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Exact Dx synthetic data · demonstration
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.

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ENC-00075: Florian Larkspur

82M · MRN75087272 · Cardiology · admitted Thu Nov 05, 2026 05:49 PM · discharged Thu Nov 12, 2026 11:32 AM · attending Dr. Isaac Abernath · 166 cm, 55.1 kg

Documented diagnoses (current)

  • Principal: “chronic systolic heart failure” · I50.22 Chronic systolic (congestive) heart failure
  • “anemia” · D64.9 Anemia, unspecified
  • “hypertension” · I10 Essential (primary) hypertension
  • “type 2 diabetes” · E11.9 Type 2 diabetes mellitus without complications
  • “hyperlipidemia” · E78.5 Hyperlipidemia, unspecified

Illustrative grouping now: MS-DRG 293 Heart failure and shock without CC/MCC. If every open specificity/validation gap were answered as the criteria suggest: MS-DRG 293.

Queries and events

No queries yet.

All rules applied

Every rule's outcome for this encounter (clean results included)
RuleCriteriaFindingOutcome
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)
StepExpressionInputs and thresholds readResult
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=1.034, 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=1.034, t.ratio_s3=3.0, creat_peak=0.92, 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=1.034, 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 met No gap Supported as documented (D64.9).
Trace
Rule trace (rule blood_loss_anemia v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
StepExpressionInputs and thresholds readResult
derived: anaemic case(sex == 'M', hgb_nadir < t.hb_m, sex == 'F', hgb_nadir < t.hb_f, null) sex=M, hgb_nadir=10.71, 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=0.0, t.drop_major=2.0, prbc_units=0, t.prbc_major=2 false
outcome: met bleeding_documented and anaemic and acute_fall bleeding_documented=False, anaemic=True, acute_fall=False false
outcome: anaemia_only anaemic and hgb_drop < t.drop_min and prbc_units == 0 anaemic=True, hgb_drop=0.0, t.drop_min=1.0, prbc_units=0 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)
StepExpressionInputs and thresholds readResult
derived: chronic egfr_n >= 2 and egfr_span_days >= t.chronic_days egfr_n=2, egfr_span_days=226, t.chronic_days=90 true
derived: staging_egfr max(egfr_early, egfr_late) egfr_early=83.1, egfr_late=85.6 85.6
derived: both_below_60 egfr_early < t.g2 and egfr_late < t.g2 egfr_early=83.1, t.g2=60, egfr_late=85.6 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=85.6, 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=83.1, egfr_late=85.6, t.g2=60 false
outcome: g1_g2 staging_egfr >= t.g2 staging_egfr=85.6, t.g2=60 true
Heart failure Criteria met No gap Supported as documented (I50.22).
Trace
Rule trace (rule heart_failure v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
StepExpressionInputs and thresholds readResult
derived: np_elevated coalesce(bnp_max >= t.bnp, false) or coalesce(ntprobnp_max >= t.ntprobnp, false) bnp_max=55.0, 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=20.0, t.ref=40, t.pres=50 systolic
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=20.0, 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=systolic false
outcome: sys_aoc hf_type == 'systolic' and acuity == 'acute on chronic' hf_type=systolic, acuity=chronic false
outcome: sys_acute hf_type == 'systolic' and acuity == 'acute' hf_type=systolic, acuity=chronic false
outcome: sys_chronic hf_type == 'systolic' and acuity == 'chronic' hf_type=systolic, 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)
StepExpressionInputs and thresholds readResult
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)
StepExpressionInputs and thresholds readResult
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)
StepExpressionInputs and thresholds readResult
outcome: not_adult age < t.adult age=82, t.adult=20 false
outcome: class3 bmi >= t.c3 bmi=20.0, t.c3=40 false
outcome: class2 bmi >= t.c2 bmi=20.0, t.c2=35 false
outcome: class1 bmi >= t.c1 bmi=20.0, t.c1=30 false
outcome: not_met bmi < t.c1 bmi=20.0, 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)
StepExpressionInputs and thresholds readResult
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)
StepExpressionInputs and thresholds readResult
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)
StepExpressionInputs and thresholds readResult
derived: sirs_temp coalesce(temp_max_48h > t.t_hi, false) or coalesce(temp_min_48h < t.t_lo, false) temp_max_48h=37.5, 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=84.0, 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=18.0, 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=9.79, t.wbc_hi=12, wbc_min_48h=6.9, 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=190.0 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=0.82 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=0.92 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=0.89 0
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=0, sofa_renal_baseline=0 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 (44)
Labs (pre-admission rows are outpatient values)
RowWhenTestValue
LAB-002539Mon Jan 12, 2026 09:15 AMcreatinine0.92 mg/dL
LAB-002540Thu Aug 27, 2026 10:05 AMcreatinine0.89 mg/dL
LAB-002541Thu Nov 05, 2026 06:49 PMcreatinine0.9 mg/dL
LAB-002549Thu Nov 05, 2026 06:49 PMbnp55.0 pg/mL
LAB-002550Thu Nov 05, 2026 06:49 PMsodium142.0 mmol/L
LAB-002558Thu Nov 05, 2026 06:49 PMhemoglobin10.71 g/dL
LAB-002566Thu Nov 05, 2026 06:49 PMwbc7.11 x10^3/uL
LAB-002567Thu Nov 05, 2026 06:49 PMplatelets295.0 x10^3/uL
LAB-002582Thu Nov 05, 2026 06:49 PMbilirubin0.82 mg/dL
LAB-002542Fri Nov 06, 2026 05:00 AMcreatinine0.89 mg/dL
LAB-002551Fri Nov 06, 2026 05:00 AMsodium137.0 mmol/L
LAB-002559Fri Nov 06, 2026 05:00 AMhemoglobin10.98 g/dL
LAB-002568Fri Nov 06, 2026 05:00 AMwbc6.9 x10^3/uL
LAB-002569Fri Nov 06, 2026 05:00 AMplatelets190.0 x10^3/uL
LAB-002543Sat Nov 07, 2026 05:00 AMcreatinine0.92 mg/dL
LAB-002552Sat Nov 07, 2026 05:00 AMsodium140.0 mmol/L
LAB-002560Sat Nov 07, 2026 05:00 AMhemoglobin10.84 g/dL
LAB-002570Sat Nov 07, 2026 05:00 AMwbc9.79 x10^3/uL
LAB-002571Sat Nov 07, 2026 05:00 AMplatelets211.0 x10^3/uL
LAB-002544Sun Nov 08, 2026 05:00 AMcreatinine0.92 mg/dL
LAB-002553Sun Nov 08, 2026 05:00 AMsodium142.0 mmol/L
LAB-002561Sun Nov 08, 2026 05:00 AMhemoglobin10.93 g/dL
LAB-002572Sun Nov 08, 2026 05:00 AMwbc7.55 x10^3/uL
LAB-002573Sun Nov 08, 2026 05:00 AMplatelets292.0 x10^3/uL
LAB-002545Mon Nov 09, 2026 05:00 AMcreatinine0.92 mg/dL
LAB-002554Mon Nov 09, 2026 05:00 AMsodium139.0 mmol/L
LAB-002562Mon Nov 09, 2026 05:00 AMhemoglobin10.8 g/dL
LAB-002574Mon Nov 09, 2026 05:00 AMwbc9.86 x10^3/uL
LAB-002575Mon Nov 09, 2026 05:00 AMplatelets295.0 x10^3/uL
LAB-002546Tue Nov 10, 2026 05:00 AMcreatinine0.91 mg/dL
LAB-002555Tue Nov 10, 2026 05:00 AMsodium137.0 mmol/L
LAB-002563Tue Nov 10, 2026 05:00 AMhemoglobin10.76 g/dL
LAB-002576Tue Nov 10, 2026 05:00 AMwbc6.73 x10^3/uL
LAB-002577Tue Nov 10, 2026 05:00 AMplatelets250.0 x10^3/uL
LAB-002547Wed Nov 11, 2026 05:00 AMcreatinine0.91 mg/dL
LAB-002556Wed Nov 11, 2026 05:00 AMsodium140.0 mmol/L
LAB-002564Wed Nov 11, 2026 05:00 AMhemoglobin10.71 g/dL
LAB-002578Wed Nov 11, 2026 05:00 AMwbc8.67 x10^3/uL
LAB-002579Wed Nov 11, 2026 05:00 AMplatelets284.0 x10^3/uL
LAB-002548Thu Nov 12, 2026 05:00 AMcreatinine0.92 mg/dL
LAB-002557Thu Nov 12, 2026 05:00 AMsodium136.0 mmol/L
LAB-002565Thu Nov 12, 2026 05:00 AMhemoglobin10.96 g/dL
LAB-002580Thu Nov 12, 2026 05:00 AMwbc8.09 x10^3/uL
LAB-002581Thu Nov 12, 2026 05:00 AMplatelets309.0 x10^3/uL
Vitals (126)
Vitals
RowWhenKindValueDetail
VIT-007328Thu Nov 05, 2026 06:09 PMspo296.0room air
VIT-007329Thu Nov 05, 2026 06:09 PMrr14.0
VIT-007370Thu Nov 05, 2026 06:09 PMtemp_c37.0
VIT-007371Thu Nov 05, 2026 06:09 PMhr79.0
VIT-007372Thu Nov 05, 2026 06:09 PMmap80.0
VIT-007373Thu Nov 05, 2026 06:09 PMgcs15.0
VIT-007330Fri Nov 06, 2026 02:09 AMspo298.0room air
VIT-007331Fri Nov 06, 2026 02:09 AMrr16.0
VIT-007374Fri Nov 06, 2026 02:09 AMtemp_c36.6
VIT-007375Fri Nov 06, 2026 02:09 AMhr69.0
VIT-007376Fri Nov 06, 2026 02:09 AMmap74.0
VIT-007377Fri Nov 06, 2026 02:09 AMgcs15.0
VIT-007332Fri Nov 06, 2026 10:09 AMspo299.0room air
VIT-007333Fri Nov 06, 2026 10:09 AMrr17.0
VIT-007378Fri Nov 06, 2026 10:09 AMtemp_c36.6
VIT-007379Fri Nov 06, 2026 10:09 AMhr84.0
VIT-007380Fri Nov 06, 2026 10:09 AMmap74.0
VIT-007381Fri Nov 06, 2026 10:09 AMgcs15.0
VIT-007334Fri Nov 06, 2026 06:09 PMspo298.0room air
VIT-007335Fri Nov 06, 2026 06:09 PMrr18.0
VIT-007382Fri Nov 06, 2026 06:09 PMtemp_c37.5
VIT-007383Fri Nov 06, 2026 06:09 PMhr76.0
VIT-007384Fri Nov 06, 2026 06:09 PMmap75.0
VIT-007385Fri Nov 06, 2026 06:09 PMgcs15.0
VIT-007336Sat Nov 07, 2026 02:09 AMspo297.0room air
VIT-007337Sat Nov 07, 2026 02:09 AMrr18.0
VIT-007386Sat Nov 07, 2026 02:09 AMtemp_c37.3
VIT-007387Sat Nov 07, 2026 02:09 AMhr68.0
VIT-007388Sat Nov 07, 2026 02:09 AMmap82.0
VIT-007389Sat Nov 07, 2026 02:09 AMgcs15.0
VIT-007338Sat Nov 07, 2026 10:09 AMspo296.0room air
VIT-007339Sat Nov 07, 2026 10:09 AMrr14.0
VIT-007390Sat Nov 07, 2026 10:09 AMtemp_c36.6
VIT-007391Sat Nov 07, 2026 10:09 AMhr73.0
VIT-007392Sat Nov 07, 2026 10:09 AMmap86.0
VIT-007393Sat Nov 07, 2026 10:09 AMgcs15.0
VIT-007340Sat Nov 07, 2026 06:09 PMspo294.0room air
VIT-007341Sat Nov 07, 2026 06:09 PMrr15.0
VIT-007394Sat Nov 07, 2026 06:09 PMtemp_c36.7
VIT-007395Sat Nov 07, 2026 06:09 PMhr77.0
VIT-007396Sat Nov 07, 2026 06:09 PMmap85.0
VIT-007397Sat Nov 07, 2026 06:09 PMgcs15.0
VIT-007342Sun Nov 08, 2026 02:09 AMspo299.0room air
VIT-007343Sun Nov 08, 2026 02:09 AMrr14.0
VIT-007398Sun Nov 08, 2026 02:09 AMtemp_c36.9
VIT-007399Sun Nov 08, 2026 02:09 AMhr91.0
VIT-007400Sun Nov 08, 2026 02:09 AMmap84.0
VIT-007401Sun Nov 08, 2026 02:09 AMgcs15.0
VIT-007344Sun Nov 08, 2026 10:09 AMspo297.0room air
VIT-007345Sun Nov 08, 2026 10:09 AMrr17.0
VIT-007402Sun Nov 08, 2026 10:09 AMtemp_c37.1
VIT-007403Sun Nov 08, 2026 10:09 AMhr69.0
VIT-007404Sun Nov 08, 2026 10:09 AMmap77.0
VIT-007405Sun Nov 08, 2026 10:09 AMgcs15.0
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Medications, orders, echo, history (5)

Notes

History and physical · DOC-000259 · Dr. Isaac Abernath (attending) · Thu Nov 05, 2026 08:49 PM

Source document DOC-000259: History and physical (synthetic)
HISTORY AND PHYSICAL
Patient: Florian Larkspur   MRN: MRN75087272   Admitted: 2026-11-05 17:49
Service: Cardiology   Attending: Dr. Isaac Abernath

History of present illness: 82-year-old man admitted with chronic systolic heart failure. 
Past medical history: heart failure with reduced ejection fraction, hypertension, type 2 diabetes, hyperlipidemia.
Review of systems otherwise negative.
Exam: Lungs: scattered crackles at the bases, no distress.
Assessment and plan:
1. Chronic systolic heart failure: diuresis and daily weights; monitor electrolytes.

Nutrition assessment · DOC-000258 · Viggo Ravensworth, RD (dietitian) · Fri Nov 06, 2026 08:49 PM

Cited facts from this note (5)
fat_loss
none · cited p. 1, line 7 · confidence 0.90
Show source for fat_loss
… MRN: MRN75087272 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 Larkspur MRN: MRN75087272 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 Larkspur MRN: MRN75087272 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-000258: Nutrition assessment (synthetic)
NUTRITION ASSESSMENT (Registered Dietitian)
Patient: Florian Larkspur   MRN: MRN75087272

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-000260 · Dr. Isaac Abernath (attending) · Sat Nov 07, 2026 08:49 PM

Source document DOC-000260: Progress note (synthetic)
PROGRESS NOTE (Attending)
Patient: Florian Larkspur   MRN: MRN75087272   Hospital day 3

Subjective: resting, tolerating diet.
Objective: vitals and labs reviewed in the flowsheet.
Assessment and plan:
1. Chronic systolic heart failure: continue current management.
2. Anemia: trend hemoglobin.

Attending: Dr. Isaac Abernath

Discharge summary · DOC-000261 · Dr. Isaac Abernath (attending) · Thu Nov 12, 2026 11:32 AM

Source document DOC-000261: Discharge summary (synthetic)
DISCHARGE SUMMARY
Patient: Florian Larkspur   MRN: MRN75087272
Admitted 2026-11-05; discharged 2026-11-12.

Discharge diagnoses:
- chronic systolic heart failure
- anemia
- hypertension
- type 2 diabetes
- hyperlipidemia

Disposition: home with follow-up.