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-00088: Farah Elsworth

71F · MRN89441163 · Hospital Medicine · admitted Sun Nov 01, 2026 03:43 PM · discharged Mon Nov 09, 2026 01:21 PM · attending Dr. Gideon Zeller · resident Dr. Greta Kowalczyk · 168 cm, 76.9 kg

Documented diagnoses (current)

Principal: “upper GI bleed” · K92.2 Gastrointestinal hemorrhage, unspecified
“heart failure” · I50.9 Heart failure, unspecified
“acute blood loss anemia” · D62 Acute posthemorrhagic anemia
“sacral pressure ulcer” · L89.159 Pressure ulcer of sacral region, unspecified stage
“GERD” · K21.9 Gastro-esophageal reflux disease without esophagitis
“hypertension” · I10 Essential (primary) hypertension

Illustrative grouping now: MS-DRG 378 GI hemorrhage with CC. If every open specificity/validation gap were answered as the criteria suggest: MS-DRG 377.

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=1.053, t.ratio_s1=1.5, creat_rise_48h=0.04, 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=1.053, t.ratio_s3=3.0, creat_peak=0.8, 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=1.053, 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=0.04, 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

Clinical judgement required

Clinical judgement required: Haemoglobin fell 1.4 g/dL without transfusion (between 1 and 2 g/dL).

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=9.51, 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=1.4, t.drop_major=2.0, prbc_units=0, t.prbc_major=2	false
outcome: met	`bleeding_documented and anaemic and acute_fall`	bleeding_documented=True, anaemic=True, acute_fall=False	false
outcome: anaemia_only	`anaemic and hgb_drop < t.drop_min and prbc_units == 0`	anaemic=True, hgb_drop=1.4, t.drop_min=1.0, prbc_units=0	false
outcome: not_anaemic	`present(hgb_nadir) and not anaemic`	hgb_nadir=9.51, anaemic=True	false
outcome: no_source	`anaemic and acute_fall`	anaemic=True, acute_fall=False	false
outcome: borderline	`anaemic`	anaemic=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=372, t.chronic_days=90	true
derived: staging_egfr	`max(egfr_early, egfr_late)`	egfr_early=82.4, egfr_late=83.7	83.7
derived: both_below_60	`egfr_early < t.g2 and egfr_late < t.g2`	egfr_early=82.4, t.g2=60, egfr_late=83.7	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=83.7, 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=82.4, egfr_late=83.7, t.g2=60	false
outcome: g1_g2	`staging_egfr >= t.g2`	staging_egfr=83.7, t.g2=60	true

Heart failure

Criteria met

Specificity gap

Documented “heart failure” (I50.9); 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=1711.0, 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=32.0, 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=32.0, 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=138.0, 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=138.0, t.low=135, na_low_count=0, t.repeat=2, na_treated=False	false
outcome: untreated	`na_min < t.low`	na_min=138.0, t.low=135	false
outcome: not_met	`na_min >= t.low`	na_min=138.0, 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=71, t.adult=20	false
outcome: class3	`bmi >= t.c3`	bmi=27.2, t.c3=40	false
outcome: class2	`bmi >= t.c2`	bmi=27.2, t.c2=35	false
outcome: class1	`bmi >= t.c1`	bmi=27.2, t.c1=30	false
outcome: not_met	`bmi < t.c1`	bmi=27.2, t.c1=30	true

Pressure injury

Criteria met

Specificity gap

Documented “sacral pressure ulcer” (L89.159); criteria support the more specific Pressure injury of sacral region, stage 4 (L89.154).

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=sacral	true
outcome: no_wound_note	`not present(wound_stage)`	wound_stage=4	false
outcome: other_site	`wound_site != 'sacral'`	wound_site=sacral	false
outcome: stage1	`sacral and wound_stage == '1'`	sacral=True, wound_stage=4	false
outcome: stage2	`sacral and wound_stage == '2'`	sacral=True, wound_stage=4	false
outcome: stage3	`sacral and wound_stage == '3'`	sacral=True, wound_stage=4	false
outcome: stage4	`sacral and wound_stage == '4'`	sacral=True, wound_stage=4	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=85.0, 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=85.0, 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=28.0, t.rr_distress=28, wob_increased=True, 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=37.5, t.t_hi=38, temp_min_48h=37.0, t.t_lo=36	false
derived: sirs_hr	`coalesce(hr_max_48h > t.hr, false)`	hr_max_48h=88.0, 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=28.0, 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=10.96, t.wbc_hi=12, wbc_min_48h=6.95, 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=186.0	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=78.0	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=0.79	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=0.76	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=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 (49)

Labs (pre-admission rows are outpatient values)
Row	When	Test	Value
LAB-002947	Mon Sep 22, 2025 09:15 AM	creatinine	0.77 mg/dL
LAB-002948	Tue Sep 29, 2026 10:05 AM	creatinine	0.76 mg/dL
LAB-002949	Sun Nov 01, 2026 04:43 PM	creatinine	0.77 mg/dL
LAB-002958	Sun Nov 01, 2026 04:43 PM	bnp	1711.0 pg/mL
LAB-002959	Sun Nov 01, 2026 04:43 PM	sodium	138.0 mmol/L
LAB-002968	Sun Nov 01, 2026 04:43 PM	hemoglobin	10.91 g/dL
LAB-002977	Sun Nov 01, 2026 04:43 PM	wbc	10.96 x10^3/uL
LAB-002978	Sun Nov 01, 2026 04:43 PM	platelets	267.0 x10^3/uL
LAB-002995	Sun Nov 01, 2026 04:43 PM	bilirubin	0.72 mg/dL
LAB-002950	Mon Nov 02, 2026 05:00 AM	creatinine	0.79 mg/dL
LAB-002960	Mon Nov 02, 2026 05:00 AM	sodium	138.0 mmol/L
LAB-002969	Mon Nov 02, 2026 05:00 AM	hemoglobin	10.11 g/dL
LAB-002979	Mon Nov 02, 2026 05:00 AM	wbc	10.34 x10^3/uL
LAB-002980	Mon Nov 02, 2026 05:00 AM	platelets	207.0 x10^3/uL
LAB-002951	Tue Nov 03, 2026 05:00 AM	creatinine	0.79 mg/dL
LAB-002961	Tue Nov 03, 2026 05:00 AM	sodium	142.0 mmol/L
LAB-002970	Tue Nov 03, 2026 05:00 AM	hemoglobin	9.51 g/dL
LAB-002981	Tue Nov 03, 2026 05:00 AM	wbc	6.95 x10^3/uL
LAB-002982	Tue Nov 03, 2026 05:00 AM	platelets	186.0 x10^3/uL
LAB-002952	Wed Nov 04, 2026 05:00 AM	creatinine	0.76 mg/dL
LAB-002962	Wed Nov 04, 2026 05:00 AM	sodium	138.0 mmol/L
LAB-002971	Wed Nov 04, 2026 05:00 AM	hemoglobin	9.61 g/dL
LAB-002983	Wed Nov 04, 2026 05:00 AM	wbc	7.33 x10^3/uL
LAB-002984	Wed Nov 04, 2026 05:00 AM	platelets	182.0 x10^3/uL
LAB-002953	Thu Nov 05, 2026 05:00 AM	creatinine	0.77 mg/dL
LAB-002963	Thu Nov 05, 2026 05:00 AM	sodium	142.0 mmol/L
LAB-002972	Thu Nov 05, 2026 05:00 AM	hemoglobin	9.71 g/dL
LAB-002985	Thu Nov 05, 2026 05:00 AM	wbc	6.68 x10^3/uL
LAB-002986	Thu Nov 05, 2026 05:00 AM	platelets	265.0 x10^3/uL
LAB-002954	Fri Nov 06, 2026 05:00 AM	creatinine	0.76 mg/dL
LAB-002964	Fri Nov 06, 2026 05:00 AM	sodium	140.0 mmol/L
LAB-002973	Fri Nov 06, 2026 05:00 AM	hemoglobin	9.71 g/dL
LAB-002987	Fri Nov 06, 2026 05:00 AM	wbc	10.88 x10^3/uL
LAB-002988	Fri Nov 06, 2026 05:00 AM	platelets	222.0 x10^3/uL
LAB-002955	Sat Nov 07, 2026 05:00 AM	creatinine	0.8 mg/dL
LAB-002965	Sat Nov 07, 2026 05:00 AM	sodium	142.0 mmol/L
LAB-002974	Sat Nov 07, 2026 05:00 AM	hemoglobin	9.71 g/dL
LAB-002989	Sat Nov 07, 2026 05:00 AM	wbc	6.97 x10^3/uL
LAB-002990	Sat Nov 07, 2026 05:00 AM	platelets	243.0 x10^3/uL
LAB-002956	Sun Nov 08, 2026 05:00 AM	creatinine	0.75 mg/dL
LAB-002966	Sun Nov 08, 2026 05:00 AM	sodium	142.0 mmol/L
LAB-002975	Sun Nov 08, 2026 05:00 AM	hemoglobin	9.71 g/dL
LAB-002991	Sun Nov 08, 2026 05:00 AM	wbc	7.37 x10^3/uL
LAB-002992	Sun Nov 08, 2026 05:00 AM	platelets	310.0 x10^3/uL
LAB-002957	Mon Nov 09, 2026 05:00 AM	creatinine	0.75 mg/dL
LAB-002967	Mon Nov 09, 2026 05:00 AM	sodium	140.0 mmol/L
LAB-002976	Mon Nov 09, 2026 05:00 AM	hemoglobin	9.71 g/dL
LAB-002993	Mon Nov 09, 2026 05:00 AM	wbc	9.34 x10^3/uL
LAB-002994	Mon Nov 09, 2026 05:00 AM	platelets	236.0 x10^3/uL

Vitals (168)

Vitals
Row	When	Kind	Value	Detail
VIT-008471	Sun Nov 01, 2026 04:03 PM	spo2	85.0	room air
VIT-008472	Sun Nov 01, 2026 04:03 PM	rr	28.0
VIT-008543	Sun Nov 01, 2026 04:03 PM	temp_c	37.0
VIT-008544	Sun Nov 01, 2026 04:03 PM	hr	76.0
VIT-008545	Sun Nov 01, 2026 04:03 PM	map	78.0
VIT-008546	Sun Nov 01, 2026 04:03 PM	gcs	15.0
VIT-008473	Sun Nov 01, 2026 04:13 PM	o2_lpm	4.0	nasal cannula
VIT-008474	Mon Nov 02, 2026 12:03 AM	spo2	94.0	nasal cannula
VIT-008475	Mon Nov 02, 2026 12:03 AM	rr	20.0
VIT-008476	Mon Nov 02, 2026 12:03 AM	o2_lpm	2.0	nasal cannula
VIT-008547	Mon Nov 02, 2026 12:03 AM	temp_c	37.4
VIT-008548	Mon Nov 02, 2026 12:03 AM	hr	80.0
VIT-008549	Mon Nov 02, 2026 12:03 AM	map	82.0
VIT-008550	Mon Nov 02, 2026 12:03 AM	gcs	15.0
VIT-008477	Mon Nov 02, 2026 08:03 AM	spo2	93.0	nasal cannula
VIT-008478	Mon Nov 02, 2026 08:03 AM	rr	23.0
VIT-008479	Mon Nov 02, 2026 08:03 AM	o2_lpm	4.0	nasal cannula
VIT-008551	Mon Nov 02, 2026 08:03 AM	temp_c	37.4
VIT-008552	Mon Nov 02, 2026 08:03 AM	hr	76.0
VIT-008553	Mon Nov 02, 2026 08:03 AM	map	82.0
VIT-008554	Mon Nov 02, 2026 08:03 AM	gcs	15.0
VIT-008480	Mon Nov 02, 2026 04:03 PM	spo2	93.0	nasal cannula
VIT-008481	Mon Nov 02, 2026 04:03 PM	rr	22.0
VIT-008482	Mon Nov 02, 2026 04:03 PM	o2_lpm	2.0	nasal cannula
VIT-008555	Mon Nov 02, 2026 04:03 PM	temp_c	37.1
VIT-008556	Mon Nov 02, 2026 04:03 PM	hr	71.0
VIT-008557	Mon Nov 02, 2026 04:03 PM	map	85.0
VIT-008558	Mon Nov 02, 2026 04:03 PM	gcs	15.0
VIT-008483	Tue Nov 03, 2026 12:03 AM	spo2	92.0	nasal cannula
VIT-008484	Tue Nov 03, 2026 12:03 AM	rr	23.0
VIT-008485	Tue Nov 03, 2026 12:03 AM	o2_lpm	3.0	nasal cannula
VIT-008559	Tue Nov 03, 2026 12:03 AM	temp_c	37.5
VIT-008560	Tue Nov 03, 2026 12:03 AM	hr	73.0
VIT-008561	Tue Nov 03, 2026 12:03 AM	map	88.0
VIT-008562	Tue Nov 03, 2026 12:03 AM	gcs	15.0
VIT-008486	Tue Nov 03, 2026 08:03 AM	spo2	92.0	nasal cannula
VIT-008487	Tue Nov 03, 2026 08:03 AM	rr	25.0
VIT-008488	Tue Nov 03, 2026 08:03 AM	o2_lpm	2.0	nasal cannula
VIT-008563	Tue Nov 03, 2026 08:03 AM	temp_c	37.1
VIT-008564	Tue Nov 03, 2026 08:03 AM	hr	88.0
VIT-008565	Tue Nov 03, 2026 08:03 AM	map	80.0
VIT-008566	Tue Nov 03, 2026 08:03 AM	gcs	15.0
VIT-008489	Tue Nov 03, 2026 04:03 PM	spo2	94.0	nasal cannula
VIT-008490	Tue Nov 03, 2026 04:03 PM	rr	21.0
VIT-008491	Tue Nov 03, 2026 04:03 PM	o2_lpm	4.0	nasal cannula
VIT-008567	Tue Nov 03, 2026 04:03 PM	temp_c	37.1
VIT-008568	Tue Nov 03, 2026 04:03 PM	hr	87.0
VIT-008569	Tue Nov 03, 2026 04:03 PM	map	77.0
VIT-008570	Tue Nov 03, 2026 04:03 PM	gcs	15.0
VIT-008492	Wed Nov 04, 2026 12:03 AM	spo2	91.0	nasal cannula
VIT-008493	Wed Nov 04, 2026 12:03 AM	rr	22.0
VIT-008494	Wed Nov 04, 2026 12:03 AM	o2_lpm	4.0	nasal cannula
VIT-008571	Wed Nov 04, 2026 12:03 AM	temp_c	36.9
VIT-008572	Wed Nov 04, 2026 12:03 AM	hr	91.0
VIT-008573	Wed Nov 04, 2026 12:03 AM	map	78.0
VIT-008574	Wed Nov 04, 2026 12:03 AM	gcs	15.0
VIT-008495	Wed Nov 04, 2026 08:03 AM	spo2	92.0	nasal cannula
VIT-008496	Wed Nov 04, 2026 08:03 AM	rr	25.0
VIT-008497	Wed Nov 04, 2026 08:03 AM	o2_lpm	2.0	nasal cannula
VIT-008575	Wed Nov 04, 2026 08:03 AM	temp_c	36.5
VIT-008576	Wed Nov 04, 2026 08:03 AM	hr	68.0
VIT-008577	Wed Nov 04, 2026 08:03 AM	map	79.0
VIT-008578	Wed Nov 04, 2026 08:03 AM	gcs	15.0
VIT-008498	Wed Nov 04, 2026 04:03 PM	spo2	94.0	nasal cannula
VIT-008499	Wed Nov 04, 2026 04:03 PM	rr	20.0
VIT-008500	Wed Nov 04, 2026 04:03 PM	o2_lpm	4.0	nasal cannula
VIT-008579	Wed Nov 04, 2026 04:03 PM	temp_c	36.7
VIT-008580	Wed Nov 04, 2026 04:03 PM	hr	78.0
VIT-008581	Wed Nov 04, 2026 04:03 PM	map	76.0
VIT-008582	Wed Nov 04, 2026 04:03 PM	gcs	15.0
VIT-008501	Thu Nov 05, 2026 12:03 AM	spo2	93.0	nasal cannula
VIT-008502	Thu Nov 05, 2026 12:03 AM	rr	21.0
VIT-008503	Thu Nov 05, 2026 12:03 AM	o2_lpm	3.0	nasal cannula
VIT-008583	Thu Nov 05, 2026 12:03 AM	temp_c	37.4
VIT-008584	Thu Nov 05, 2026 12:03 AM	hr	69.0
VIT-008585	Thu Nov 05, 2026 12:03 AM	map	83.0
VIT-008586	Thu Nov 05, 2026 12:03 AM	gcs	15.0
VIT-008504	Thu Nov 05, 2026 08:03 AM	spo2	92.0	nasal cannula
VIT-008505	Thu Nov 05, 2026 08:03 AM	rr	21.0
VIT-008506	Thu Nov 05, 2026 08:03 AM	o2_lpm	4.0	nasal cannula
VIT-008587	Thu Nov 05, 2026 08:03 AM	temp_c	37.4
VIT-008588	Thu Nov 05, 2026 08:03 AM	hr	90.0
VIT-008589	Thu Nov 05, 2026 08:03 AM	map	90.0
VIT-008590	Thu Nov 05, 2026 08:03 AM	gcs	15.0
VIT-008507	Thu Nov 05, 2026 04:03 PM	spo2	95.0	nasal cannula
VIT-008508	Thu Nov 05, 2026 04:03 PM	rr	20.0
VIT-008509	Thu Nov 05, 2026 04:03 PM	o2_lpm	4.0	nasal cannula
VIT-008591	Thu Nov 05, 2026 04:03 PM	temp_c	36.8
VIT-008592	Thu Nov 05, 2026 04:03 PM	hr	75.0
VIT-008593	Thu Nov 05, 2026 04:03 PM	map	85.0
VIT-008594	Thu Nov 05, 2026 04:03 PM	gcs	15.0
VIT-008510	Fri Nov 06, 2026 12:03 AM	spo2	95.0	nasal cannula
VIT-008511	Fri Nov 06, 2026 12:03 AM	rr	21.0
VIT-008512	Fri Nov 06, 2026 12:03 AM	o2_lpm	4.0	nasal cannula
VIT-008595	Fri Nov 06, 2026 12:03 AM	temp_c	36.6
VIT-008596	Fri Nov 06, 2026 12:03 AM	hr	92.0
VIT-008597	Fri Nov 06, 2026 12:03 AM	map	89.0
VIT-008598	Fri Nov 06, 2026 12:03 AM	gcs	15.0
VIT-008513	Fri Nov 06, 2026 08:03 AM	spo2	91.0	nasal cannula
VIT-008514	Fri Nov 06, 2026 08:03 AM	rr	26.0
VIT-008515	Fri Nov 06, 2026 08:03 AM	o2_lpm	3.0	nasal cannula
VIT-008599	Fri Nov 06, 2026 08:03 AM	temp_c	37.3
VIT-008600	Fri Nov 06, 2026 08:03 AM	hr	83.0
VIT-008601	Fri Nov 06, 2026 08:03 AM	map	74.0
VIT-008602	Fri Nov 06, 2026 08:03 AM	gcs	15.0
VIT-008516	Fri Nov 06, 2026 04:03 PM	spo2	95.0	nasal cannula
VIT-008517	Fri Nov 06, 2026 04:03 PM	rr	23.0
VIT-008518	Fri Nov 06, 2026 04:03 PM	o2_lpm	2.0	nasal cannula
VIT-008603	Fri Nov 06, 2026 04:03 PM	temp_c	37.2
VIT-008604	Fri Nov 06, 2026 04:03 PM	hr	86.0
VIT-008605	Fri Nov 06, 2026 04:03 PM	map	90.0
VIT-008606	Fri Nov 06, 2026 04:03 PM	gcs	15.0
VIT-008519	Sat Nov 07, 2026 12:03 AM	spo2	93.0	nasal cannula
VIT-008520	Sat Nov 07, 2026 12:03 AM	rr	23.0
VIT-008521	Sat Nov 07, 2026 12:03 AM	o2_lpm	3.0	nasal cannula
VIT-008607	Sat Nov 07, 2026 12:03 AM	temp_c	37.5
VIT-008608	Sat Nov 07, 2026 12:03 AM	hr	89.0
VIT-008609	Sat Nov 07, 2026 12:03 AM	map	90.0
VIT-008610	Sat Nov 07, 2026 12:03 AM	gcs	15.0
VIT-008522	Sat Nov 07, 2026 08:03 AM	spo2	92.0	nasal cannula
VIT-008523	Sat Nov 07, 2026 08:03 AM	rr	24.0
VIT-008524	Sat Nov 07, 2026 08:03 AM	o2_lpm	2.0	nasal cannula
VIT-008611	Sat Nov 07, 2026 08:03 AM	temp_c	37.3
VIT-008612	Sat Nov 07, 2026 08:03 AM	hr	72.0
VIT-008613	Sat Nov 07, 2026 08:03 AM	map	83.0
VIT-008614	Sat Nov 07, 2026 08:03 AM	gcs	15.0
VIT-008525	Sat Nov 07, 2026 04:03 PM	spo2	91.0	nasal cannula
VIT-008526	Sat Nov 07, 2026 04:03 PM	rr	23.0
VIT-008527	Sat Nov 07, 2026 04:03 PM	o2_lpm	4.0	nasal cannula
VIT-008615	Sat Nov 07, 2026 04:03 PM	temp_c	36.8
VIT-008616	Sat Nov 07, 2026 04:03 PM	hr	79.0
VIT-008617	Sat Nov 07, 2026 04:03 PM	map	84.0
VIT-008618	Sat Nov 07, 2026 04:03 PM	gcs	15.0
VIT-008528	Sun Nov 08, 2026 12:03 AM	spo2	93.0	nasal cannula
VIT-008529	Sun Nov 08, 2026 12:03 AM	rr	24.0
VIT-008530	Sun Nov 08, 2026 12:03 AM	o2_lpm	3.0	nasal cannula
VIT-008619	Sun Nov 08, 2026 12:03 AM	temp_c	36.9
VIT-008620	Sun Nov 08, 2026 12:03 AM	hr	90.0
VIT-008621	Sun Nov 08, 2026 12:03 AM	map	86.0
VIT-008622	Sun Nov 08, 2026 12:03 AM	gcs	15.0
VIT-008531	Sun Nov 08, 2026 08:03 AM	spo2	95.0	nasal cannula
VIT-008532	Sun Nov 08, 2026 08:03 AM	rr	24.0
VIT-008533	Sun Nov 08, 2026 08:03 AM	o2_lpm	3.0	nasal cannula
VIT-008623	Sun Nov 08, 2026 08:03 AM	temp_c	36.8
VIT-008624	Sun Nov 08, 2026 08:03 AM	hr	73.0
VIT-008625	Sun Nov 08, 2026 08:03 AM	map	79.0
VIT-008626	Sun Nov 08, 2026 08:03 AM	gcs	15.0
VIT-008534	Sun Nov 08, 2026 04:03 PM	spo2	93.0	nasal cannula
VIT-008535	Sun Nov 08, 2026 04:03 PM	rr	24.0
VIT-008536	Sun Nov 08, 2026 04:03 PM	o2_lpm	2.0	nasal cannula
VIT-008627	Sun Nov 08, 2026 04:03 PM	temp_c	36.7
VIT-008628	Sun Nov 08, 2026 04:03 PM	hr	84.0
VIT-008629	Sun Nov 08, 2026 04:03 PM	map	74.0
VIT-008630	Sun Nov 08, 2026 04:03 PM	gcs	15.0
VIT-008537	Mon Nov 09, 2026 12:03 AM	spo2	91.0	nasal cannula
VIT-008538	Mon Nov 09, 2026 12:03 AM	rr	23.0
VIT-008539	Mon Nov 09, 2026 12:03 AM	o2_lpm	2.0	nasal cannula
VIT-008631	Mon Nov 09, 2026 12:03 AM	temp_c	36.7
VIT-008632	Mon Nov 09, 2026 12:03 AM	hr	92.0
VIT-008633	Mon Nov 09, 2026 12:03 AM	map	83.0
VIT-008634	Mon Nov 09, 2026 12:03 AM	gcs	15.0
VIT-008540	Mon Nov 09, 2026 08:03 AM	spo2	94.0	nasal cannula
VIT-008541	Mon Nov 09, 2026 08:03 AM	rr	22.0
VIT-008542	Mon Nov 09, 2026 08:03 AM	o2_lpm	2.0	nasal cannula
VIT-008635	Mon Nov 09, 2026 08:03 AM	temp_c	36.9
VIT-008636	Mon Nov 09, 2026 08:03 AM	hr	70.0
VIT-008637	Mon Nov 09, 2026 08:03 AM	map	87.0
VIT-008638	Mon Nov 09, 2026 08:03 AM	gcs	15.0

Medications, orders, echo, history (8)

MED-000342 11-01 08:00 furosemide 40 mg IV
MED-000343 11-01 20:00 furosemide 40 mg IV
MED-000344 11-02 08:00 furosemide 40 mg IV
MED-000345 11-02 20:00 furosemide 40 mg IV
MED-000346 11-03 08:00 furosemide 40 mg IV
MED-000347 11-03 20:00 furosemide 40 mg IV
ECH-000041 2026-11-02 echo LVEF 32.0%
HX-000032 history: heart failure with reduced ejection fraction

Notes

History and physical · DOC-000299 · Dr. Greta Kowalczyk (resident) · Sun Nov 01, 2026 06:43 PM

Cited facts from this note (2)

bleeding_source: hematemesis · cited p. 1, line 5 · confidence 0.85

Show source for bleeding_source

… vice: Hospital Medicine Attending: Dr. Gideon Zeller History of present illness: 71-year-old woman admitted with upper GI bleed. Presented after two days of hematemesis; GI consulted for endoscopy. Past medical history: heart failure with reduced ejection fraction, GERD, hypertension. Review of systems otherwise negative. Exam …
work_of_breathing: increased · cited p. 1, line 8 · confidence 0.90

Show source for work_of_breathing

… ulted for endoscopy. Past medical history: heart failure with reduced ejection fraction, GERD, hypertension. Review of systems otherwise negative. Exam: Lungs: increased work of breathing with accessory muscle use. Assessment and plan: 1. Upper GI bleed: PPI, GI following.

Source document DOC-000299: History and physical (synthetic)

HISTORY AND PHYSICAL
Patient: Farah Elsworth   MRN: MRN89441163   Admitted: 2026-11-01 15:43
Service: Hospital Medicine   Attending: Dr. Gideon Zeller

History of present illness: 71-year-old woman admitted with upper GI bleed. Presented after two days of hematemesis; GI consulted for endoscopy.
Past medical history: heart failure with reduced ejection fraction, GERD, hypertension.
Review of systems otherwise negative.
Exam: Lungs: increased work of breathing with accessory muscle use.
Assessment and plan:
1. Upper GI bleed: PPI, GI following.

Wound care note · DOC-000298 · Ines Ingram, RN, CWOCN (wound_nurse) · Mon Nov 02, 2026 10:43 PM

Cited facts from this note (2)

wound_site: sacral · cited p. 1, line 4 · confidence 0.95

Show source for wound_site

WOUND CARE NOTE Patient: Farah Elsworth MRN: MRN89441163 Location: sacrum Stage: 4 (NPIAP) Description: full-thickness tissue loss with palpable bone. Size: 2.5 x 3.2 x 1.1 cm. Plan: offloading every 2 hours, foam dressing, nutrition …
wound_stage: 4 · cited p. 1, line 5 · confidence 0.95

Show source for wound_stage

WOUND CARE NOTE Patient: Farah Elsworth MRN: MRN89441163 Location: sacrum Stage: 4 (NPIAP) Description: full-thickness tissue loss with palpable bone. Size: 2.5 x 3.2 x 1.1 cm. Plan: offloading every 2 hours, foam dressing, nutrition consult.

Source document DOC-000298: Wound care note (synthetic)

WOUND CARE NOTE
Patient: Farah Elsworth   MRN: MRN89441163

Location: sacrum
Stage: 4 (NPIAP)
Description: full-thickness tissue loss with palpable bone.
Size: 2.5 x 3.2 x 1.1 cm.
Plan: offloading every 2 hours, foam dressing, nutrition consult.

Progress note · DOC-000300 · Dr. Greta Kowalczyk (resident) · Tue Nov 03, 2026 06:43 PM

Source document DOC-000300: Progress note (synthetic)

PROGRESS NOTE (Resident)
Patient: Farah Elsworth   MRN: MRN89441163   Hospital day 3

Subjective: resting, tolerating diet.
Objective: vitals and labs reviewed in the flowsheet.
Assessment and plan:
1. Upper GI bleed: continue current management.
2. Heart failure: diuresis and daily weights; monitor electrolytes.
3. Acute blood loss anemia: trend hemoglobin, transfuse if needed.
4. Sacral pressure ulcer: wound care following, offloading.

Resident: Dr. Greta Kowalczyk   Attending cosign: completed

Discharge summary · DOC-000301 · Dr. Gideon Zeller (attending) · Mon Nov 09, 2026 01:21 PM

Source document DOC-000301: Discharge summary (synthetic)

DISCHARGE SUMMARY
Patient: Farah Elsworth   MRN: MRN89441163
Admitted 2026-11-01; discharged 2026-11-09.

Discharge diagnoses:
- upper GI bleed
- heart failure
- acute blood loss anemia
- sacral pressure ulcer
- GERD
- hypertension

Disposition: home with follow-up.