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-00077: Celeste Ravensworth

79F · MRN48353963 · Cardiology · admitted Tue Nov 10, 2026 06:28 PM · in hospital · attending Dr. Kenji Stavros · 169 cm, 72.6 kg

Documented diagnoses (current)

“AKI” · N17.9 Acute kidney failure, unspecified
Principal: “systolic heart failure” · I50.20 Unspecified systolic (congestive) heart failure
“anemia” · D64.9 Anemia, unspecified

Illustrative grouping now: MS-DRG 292 Heart failure and shock with CC. If every open specificity/validation gap were answered as the criteria suggest: MS-DRG 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=3.286, t.ratio_s1=1.5, creat_rise_48h=0.41, 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=3.286, t.ratio_s3=3.0, creat_peak=1.84, 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	true
derived: stage2	`creat_ratio >= t.ratio_s2 or coalesce(uo_hours_lt_0_5 >= t.uo_s2_h, false)`	creat_ratio=3.286, t.ratio_s2=2.0, uo_hours_lt_0_5=unknown, 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=0.41, t.rise_abs=0.3, rrt_started=False	true
outcome: aki_staged	`stage >= 1 and baseline_independent`	stage=3, baseline_independent=True	true

Acute blood loss anaemia

Criteria met

Specificity gap

Documented “anemia” (D64.9); criteria support the more specific Acute blood loss anemia (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=F, hgb_nadir=8.85, t.hb_m=13, t.hb_f=12	true
derived: acute_fall	`hgb_drop >= t.drop_major or prbc_units >= t.prbc_major`	hgb_drop=3.5, t.drop_major=2.0, prbc_units=2, t.prbc_major=2	true
outcome: met	`bleeding_documented and anaemic and acute_fall`	bleeding_documented=True, anaemic=True, acute_fall=True	true

Chronic kidney disease

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=255, t.chronic_days=90	true
derived: staging_egfr	`max(egfr_early, egfr_late)`	egfr_early=93.6, egfr_late=92.8	93.6
derived: both_below_60	`egfr_early < t.g2 and egfr_late < t.g2`	egfr_early=93.6, t.g2=60, egfr_late=92.8	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=93.6, 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=93.6, egfr_late=92.8, t.g2=60	false
outcome: g1_g2	`staging_egfr >= t.g2`	staging_egfr=93.6, t.g2=60	true

Heart failure

Criteria met

Specificity gap

Documented “systolic heart failure” (I50.20); criteria support the more specific Acute on chronic systolic (HFrEF) heart failure (I50.23).

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=1192.0, 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=35.0, 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=35.0, 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=systolic	false
outcome: sys_aoc	`hf_type == 'systolic' and acuity == 'acute on chronic'`	hf_type=systolic, 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=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=79, t.adult=20	false
outcome: class3	`bmi >= t.c3`	bmi=25.4, t.c3=40	false
outcome: class2	`bmi >= t.c2`	bmi=25.4, t.c2=35	false
outcome: class1	`bmi >= t.c1`	bmi=25.4, t.c1=30	false
outcome: not_met	`bmi < t.c1`	bmi=25.4, 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

Criteria support Acute respiratory failure with hypoxia (J96.01); no corresponding diagnosis is documented.

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=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=86.0, t.spo2_ra=88, pao2_min_ra=unknown, t.pao2=60, pf_min=unknown, t.pf=300	true
derived: distress	`coalesce(rr_max >= t.rr_distress, false) or coalesce(wob_increased, false) or adv_resp_support`	rr_max=30.0, t.rr_distress=28, wob_increased=unknown, 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=89.0, 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=30.0, 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=10.65, t.wbc_hi=12, wbc_min_48h=5.79, 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=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=204.0	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=0.43	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=1.84	1
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=0.56	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=1, sofa_renal_baseline=0	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=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 (24)

Labs (pre-admission rows are outpatient values)
Row	When	Test	Value
LAB-002616	Sat Jan 24, 2026 09:15 AM	creatinine	0.54 mg/dL
LAB-002617	Wed Oct 07, 2026 10:05 AM	creatinine	0.56 mg/dL
LAB-002618	Tue Nov 10, 2026 07:28 PM	creatinine	1.43 mg/dL
LAB-002622	Tue Nov 10, 2026 07:28 PM	bnp	1192.0 pg/mL
LAB-002623	Tue Nov 10, 2026 07:28 PM	sodium	136.0 mmol/L
LAB-002627	Tue Nov 10, 2026 07:28 PM	hemoglobin	12.36 g/dL
LAB-002631	Tue Nov 10, 2026 07:28 PM	wbc	10.65 x10^3/uL
LAB-002632	Tue Nov 10, 2026 07:28 PM	platelets	204.0 x10^3/uL
LAB-002639	Tue Nov 10, 2026 07:28 PM	bilirubin	0.43 mg/dL
LAB-002619	Wed Nov 11, 2026 05:00 AM	creatinine	1.84 mg/dL
LAB-002624	Wed Nov 11, 2026 05:00 AM	sodium	140.0 mmol/L
LAB-002628	Wed Nov 11, 2026 05:00 AM	hemoglobin	10.26 g/dL
LAB-002633	Wed Nov 11, 2026 05:00 AM	wbc	8.02 x10^3/uL
LAB-002634	Wed Nov 11, 2026 05:00 AM	platelets	252.0 x10^3/uL
LAB-002620	Thu Nov 12, 2026 05:00 AM	creatinine	1.65 mg/dL
LAB-002625	Thu Nov 12, 2026 05:00 AM	sodium	138.0 mmol/L
LAB-002629	Thu Nov 12, 2026 05:00 AM	hemoglobin	8.85 g/dL
LAB-002635	Thu Nov 12, 2026 05:00 AM	wbc	5.79 x10^3/uL
LAB-002636	Thu Nov 12, 2026 05:00 AM	platelets	246.0 x10^3/uL
LAB-002621	Fri Nov 13, 2026 05:00 AM	creatinine	1.38 mg/dL
LAB-002626	Fri Nov 13, 2026 05:00 AM	sodium	139.0 mmol/L
LAB-002630	Fri Nov 13, 2026 05:00 AM	hemoglobin	9.65 g/dL
LAB-002637	Fri Nov 13, 2026 05:00 AM	wbc	10.04 x10^3/uL
LAB-002638	Fri Nov 13, 2026 05:00 AM	platelets	245.0 x10^3/uL

Vitals (63)

Vitals
Row	When	Kind	Value	Detail
VIT-007566	Tue Nov 10, 2026 06:48 PM	spo2	86.0	room air
VIT-007567	Tue Nov 10, 2026 06:48 PM	rr	30.0
VIT-007593	Tue Nov 10, 2026 06:48 PM	temp_c	36.8
VIT-007594	Tue Nov 10, 2026 06:48 PM	hr	75.0
VIT-007595	Tue Nov 10, 2026 06:48 PM	map	88.0
VIT-007596	Tue Nov 10, 2026 06:48 PM	gcs	15.0
VIT-007568	Tue Nov 10, 2026 06:58 PM	o2_lpm	6.0	nasal cannula
VIT-007569	Wed Nov 11, 2026 02:48 AM	spo2	94.0	nasal cannula
VIT-007570	Wed Nov 11, 2026 02:48 AM	rr	24.0
VIT-007571	Wed Nov 11, 2026 02:48 AM	o2_lpm	3.0	nasal cannula
VIT-007597	Wed Nov 11, 2026 02:48 AM	temp_c	37.5
VIT-007598	Wed Nov 11, 2026 02:48 AM	hr	88.0
VIT-007599	Wed Nov 11, 2026 02:48 AM	map	74.0
VIT-007600	Wed Nov 11, 2026 02:48 AM	gcs	15.0
VIT-007572	Wed Nov 11, 2026 10:48 AM	spo2	94.0	nasal cannula
VIT-007573	Wed Nov 11, 2026 10:48 AM	rr	22.0
VIT-007574	Wed Nov 11, 2026 10:48 AM	o2_lpm	3.0	nasal cannula
VIT-007601	Wed Nov 11, 2026 10:48 AM	temp_c	36.7
VIT-007602	Wed Nov 11, 2026 10:48 AM	hr	74.0
VIT-007603	Wed Nov 11, 2026 10:48 AM	map	77.0
VIT-007604	Wed Nov 11, 2026 10:48 AM	gcs	15.0
VIT-007575	Wed Nov 11, 2026 06:48 PM	spo2	94.0	nasal cannula
VIT-007576	Wed Nov 11, 2026 06:48 PM	rr	24.0
VIT-007577	Wed Nov 11, 2026 06:48 PM	o2_lpm	4.0	nasal cannula
VIT-007605	Wed Nov 11, 2026 06:48 PM	temp_c	37.3
VIT-007606	Wed Nov 11, 2026 06:48 PM	hr	80.0
VIT-007607	Wed Nov 11, 2026 06:48 PM	map	74.0
VIT-007608	Wed Nov 11, 2026 06:48 PM	gcs	15.0
VIT-007578	Thu Nov 12, 2026 02:48 AM	spo2	91.0	nasal cannula
VIT-007579	Thu Nov 12, 2026 02:48 AM	rr	20.0
VIT-007580	Thu Nov 12, 2026 02:48 AM	o2_lpm	3.0	nasal cannula
VIT-007609	Thu Nov 12, 2026 02:48 AM	temp_c	37.1
VIT-007610	Thu Nov 12, 2026 02:48 AM	hr	89.0
VIT-007611	Thu Nov 12, 2026 02:48 AM	map	84.0
VIT-007612	Thu Nov 12, 2026 02:48 AM	gcs	15.0
VIT-007581	Thu Nov 12, 2026 10:48 AM	spo2	91.0	nasal cannula
VIT-007582	Thu Nov 12, 2026 10:48 AM	rr	22.0
VIT-007583	Thu Nov 12, 2026 10:48 AM	o2_lpm	4.0	nasal cannula
VIT-007613	Thu Nov 12, 2026 10:48 AM	temp_c	37.6
VIT-007614	Thu Nov 12, 2026 10:48 AM	hr	81.0
VIT-007615	Thu Nov 12, 2026 10:48 AM	map	77.0
VIT-007616	Thu Nov 12, 2026 10:48 AM	gcs	15.0
VIT-007584	Thu Nov 12, 2026 06:48 PM	spo2	92.0	nasal cannula
VIT-007585	Thu Nov 12, 2026 06:48 PM	rr	22.0
VIT-007586	Thu Nov 12, 2026 06:48 PM	o2_lpm	4.0	nasal cannula
VIT-007617	Thu Nov 12, 2026 06:48 PM	temp_c	37.4
VIT-007618	Thu Nov 12, 2026 06:48 PM	hr	70.0
VIT-007619	Thu Nov 12, 2026 06:48 PM	map	85.0
VIT-007620	Thu Nov 12, 2026 06:48 PM	gcs	15.0
VIT-007587	Fri Nov 13, 2026 02:48 AM	spo2	93.0	nasal cannula
VIT-007588	Fri Nov 13, 2026 02:48 AM	rr	24.0
VIT-007589	Fri Nov 13, 2026 02:48 AM	o2_lpm	3.0	nasal cannula
VIT-007621	Fri Nov 13, 2026 02:48 AM	temp_c	36.7
VIT-007622	Fri Nov 13, 2026 02:48 AM	hr	69.0
VIT-007623	Fri Nov 13, 2026 02:48 AM	map	74.0
VIT-007624	Fri Nov 13, 2026 02:48 AM	gcs	15.0
VIT-007590	Fri Nov 13, 2026 10:48 AM	spo2	92.0	nasal cannula
VIT-007591	Fri Nov 13, 2026 10:48 AM	rr	22.0
VIT-007592	Fri Nov 13, 2026 10:48 AM	o2_lpm	2.0	nasal cannula
VIT-007625	Fri Nov 13, 2026 10:48 AM	temp_c	36.9
VIT-007626	Fri Nov 13, 2026 10:48 AM	hr	84.0
VIT-007627	Fri Nov 13, 2026 10:48 AM	map	82.0
VIT-007628	Fri Nov 13, 2026 10:48 AM	gcs	15.0

Medications, orders, echo, history (9)

MED-000294 11-10 08:00 furosemide 40 mg IV
MED-000295 11-10 20:00 furosemide 40 mg IV
MED-000296 11-11 08:00 furosemide 40 mg IV
MED-000297 11-11 20:00 furosemide 40 mg IV
MED-000298 11-12 08:00 furosemide 40 mg IV
MED-000299 11-12 20:00 furosemide 40 mg IV
ORD-000067 11-11 09:00 transfusion_prbc: transfuse PRBC
ECH-000036 2026-11-12 echo LVEF 35.0%
HX-000028 history: heart failure with reduced ejection fraction

Notes

History and physical · DOC-000266 · Dr. Kenji Stavros (attending) · Tue Nov 10, 2026 09:28 PM

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

… : Cardiology Attending: Dr. Kenji Stavros History of present illness: 79-year-old woman admitted with systolic heart failure. Hospital course complicated by bleeding from the surgical drain. Past medical history: heart failure with reduced ejection fraction. Review of systems otherwise negative. Exam: Lungs: labored respirations. Assessment and pl …

Source document DOC-000266: History and physical (synthetic)

HISTORY AND PHYSICAL
Patient: Celeste Ravensworth   MRN: MRN48353963   Admitted: 2026-11-10 18:28
Service: Cardiology   Attending: Dr. Kenji Stavros

History of present illness: 79-year-old woman admitted with systolic heart failure. Hospital course complicated by bleeding from the surgical drain.
Past medical history: heart failure with reduced ejection fraction.
Review of systems otherwise negative.
Exam: Lungs: labored respirations.
Assessment and plan:
1. Systolic heart failure: diuresis and daily weights; monitor electrolytes.

Nutrition assessment · DOC-000265 · Dario Larkspur, RD (dietitian) · Wed Nov 11, 2026 11:28 PM

Cited facts from this note (5)

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

Show source for fat_loss

… MRN: MRN48353963 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: Celeste Ravensworth MRN: MRN48353963 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: Celeste Ravensworth MRN: MRN48353963 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-000265: Nutrition assessment (synthetic)

NUTRITION ASSESSMENT (Registered Dietitian)
Patient: Celeste Ravensworth   MRN: MRN48353963

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-000267 · Dr. Kenji Stavros (attending) · Fri Nov 13, 2026 11:55 AM

Source document DOC-000267: Progress note (synthetic)

PROGRESS NOTE (Attending)
Patient: Celeste Ravensworth   MRN: MRN48353963   Hospital day 3

Subjective: resting, tolerating diet.
Objective: vitals and labs reviewed in the flowsheet.
Assessment and plan:
1. Systolic heart failure: continue current management.
2. AKI: trend creatinine, hold nephrotoxins, strict intake and output.
3. Anemia: trend hemoglobin.

Attending: Dr. Kenji Stavros