:14 AM

Source document DOC-000186: Progress note (synthetic)

PROGRESS NOTE (Attending)
Patient: Amara Merriweather   MRN: MRN35922532   Hospital day 3

Subjective: resting, tolerating diet.
Objective: vitals and labs reviewed in the flowsheet.
Assessment and plan:
1. COPD exacerbation: continue current management.
2. Acute renal insufficiency: trend creatinine, avoid nephrotoxins.
3. Acute on chronic diastolic heart failure: diuresis and daily weights; monitor electrolytes.
4. Acute blood loss anemia: trend hemoglobin, transfuse if needed.

Attending: Dr. Wes Merriweather

Discharge summary · DOC-000187 · Dr. Wes Merriweather (attending) · Wed Nov 04, 2026 01:41 PM

Source document DOC-000187: Discharge summary (synthetic)

DISCHARGE SUMMARY
Patient: Amara Merriweather   MRN: MRN35922532
Admitted 2026-11-01; discharged 2026-11-04.

Discharge diagnoses:
- COPD exacerbation
- chronic kidney disease
- acute renal insufficiency
- acute on chronic diastolic heart failure
- acute blood loss anemia
- hyperlipidemia

Disposition: home with follow-up.