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-00079: Viggo Elsworth

75F · MRN45688176 · Hospital Medicine · admitted Sat Oct 31, 2026 01:16 PM · discharged Fri Nov 06, 2026 04:29 PM · attending Dr. Odette Galloway · resident Dr. Camila Oyelaran · 160 cm, 52.5 kg

Documented diagnoses (current)

Principal: “community-acquired pneumonia” · J18.9 Pneumonia, unspecified organism
“malnutrition” · E46 Unspecified protein-calorie malnutrition
“acute renal insufficiency” · N28.9 Disorder of kidney and ureter, unspecified (renal insufficiency)
“hyponatremia” · E87.1 Hypo-osmolality and hyponatremia
“anemia” · D64.9 Anemia, unspecified

Illustrative grouping now: MS-DRG 194 Simple pneumonia and pleurisy with CC. If every open specificity/validation gap were answered as the criteria suggest: MS-DRG 193.

Queries and events

No queries yet.

All rules applied

Rule Criteria Finding Outcome

Acute kidney injury

Clinical judgement required

Clinical judgement required: AKI criteria met only against a presumed baseline (no pre-admission creatinine on file).

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=1.793, t.ratio_s1=1.5, creat_rise_48h=0.02, 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=1.793, t.ratio_s3=3.0, creat_peak=1.56, 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=1.793, 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=False, creat_rise_48h=0.02, t.rise_abs=0.3, rrt_started=False	false
outcome: aki_staged	`stage >= 1 and baseline_independent`	stage=1, baseline_independent=False	false
outcome: aki_presumed_baseline	`stage >= 1`	stage=1	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)
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=9.77, 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=0.3, 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=True, acute_fall=False	false
outcome: anaemia_only	`anaemic and hgb_drop < t.drop_min and prbc_units == 0`	anaemic=True, hgb_drop=0.3, t.drop_min=1.0, prbc_units=0	true

Chronic kidney disease

Insufficient data

No gap

Insufficient data: the criteria could not be applied.

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=0, egfr_span_days=unknown, t.chronic_days=90	false
derived: staging_egfr	`max(egfr_early, egfr_late)`	egfr_early=unknown, egfr_late=unknown	unknown
derived: both_below_60	`egfr_early < t.g2 and egfr_late < t.g2`	egfr_early=unknown, t.g2=60, egfr_late=unknown	unknown
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=unknown, t.g2=60, t.g3a=45, t.g3b=30, t.g4=15	unknown
outcome: duration_not_shown	`not chronic`	chronic=False	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 met

No gap

Supported as documented (E87.1).

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=125.0, t.profound=125, t.moderate=130, t.low=135	moderate
outcome: met	`na_min < t.low and na_low_count >= t.repeat and na_treated`	na_min=125.0, t.low=135, na_low_count=6, t.repeat=2, na_treated=True	true

Malnutrition

Criteria met

Specificity gap

Documented “malnutrition” (E46); criteria support the more specific Severe protein-calorie malnutrition (chronic illness context) (E43).

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=60.0, t.a_sev_intake_pct=50, intake_days=42.0, 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=60.0, t.a_mod_intake_pct=75, intake_days=42.0, t.a_mod_intake_days=7	true
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=180.0, wt_loss_pct=11.5	false
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=180.0, wt_loss_pct=11.5	false
derived: c_sev_intake	`intake_pct <= t.c_intake_pct and intake_days >= t.c_intake_days`	intake_pct=60.0, t.c_intake_pct=75, intake_days=42.0, t.c_intake_days=30	true
derived: c_mod_intake	`intake_pct < t.c_intake_pct and intake_days >= t.c_intake_days`	intake_pct=60.0, t.c_intake_pct=75, intake_days=42.0, t.c_intake_days=30	true
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=180.0, wt_loss_pct=11.5	true
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=180.0, wt_loss_pct=11.5	true
derived: n_assessed	`known(intake_pct, wt_loss_pct, fat_loss, muscle_loss, fluid, grip_reduced)`	intake_pct=60.0, wt_loss_pct=11.5, fat_loss=3, muscle_loss=2, fluid=0, grip_reduced=unknown	5
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=chronic, a_sev_intake=False, a_sev_wt=False, fat_loss=3, muscle_loss=2, fluid=0, grip_reduced=unknown, c_sev_intake=True, c_sev_wt=True	3
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=chronic, a_sev_intake=False, a_mod_intake=True, a_sev_wt=False, a_mod_wt=False, fat_loss=3, muscle_loss=2, fluid=0, grip_reduced=unknown, c_sev_intake=True, c_mod_intake=True, c_sev_wt=True, c_mod_wt=True	4
outcome: severe	`n_severe >= 2`	n_severe=3	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=75, t.adult=20	false
outcome: class3	`bmi >= t.c3`	bmi=20.5, t.c3=40	false
outcome: class2	`bmi >= t.c2`	bmi=20.5, t.c2=35	false
outcome: class1	`bmi >= t.c1`	bmi=20.5, t.c1=30	false
outcome: not_met	`bmi < t.c1`	bmi=20.5, 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=19.0, 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=37.5, 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=90.0, 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=8.75, t.wbc_hi=12, wbc_min_48h=7.54, 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=207.0	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=0.72	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=1.56	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=0.87	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=True, sofa_delta=1, t.sofa_delta=2	false
derived: sepsis2	`infection_documented and sirs_count >= t.sirs_min`	infection_documented=True, 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=True	false
outcome: septic_shock	`shock`	shock=False	false
outcome: both	`sepsis3 and sepsis2`	sepsis3=False, sepsis2=False	false
outcome: sepsis3_only	`sepsis3`	sepsis3=False	false
outcome: definitions_disagree	`sepsis2`	sepsis2=False	false
outcome: neither	`true`	—	true

Structured data

Labs (36)

Labs (pre-admission rows are outpatient values)
Row	When	Test	Value
LAB-002673	Sat Oct 31, 2026 02:16 PM	creatinine	1.56 mg/dL
LAB-002680	Sat Oct 31, 2026 02:16 PM	sodium	127.0 mmol/L
LAB-002687	Sat Oct 31, 2026 02:16 PM	hemoglobin	9.89 g/dL
LAB-002694	Sat Oct 31, 2026 02:16 PM	wbc	8.75 x10^3/uL
LAB-002695	Sat Oct 31, 2026 02:16 PM	platelets	207.0 x10^3/uL
LAB-002708	Sat Oct 31, 2026 02:16 PM	bilirubin	0.72 mg/dL
LAB-002674	Sun Nov 01, 2026 05:00 AM	creatinine	1.29 mg/dL
LAB-002681	Sun Nov 01, 2026 05:00 AM	sodium	125.0 mmol/L
LAB-002688	Sun Nov 01, 2026 05:00 AM	hemoglobin	9.93 g/dL
LAB-002696	Sun Nov 01, 2026 05:00 AM	wbc	7.54 x10^3/uL
LAB-002697	Sun Nov 01, 2026 05:00 AM	platelets	240.0 x10^3/uL
LAB-002675	Mon Nov 02, 2026 05:00 AM	creatinine	1.09 mg/dL
LAB-002682	Mon Nov 02, 2026 05:00 AM	sodium	126.0 mmol/L
LAB-002689	Mon Nov 02, 2026 05:00 AM	hemoglobin	10.0 g/dL
LAB-002698	Mon Nov 02, 2026 05:00 AM	wbc	7.66 x10^3/uL
LAB-002699	Mon Nov 02, 2026 05:00 AM	platelets	260.0 x10^3/uL
LAB-002676	Tue Nov 03, 2026 05:00 AM	creatinine	0.96 mg/dL
LAB-002683	Tue Nov 03, 2026 05:00 AM	sodium	129.0 mmol/L
LAB-002690	Tue Nov 03, 2026 05:00 AM	hemoglobin	10.08 g/dL
LAB-002700	Tue Nov 03, 2026 05:00 AM	wbc	6.77 x10^3/uL
LAB-002701	Tue Nov 03, 2026 05:00 AM	platelets	186.0 x10^3/uL
LAB-002677	Wed Nov 04, 2026 05:00 AM	creatinine	0.89 mg/dL
LAB-002684	Wed Nov 04, 2026 05:00 AM	sodium	131.0 mmol/L
LAB-002691	Wed Nov 04, 2026 05:00 AM	hemoglobin	9.89 g/dL
LAB-002702	Wed Nov 04, 2026 05:00 AM	wbc	5.91 x10^3/uL
LAB-002703	Wed Nov 04, 2026 05:00 AM	platelets	269.0 x10^3/uL
LAB-002678	Thu Nov 05, 2026 05:00 AM	creatinine	0.87 mg/dL
LAB-002685	Thu Nov 05, 2026 05:00 AM	sodium	134.0 mmol/L
LAB-002692	Thu Nov 05, 2026 05:00 AM	hemoglobin	10.01 g/dL
LAB-002704	Thu Nov 05, 2026 05:00 AM	wbc	9.48 x10^3/uL
LAB-002705	Thu Nov 05, 2026 05:00 AM	platelets	176.0 x10^3/uL
LAB-002679	Fri Nov 06, 2026 05:00 AM	creatinine	0.89 mg/dL
LAB-002686	Fri Nov 06, 2026 05:00 AM	sodium	136.0 mmol/L
LAB-002693	Fri Nov 06, 2026 05:00 AM	hemoglobin	9.77 g/dL
LAB-002706	Fri Nov 06, 2026 05:00 AM	wbc	5.72 x10^3/uL
LAB-002707	Fri Nov 06, 2026 05:00 AM	platelets	254.0 x10^3/uL

Vitals (114)

Vitals
Row	When	Kind	Value	Detail
VIT-007719	Sat Oct 31, 2026 01:36 PM	spo2	97.0	room air
VIT-007720	Sat Oct 31, 2026 01:36 PM	rr	19.0
VIT-007757	Sat Oct 31, 2026 01:36 PM	temp_c	37.1
VIT-007758	Sat Oct 31, 2026 01:36 PM	hr	85.0
VIT-007759	Sat Oct 31, 2026 01:36 PM	map	84.0
VIT-007760	Sat Oct 31, 2026 01:36 PM	gcs	15.0
VIT-007721	Sat Oct 31, 2026 09:36 PM	spo2	99.0	room air
VIT-007722	Sat Oct 31, 2026 09:36 PM	rr	16.0
VIT-007761	Sat Oct 31, 2026 09:36 PM	temp_c	37.5
VIT-007762	Sat Oct 31, 2026 09:36 PM	hr	90.0
VIT-007763	Sat Oct 31, 2026 09:36 PM	map	91.0
VIT-007764	Sat Oct 31, 2026 09:36 PM	gcs	15.0
VIT-007723	Sun Nov 01, 2026 05:36 AM	spo2	94.0	room air
VIT-007724	Sun Nov 01, 2026 05:36 AM	rr	14.0
VIT-007765	Sun Nov 01, 2026 05:36 AM	temp_c	37.1
VIT-007766	Sun Nov 01, 2026 05:36 AM	hr	71.0
VIT-007767	Sun Nov 01, 2026 05:36 AM	map	92.0
VIT-007768	Sun Nov 01, 2026 05:36 AM	gcs	15.0
VIT-007725	Sun Nov 01, 2026 01:36 PM	spo2	98.0	room air
VIT-007726	Sun Nov 01, 2026 01:36 PM	rr	16.0
VIT-007769	Sun Nov 01, 2026 01:36 PM	temp_c	36.8
VIT-007770	Sun Nov 01, 2026 01:36 PM	hr	70.0
VIT-007771	Sun Nov 01, 2026 01:36 PM	map	83.0
VIT-007772	Sun Nov 01, 2026 01:36 PM	gcs	15.0
VIT-007727	Sun Nov 01, 2026 09:36 PM	spo2	98.0	room air
VIT-007728	Sun Nov 01, 2026 09:36 PM	rr	19.0
VIT-007773	Sun Nov 01, 2026 09:36 PM	temp_c	37.1
VIT-007774	Sun Nov 01, 2026 09:36 PM	hr	89.0
VIT-007775	Sun Nov 01, 2026 09:36 PM	map	79.0
VIT-007776	Sun Nov 01, 2026 09:36 PM	gcs	15.0
VIT-007729	Mon Nov 02, 2026 05:36 AM	spo2	95.0	room air
VIT-007730	Mon Nov 02, 2026 05:36 AM	rr	14.0
VIT-007777	Mon Nov 02, 2026 05:36 AM	temp_c	37.5
VIT-007778	Mon Nov 02, 2026 05:36 AM	hr	69.0
VIT-007779	Mon Nov 02, 2026 05:36 AM	map	75.0
VIT-007780	Mon Nov 02, 2026 05:36 AM	gcs	15.0
VIT-007731	Mon Nov 02, 2026 01:36 PM	spo2	98.0	room air
VIT-007732	Mon Nov 02, 2026 01:36 PM	rr	16.0
VIT-007781	Mon Nov 02, 2026 01:36 PM	temp_c	36.9
VIT-007782	Mon Nov 02, 2026 01:36 PM	hr	84.0
VIT-007783	Mon Nov 02, 2026 01:36 PM	map	89.0
VIT-007784	Mon Nov 02, 2026 01:36 PM	gcs	15.0
VIT-007733	Mon Nov 02, 2026 09:36 PM	spo2	96.0	room air
VIT-007734	Mon Nov 02, 2026 09:36 PM	rr	18.0
VIT-007785	Mon Nov 02, 2026 09:36 PM	temp_c	37.0
VIT-007786	Mon Nov 02, 2026 09:36 PM	hr	71.0
VIT-007787	Mon Nov 02, 2026 09:36 PM	map	83.0
VIT-007788	Mon Nov 02, 2026 09:36 PM	gcs	15.0
VIT-007735	Tue Nov 03, 2026 05:36 AM	spo2	98.0	room air
VIT-007736	Tue Nov 03, 2026 05:36 AM	rr	15.0
VIT-007789	Tue Nov 03, 2026 05:36 AM	temp_c	36.5
VIT-007790	Tue Nov 03, 2026 05:36 AM	hr	91.0
VIT-007791	Tue Nov 03, 2026 05:36 AM	map	81.0
VIT-007792	Tue Nov 03, 2026 05:36 AM	gcs	15.0
VIT-007737	Tue Nov 03, 2026 01:36 PM	spo2	98.0	room air
VIT-007738	Tue Nov 03, 2026 01:36 PM	rr	15.0
VIT-007793	Tue Nov 03, 2026 01:36 PM	temp_c	37.1
VIT-007794	Tue Nov 03, 2026 01:36 PM	hr	78.0
VIT-007795	Tue Nov 03, 2026 01:36 PM	map	80.0
VIT-007796	Tue Nov 03, 2026 01:36 PM	gcs	15.0
VIT-007739	Tue Nov 03, 2026 09:36 PM	spo2	96.0	room air
VIT-007740	Tue Nov 03, 2026 09:36 PM	rr	18.0
VIT-007797	Tue Nov 03, 2026 09:36 PM	temp_c	37.4
VIT-007798	Tue Nov 03, 2026 09:36 PM	hr	77.0
VIT-007799	Tue Nov 03, 2026 09:36 PM	map	84.0
VIT-007800	Tue Nov 03, 2026 09:36 PM	gcs	15.0
VIT-007741	Wed Nov 04, 2026 05:36 AM	spo2	98.0	room air
VIT-007742	Wed Nov 04, 2026 05:36 AM	rr	19.0
VIT-007801	Wed Nov 04, 2026 05:36 AM	temp_c	36.7
VIT-007802	Wed Nov 04, 2026 05:36 AM	hr	91.0
VIT-007803	Wed Nov 04, 2026 05:36 AM	map	85.0
VIT-007804	Wed Nov 04, 2026 05:36 AM	gcs	15.0
VIT-007743	Wed Nov 04, 2026 01:36 PM	spo2	98.0	room air
VIT-007744	Wed Nov 04, 2026 01:36 PM	rr	19.0
VIT-007805	Wed Nov 04, 2026 01:36 PM	temp_c	37.6
VIT-007806	Wed Nov 04, 2026 01:36 PM	hr	92.0
VIT-007807	Wed Nov 04, 2026 01:36 PM	map	85.0
VIT-007808	Wed Nov 04, 2026 01:36 PM	gcs	15.0
VIT-007745	Wed Nov 04, 2026 09:36 PM	spo2	96.0	room air
VIT-007746	Wed Nov 04, 2026 09:36 PM	rr	14.0
VIT-007809	Wed Nov 04, 2026 09:36 PM	temp_c	36.7
VIT-007810	Wed Nov 04, 2026 09:36 PM	hr	89.0
VIT-007811	Wed Nov 04, 2026 09:36 PM	map	78.0
VIT-007812	Wed Nov 04, 2026 09:36 PM	gcs	15.0
VIT-007747	Thu Nov 05, 2026 05:36 AM	spo2	97.0	room air
VIT-007748	Thu Nov 05, 2026 05:36 AM	rr	17.0
VIT-007813	Thu Nov 05, 2026 05:36 AM	temp_c	36.6
VIT-007814	Thu Nov 05, 2026 05:36 AM	hr	73.0
VIT-007815	Thu Nov 05, 2026 05:36 AM	map	76.0
VIT-007816	Thu Nov 05, 2026 05:36 AM	gcs	15.0
VIT-007749	Thu Nov 05, 2026 01:36 PM	spo2	98.0	room air
VIT-007750	Thu Nov 05, 2026 01:36 PM	rr	18.0
VIT-007817	Thu Nov 05, 2026 01:36 PM	temp_c	36.6
VIT-007818	Thu Nov 05, 2026 01:36 PM	hr	76.0
VIT-007819	Thu Nov 05, 2026 01:36 PM	map	79.0
VIT-007820	Thu Nov 05, 2026 01:36 PM	gcs	15.0
VIT-007751	Thu Nov 05, 2026 09:36 PM	spo2	96.0	room air
VIT-007752	Thu Nov 05, 2026 09:36 PM	rr	19.0
VIT-007821	Thu Nov 05, 2026 09:36 PM	temp_c	37.5
VIT-007822	Thu Nov 05, 2026 09:36 PM	hr	77.0
VIT-007823	Thu Nov 05, 2026 09:36 PM	map	82.0
VIT-007824	Thu Nov 05, 2026 09:36 PM	gcs	15.0
VIT-007753	Fri Nov 06, 2026 05:36 AM	spo2	95.0	room air
VIT-007754	Fri Nov 06, 2026 05:36 AM	rr	18.0
VIT-007825	Fri Nov 06, 2026 05:36 AM	temp_c	37.5
VIT-007826	Fri Nov 06, 2026 05:36 AM	hr	71.0
VIT-007827	Fri Nov 06, 2026 05:36 AM	map	87.0
VIT-007828	Fri Nov 06, 2026 05:36 AM	gcs	15.0
VIT-007755	Fri Nov 06, 2026 01:36 PM	spo2	99.0	room air
VIT-007756	Fri Nov 06, 2026 01:36 PM	rr	15.0
VIT-007829	Fri Nov 06, 2026 01:36 PM	temp_c	36.8
VIT-007830	Fri Nov 06, 2026 01:36 PM	hr	75.0
VIT-007831	Fri Nov 06, 2026 01:36 PM	map	85.0
VIT-007832	Fri Nov 06, 2026 01:36 PM	gcs	15.0

Medications, orders, echo, history (5)

MED-000300 10-31 14:16 piperacillin-tazobactam per protocol IV
MED-000301 11-01 05:00 piperacillin-tazobactam per protocol IV
MED-000302 11-02 05:00 piperacillin-tazobactam per protocol IV
ORD-000068 10-31 13:46 blood_culture: blood cultures x2
ORD-000069 10-31 16:16 fluid_restriction: fluid restriction 1.2 L/day

Notes

History and physical · DOC-000272 · Dr. Camila Oyelaran (resident) · Sat Oct 31, 2026 04:16 PM

Cited facts from this note (1)

infection_source: multifocal pneumonia · cited p. 1, line 5 · confidence 0.85

Show source for infection_source

… Hospital Medicine Attending: Dr. Odette Galloway History of present illness: 75-year-old woman admitted with community-acquired pneumonia. Chest x-ray shows multifocal pneumonia; blood cultures drawn and ceftriaxone started. Past medical history: none significant. Review of systems otherwise negative. Exam: Lungs: scattered crackles at …

Source document DOC-000272: History and physical (synthetic)

HISTORY AND PHYSICAL
Patient: Viggo Elsworth   MRN: MRN45688176   Admitted: 2026-10-31 13:16
Service: Hospital Medicine   Attending: Dr. Odette Galloway

History of present illness: 75-year-old woman admitted with community-acquired pneumonia. Chest x-ray shows multifocal pneumonia; blood cultures drawn and ceftriaxone started.
Past medical history: none significant.
Review of systems otherwise negative.
Exam: Lungs: scattered crackles at the bases, no distress.
Assessment and plan:
1. Community-acquired pneumonia: antibiotics.

Nutrition assessment · DOC-000271 · Viggo Ravensworth, RD (dietitian) · Sun Nov 01, 2026 07:16 PM

Cited facts from this note (8)

fat_loss: severe · cited p. 1, line 7 · confidence 0.90

Show source for fat_loss

… xt: chronic illness Intake: estimated energy intake 60% of needs for 42 days. Weight history: 11.5% weight loss over 180 days. Nutrition-focused physical exam: severe loss of subcutaneous fat; moderate muscle wasting; no fluid accumulation. Recommendations: high-protein oral supplement; calorie counts; weekly weights.
fluid_accumulation: none · cited p. 1, line 7 · confidence 0.90

Show source for fluid_accumulation

… needs for 42 days. Weight history: 11.5% weight loss over 180 days. Nutrition-focused physical exam: severe loss of subcutaneous fat; moderate muscle wasting; no fluid accumulation. Recommendations: high-protein oral supplement; calorie counts; weekly weights.
intake_days: 42 · cited p. 1, line 5 · confidence 0.95

Show source for intake_days

NUTRITION ASSESSMENT (Registered Dietitian) Patient: Viggo Elsworth MRN: MRN45688176 Context: chronic illness Intake: estimated energy intake 60% of needs for 42 days. Weight history: 11.5% weight loss over 180 days. Nutrition-focused physical exam: severe loss of subcutaneous fat; moderate muscle wasting; no fluid accumulat …
intake_pct: 60 · cited p. 1, line 5 · confidence 0.95

Show source for intake_pct

NUTRITION ASSESSMENT (Registered Dietitian) Patient: Viggo Elsworth MRN: MRN45688176 Context: chronic illness Intake: estimated energy intake 60% of needs for 42 days. Weight history: 11.5% weight loss over 180 days. Nutrition-focused physical exam: severe loss of subcutaneous fat; moderate muscle wasting; no fluid accumulat …
muscle_loss: moderate · cited p. 1, line 7 · confidence 0.90

Show source for muscle_loss

… ated energy intake 60% of needs for 42 days. Weight history: 11.5% weight loss over 180 days. Nutrition-focused physical exam: severe loss of subcutaneous fat; moderate muscle wasting; no fluid accumulation. Recommendations: high-protein oral supplement; calorie counts; weekly weights.
nutrition_context: chronic · cited p. 1, line 4 · confidence 0.95

Show source for nutrition_context

NUTRITION ASSESSMENT (Registered Dietitian) Patient: Viggo Elsworth MRN: MRN45688176 Context: chronic illness Intake: estimated energy intake 60% of needs for 42 days. Weight history: 11.5% weight loss over 180 days. Nutrition-focused physical exam: severe loss of subc …
weight_loss_days: 180 · cited p. 1, line 6 · confidence 0.95

Show source for weight_loss_days

… tered Dietitian) Patient: Viggo Elsworth MRN: MRN45688176 Context: chronic illness Intake: estimated energy intake 60% of needs for 42 days. Weight history: 11.5% weight loss over 180 days. Nutrition-focused physical exam: severe loss of subcutaneous fat; moderate muscle wasting; no fluid accumulation. Recommendations: high-protein oral supplemen …
weight_loss_pct: 11.5 · cited p. 1, line 6 · confidence 0.95

Show source for weight_loss_pct

… tered Dietitian) Patient: Viggo Elsworth MRN: MRN45688176 Context: chronic illness Intake: estimated energy intake 60% of needs for 42 days. Weight history: 11.5% weight loss over 180 days. Nutrition-focused physical exam: severe loss of subcutaneous fat; moderate muscle wasting; no fluid accumulation. Recommendations: high-protein oral supplemen …

Source document DOC-000271: Nutrition assessment (synthetic)

NUTRITION ASSESSMENT (Registered Dietitian)
Patient: Viggo Elsworth   MRN: MRN45688176

Context: chronic illness
Intake: estimated energy intake 60% of needs for 42 days.
Weight history: 11.5% weight loss over 180 days.
Nutrition-focused physical exam: severe loss of subcutaneous fat; moderate muscle wasting; no fluid accumulation.
Recommendations: high-protein oral supplement; calorie counts; weekly weights.

Progress note · DOC-000273 · Dr. Camila Oyelaran (resident) · Mon Nov 02, 2026 01:16 PM

Source document DOC-000273: Progress note (synthetic)

PROGRESS NOTE (Resident)
Patient: Viggo Elsworth   MRN: MRN45688176   Hospital day 3

Subjective: resting, tolerating diet.
Objective: vitals and labs reviewed in the flowsheet.
Assessment and plan:
1. Community-acquired pneumonia: continue current management.
2. Malnutrition: dietitian following.
3. Acute renal insufficiency: trend creatinine, avoid nephrotoxins.
4. Hyponatremia: trend sodium.
5. Anemia: trend hemoglobin.

Resident: Dr. Camila Oyelaran   Attending cosign: completed

Discharge summary · DOC-000274 · Dr. Odette Galloway (attending) · Fri Nov 06, 2026 04:29 PM

Source document DOC-000274: Discharge summary (synthetic)

DISCHARGE SUMMARY
Patient: Viggo Elsworth   MRN: MRN45688176
Admitted 2026-10-31; discharged 2026-11-06.

Discharge diagnoses:
- community-acquired pneumonia
- malnutrition
- acute renal insufficiency
- hyponatremia
- anemia

Disposition: home with follow-up.