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-00078: Florian Upfield

76F · MRN18554294 · Pulmonology · admitted Tue Oct 27, 2026 05:48 PM · discharged Sun Nov 01, 2026 03:49 PM · attending Dr. Kenji Stavros · resident Dr. Greta Kowalczyk · 163 cm, 58.6 kg

Documented diagnoses (current)

Principal: “COPD exacerbation” · J44.1 Chronic obstructive pulmonary disease with (acute) exacerbation
“GERD” · K21.9 Gastro-esophageal reflux disease without esophagitis
“hypertension” · I10 Essential (primary) hypertension

Illustrative grouping now: MS-DRG 192 Chronic obstructive pulmonary disease without CC/MCC. If every open specificity/validation gap were answered as the criteria suggest: MS-DRG 192.

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=1.047, 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=1.047, t.ratio_s3=3.0, creat_peak=0.89, 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=1.047, 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=12.74, 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=12.74, 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=315, t.chronic_days=90	true
derived: staging_egfr	`max(egfr_early, egfr_late)`	egfr_early=74.1, egfr_late=71.0	74.1
derived: both_below_60	`egfr_early < t.g2 and egfr_late < t.g2`	egfr_early=74.1, t.g2=60, egfr_late=71.0	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=74.1, 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=74.1, egfr_late=71.0, t.g2=60	false
outcome: g1_g2	`staging_egfr >= t.g2`	staging_egfr=74.1, 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

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=76, t.adult=20	false
outcome: class3	`bmi >= t.c3`	bmi=22.1, t.c3=40	false
outcome: class2	`bmi >= t.c2`	bmi=22.1, t.c2=35	false
outcome: class1	`bmi >= t.c1`	bmi=22.1, t.c1=30	false
outcome: not_met	`bmi < t.c1`	bmi=22.1, 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=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)
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=36.8, t.t_lo=36	false
derived: sirs_hr	`coalesce(hr_max_48h > t.hr, false)`	hr_max_48h=81.0, 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=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=7.98, t.wbc_hi=12, wbc_min_48h=5.53, 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=195.0	0
derived: sofa_liver	`coalesce(case(bili_max_48h >= 12, 4, bili_max_48h >= 6, 3, bili_max_48h >= 2, 2, bili_max_48h >= 1.2, 1, 0), 0)`	bili_max_48h=0.48	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=77.0	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=0.89	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=0.85	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 (33)

Labs (pre-admission rows are outpatient values)
Row	When	Test	Value
LAB-002640	Tue Oct 28, 2025 09:15 AM	creatinine	0.82 mg/dL
LAB-002641	Tue Sep 08, 2026 10:05 AM	creatinine	0.85 mg/dL
LAB-002642	Tue Oct 27, 2026 06:48 PM	creatinine	0.86 mg/dL
LAB-002648	Tue Oct 27, 2026 06:48 PM	sodium	141.0 mmol/L
LAB-002654	Tue Oct 27, 2026 06:48 PM	hemoglobin	13.04 g/dL
LAB-002660	Tue Oct 27, 2026 06:48 PM	wbc	7.98 x10^3/uL
LAB-002661	Tue Oct 27, 2026 06:48 PM	platelets	253.0 x10^3/uL
LAB-002672	Tue Oct 27, 2026 06:48 PM	bilirubin	0.48 mg/dL
LAB-002643	Wed Oct 28, 2026 05:00 AM	creatinine	0.89 mg/dL
LAB-002649	Wed Oct 28, 2026 05:00 AM	sodium	136.0 mmol/L
LAB-002655	Wed Oct 28, 2026 05:00 AM	hemoglobin	12.99 g/dL
LAB-002662	Wed Oct 28, 2026 05:00 AM	wbc	5.53 x10^3/uL
LAB-002663	Wed Oct 28, 2026 05:00 AM	platelets	195.0 x10^3/uL
LAB-002644	Thu Oct 29, 2026 05:00 AM	creatinine	0.84 mg/dL
LAB-002650	Thu Oct 29, 2026 05:00 AM	sodium	140.0 mmol/L
LAB-002656	Thu Oct 29, 2026 05:00 AM	hemoglobin	12.9 g/dL
LAB-002664	Thu Oct 29, 2026 05:00 AM	wbc	7.48 x10^3/uL
LAB-002665	Thu Oct 29, 2026 05:00 AM	platelets	285.0 x10^3/uL
LAB-002645	Fri Oct 30, 2026 05:00 AM	creatinine	0.85 mg/dL
LAB-002651	Fri Oct 30, 2026 05:00 AM	sodium	142.0 mmol/L
LAB-002657	Fri Oct 30, 2026 05:00 AM	hemoglobin	13.0 g/dL
LAB-002666	Fri Oct 30, 2026 05:00 AM	wbc	10.5 x10^3/uL
LAB-002667	Fri Oct 30, 2026 05:00 AM	platelets	301.0 x10^3/uL
LAB-002646	Sat Oct 31, 2026 05:00 AM	creatinine	0.85 mg/dL
LAB-002652	Sat Oct 31, 2026 05:00 AM	sodium	140.0 mmol/L
LAB-002658	Sat Oct 31, 2026 05:00 AM	hemoglobin	13.04 g/dL
LAB-002668	Sat Oct 31, 2026 05:00 AM	wbc	8.61 x10^3/uL
LAB-002669	Sat Oct 31, 2026 05:00 AM	platelets	252.0 x10^3/uL
LAB-002647	Sun Nov 01, 2026 05:00 AM	creatinine	0.85 mg/dL
LAB-002653	Sun Nov 01, 2026 05:00 AM	sodium	141.0 mmol/L
LAB-002659	Sun Nov 01, 2026 05:00 AM	hemoglobin	12.74 g/dL
LAB-002670	Sun Nov 01, 2026 05:00 AM	wbc	8.39 x10^3/uL
LAB-002671	Sun Nov 01, 2026 05:00 AM	platelets	223.0 x10^3/uL

Vitals (90)

Vitals
Row	When	Kind	Value	Detail
VIT-007629	Tue Oct 27, 2026 06:08 PM	spo2	96.0	room air
VIT-007630	Tue Oct 27, 2026 06:08 PM	rr	20.0
VIT-007659	Tue Oct 27, 2026 06:08 PM	temp_c	36.8
VIT-007660	Tue Oct 27, 2026 06:08 PM	hr	72.0
VIT-007661	Tue Oct 27, 2026 06:08 PM	map	77.0
VIT-007662	Tue Oct 27, 2026 06:08 PM	gcs	15.0
VIT-007631	Wed Oct 28, 2026 02:08 AM	spo2	97.0	room air
VIT-007632	Wed Oct 28, 2026 02:08 AM	rr	19.0
VIT-007663	Wed Oct 28, 2026 02:08 AM	temp_c	36.8
VIT-007664	Wed Oct 28, 2026 02:08 AM	hr	76.0
VIT-007665	Wed Oct 28, 2026 02:08 AM	map	91.0
VIT-007666	Wed Oct 28, 2026 02:08 AM	gcs	15.0
VIT-007633	Wed Oct 28, 2026 10:08 AM	spo2	98.0	room air
VIT-007634	Wed Oct 28, 2026 10:08 AM	rr	17.0
VIT-007667	Wed Oct 28, 2026 10:08 AM	temp_c	37.6
VIT-007668	Wed Oct 28, 2026 10:08 AM	hr	68.0
VIT-007669	Wed Oct 28, 2026 10:08 AM	map	91.0
VIT-007670	Wed Oct 28, 2026 10:08 AM	gcs	15.0
VIT-007635	Wed Oct 28, 2026 06:08 PM	spo2	99.0	room air
VIT-007636	Wed Oct 28, 2026 06:08 PM	rr	19.0
VIT-007671	Wed Oct 28, 2026 06:08 PM	temp_c	37.3
VIT-007672	Wed Oct 28, 2026 06:08 PM	hr	81.0
VIT-007673	Wed Oct 28, 2026 06:08 PM	map	87.0
VIT-007674	Wed Oct 28, 2026 06:08 PM	gcs	15.0
VIT-007637	Thu Oct 29, 2026 02:08 AM	spo2	97.0	room air
VIT-007638	Thu Oct 29, 2026 02:08 AM	rr	18.0
VIT-007675	Thu Oct 29, 2026 02:08 AM	temp_c	37.0
VIT-007676	Thu Oct 29, 2026 02:08 AM	hr	79.0
VIT-007677	Thu Oct 29, 2026 02:08 AM	map	83.0
VIT-007678	Thu Oct 29, 2026 02:08 AM	gcs	15.0
VIT-007639	Thu Oct 29, 2026 10:08 AM	spo2	98.0	room air
VIT-007640	Thu Oct 29, 2026 10:08 AM	rr	14.0
VIT-007679	Thu Oct 29, 2026 10:08 AM	temp_c	37.3
VIT-007680	Thu Oct 29, 2026 10:08 AM	hr	80.0
VIT-007681	Thu Oct 29, 2026 10:08 AM	map	91.0
VIT-007682	Thu Oct 29, 2026 10:08 AM	gcs	15.0
VIT-007641	Thu Oct 29, 2026 06:08 PM	spo2	99.0	room air
VIT-007642	Thu Oct 29, 2026 06:08 PM	rr	16.0
VIT-007683	Thu Oct 29, 2026 06:08 PM	temp_c	37.3
VIT-007684	Thu Oct 29, 2026 06:08 PM	hr	78.0
VIT-007685	Thu Oct 29, 2026 06:08 PM	map	76.0
VIT-007686	Thu Oct 29, 2026 06:08 PM	gcs	15.0
VIT-007643	Fri Oct 30, 2026 02:08 AM	spo2	97.0	room air
VIT-007644	Fri Oct 30, 2026 02:08 AM	rr	18.0
VIT-007687	Fri Oct 30, 2026 02:08 AM	temp_c	37.5
VIT-007688	Fri Oct 30, 2026 02:08 AM	hr	78.0
VIT-007689	Fri Oct 30, 2026 02:08 AM	map	87.0
VIT-007690	Fri Oct 30, 2026 02:08 AM	gcs	15.0
VIT-007645	Fri Oct 30, 2026 10:08 AM	spo2	95.0	room air
VIT-007646	Fri Oct 30, 2026 10:08 AM	rr	14.0
VIT-007691	Fri Oct 30, 2026 10:08 AM	temp_c	36.9
VIT-007692	Fri Oct 30, 2026 10:08 AM	hr	71.0
VIT-007693	Fri Oct 30, 2026 10:08 AM	map	90.0
VIT-007694	Fri Oct 30, 2026 10:08 AM	gcs	15.0
VIT-007647	Fri Oct 30, 2026 06:08 PM	spo2	94.0	room air
VIT-007648	Fri Oct 30, 2026 06:08 PM	rr	19.0
VIT-007695	Fri Oct 30, 2026 06:08 PM	temp_c	37.2
VIT-007696	Fri Oct 30, 2026 06:08 PM	hr	75.0
VIT-007697	Fri Oct 30, 2026 06:08 PM	map	81.0
VIT-007698	Fri Oct 30, 2026 06:08 PM	gcs	15.0
VIT-007649	Sat Oct 31, 2026 02:08 AM	spo2	98.0	room air
VIT-007650	Sat Oct 31, 2026 02:08 AM	rr	20.0
VIT-007699	Sat Oct 31, 2026 02:08 AM	temp_c	37.6
VIT-007700	Sat Oct 31, 2026 02:08 AM	hr	72.0
VIT-007701	Sat Oct 31, 2026 02:08 AM	map	84.0
VIT-007702	Sat Oct 31, 2026 02:08 AM	gcs	15.0
VIT-007651	Sat Oct 31, 2026 10:08 AM	spo2	95.0	room air
VIT-007652	Sat Oct 31, 2026 10:08 AM	rr	17.0
VIT-007703	Sat Oct 31, 2026 10:08 AM	temp_c	37.3
VIT-007704	Sat Oct 31, 2026 10:08 AM	hr	77.0
VIT-007705	Sat Oct 31, 2026 10:08 AM	map	75.0
VIT-007706	Sat Oct 31, 2026 10:08 AM	gcs	15.0
VIT-007653	Sat Oct 31, 2026 06:08 PM	spo2	99.0	room air
VIT-007654	Sat Oct 31, 2026 06:08 PM	rr	15.0
VIT-007707	Sat Oct 31, 2026 06:08 PM	temp_c	36.9
VIT-007708	Sat Oct 31, 2026 06:08 PM	hr	87.0
VIT-007709	Sat Oct 31, 2026 06:08 PM	map	78.0
VIT-007710	Sat Oct 31, 2026 06:08 PM	gcs	15.0
VIT-007655	Sun Nov 01, 2026 02:08 AM	spo2	98.0	room air
VIT-007656	Sun Nov 01, 2026 02:08 AM	rr	15.0
VIT-007711	Sun Nov 01, 2026 02:08 AM	temp_c	37.5
VIT-007712	Sun Nov 01, 2026 02:08 AM	hr	71.0
VIT-007713	Sun Nov 01, 2026 02:08 AM	map	88.0
VIT-007714	Sun Nov 01, 2026 02:08 AM	gcs	15.0
VIT-007657	Sun Nov 01, 2026 10:08 AM	spo2	94.0	room air
VIT-007658	Sun Nov 01, 2026 10:08 AM	rr	18.0
VIT-007715	Sun Nov 01, 2026 10:08 AM	temp_c	37.2
VIT-007716	Sun Nov 01, 2026 10:08 AM	hr	69.0
VIT-007717	Sun Nov 01, 2026 10:08 AM	map	91.0
VIT-007718	Sun Nov 01, 2026 10:08 AM	gcs	15.0

Medications, orders, echo, history (0)

Notes

History and physical · DOC-000268 · Dr. Greta Kowalczyk (resident) · Tue Oct 27, 2026 08:48 PM

Source document DOC-000268: History and physical (synthetic)

HISTORY AND PHYSICAL
Patient: Florian Upfield   MRN: MRN18554294   Admitted: 2026-10-27 17:48
Service: Pulmonology   Attending: Dr. Kenji Stavros

History of present illness: 76-year-old woman admitted with COPD exacerbation. 
Past medical history: GERD, hypertension.
Review of systems otherwise negative.
Exam: Lungs: clear to auscultation bilaterally.
Assessment and plan:
1. COPD exacerbation: bronchodilators and steroids.

Progress note · DOC-000269 · Dr. Greta Kowalczyk (resident) · Thu Oct 29, 2026 05:48 PM

Source document DOC-000269: Progress note (synthetic)

PROGRESS NOTE (Resident)
Patient: Florian Upfield   MRN: MRN18554294   Hospital day 3

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

Resident: Dr. Greta Kowalczyk   Attending cosign: completed

Discharge summary · DOC-000270 · Dr. Kenji Stavros (attending) · Sun Nov 01, 2026 03:49 PM

Source document DOC-000270: Discharge summary (synthetic)

DISCHARGE SUMMARY
Patient: Florian Upfield   MRN: MRN18554294
Admitted 2026-10-27; discharged 2026-11-01.

Discharge diagnoses:
- COPD exacerbation
- GERD
- hypertension

Disposition: home with follow-up.