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-00092: Pilar Kestrel

78M · MRN94511993 · Hospital Medicine · admitted Sat Oct 31, 2026 11:04 AM · discharged Sat Nov 07, 2026 11:56 AM · attending Dr. Cyrus Ellingham · 167 cm, 115.0 kg

Documented diagnoses (current)

Principal: “sepsis” · A41.9 Sepsis, unspecified organism
“community-acquired pneumonia” · J18.9 Pneumonia, unspecified organism
“class 3 obesity” · E66.813 Obesity, class 3
“type 2 diabetes” · E11.9 Type 2 diabetes mellitus without complications
“hyperlipidemia” · E78.5 Hyperlipidemia, unspecified

Illustrative grouping now: MS-DRG 871 Septicemia or severe sepsis without MV >96 hours with MCC. If every open specificity/validation gap were answered as the criteria suggest: MS-DRG 871.

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=1.051, t.ratio_s1=1.5, creat_rise_48h=0.17, 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=1.051, t.ratio_s3=3.0, creat_peak=2.67, 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=1.051, 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=0.17, 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=M, hgb_nadir=13.31, 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=0.4, t.drop_major=2.0, prbc_units=0, t.prbc_major=2	false
outcome: met	`bleeding_documented and anaemic and acute_fall`	bleeding_documented=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=0.4, t.drop_min=1.0, prbc_units=0	false
outcome: not_anaemic	`present(hgb_nadir) and not anaemic`	hgb_nadir=13.31, anaemic=False	true

Chronic kidney disease

Criteria met

Specificity gap

Criteria support Chronic kidney disease stage 4 (N18.4); no corresponding diagnosis is documented.

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=344, t.chronic_days=90	true
derived: staging_egfr	`max(egfr_early, egfr_late)`	egfr_early=21.8, egfr_late=25.2	25.2
derived: both_below_60	`egfr_early < t.g2 and egfr_late < t.g2`	egfr_early=21.8, t.g2=60, egfr_late=25.2	true
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=25.2, t.g2=60, t.g3a=45, t.g3b=30, t.g4=15	G4
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=True, egfr_early=21.8, egfr_late=25.2, t.g2=60	false
outcome: g1_g2	`staging_egfr >= t.g2`	staging_egfr=25.2, t.g2=60	false
outcome: g3a	`category == 'G3a'`	category=G4	false
outcome: g3b	`category == 'G3b'`	category=G4	false
outcome: g4	`category == 'G4'`	category=G4	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 met

No gap

Supported as documented (E66.813).

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=78, t.adult=20	false
outcome: class3	`bmi >= t.c3`	bmi=41.2, t.c3=40	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

Clinical judgement required

Clinical judgement required: Definition-dependent: 3 SIRS criteria (Sepsis-2 met) but SOFA change only 0 (Sepsis-3 not met).

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=39.2, t.t_hi=38, temp_min_48h=38.7, t.t_lo=36	true
derived: sirs_hr	`coalesce(hr_max_48h > t.hr, false)`	hr_max_48h=121.0, t.hr=90	true
derived: sirs_rr	`coalesce(rr_max_48h > t.rr, false) or coalesce(paco2_min_48h < t.paco2, false)`	rr_max_48h=18.0, t.rr=20, paco2_min_48h=unknown, t.paco2=32	false
derived: sirs_wbc	`coalesce(wbc_max_48h > t.wbc_hi, false) or coalesce(wbc_min_48h < t.wbc_lo, false) or coalesce(bands_max_48h > t.bands, false)`	wbc_max_48h=18.6, t.wbc_hi=12, wbc_min_48h=15.08, t.wbc_lo=4, bands_max_48h=unknown, t.bands=10	true
derived: sirs_count	`count(sirs_temp, sirs_hr, sirs_rr, sirs_wbc)`	sirs_temp=True, sirs_hr=True, sirs_rr=False, sirs_wbc=True	3
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=225.0	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=0.76	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=81.0	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=2.65	2
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=2.54	2
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=2, sofa_renal_baseline=2	0
derived: sepsis3	`infection_documented and sofa_delta >= t.sofa_delta`	infection_documented=True, sofa_delta=0, t.sofa_delta=2	false
derived: sepsis2	`infection_documented and sirs_count >= t.sirs_min`	infection_documented=True, sirs_count=3, t.sirs_min=2	true
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=True	false
outcome: sepsis3_only	`sepsis3`	sepsis3=False	false
outcome: definitions_disagree	`sepsis2`	sepsis2=True	true

Structured data

Labs (43)

Labs (pre-admission rows are outpatient values)
Row	When	Test	Value
LAB-003116	Sat Oct 11, 2025 09:15 AM	creatinine	2.86 mg/dL
LAB-003117	Sun Sep 20, 2026 10:05 AM	creatinine	2.54 mg/dL
LAB-003118	Sat Oct 31, 2026 12:04 PM	creatinine	2.65 mg/dL
LAB-003126	Sat Oct 31, 2026 12:04 PM	sodium	136.0 mmol/L
LAB-003134	Sat Oct 31, 2026 12:04 PM	hemoglobin	13.72 g/dL
LAB-003142	Sat Oct 31, 2026 12:04 PM	wbc	15.08 x10^3/uL
LAB-003143	Sat Oct 31, 2026 12:04 PM	platelets	251.0 x10^3/uL
LAB-003158	Sat Oct 31, 2026 12:04 PM	bilirubin	0.76 mg/dL
LAB-003119	Sun Nov 01, 2026 05:00 AM	creatinine	2.58 mg/dL
LAB-003127	Sun Nov 01, 2026 05:00 AM	sodium	139.0 mmol/L
LAB-003135	Sun Nov 01, 2026 05:00 AM	hemoglobin	13.5 g/dL
LAB-003144	Sun Nov 01, 2026 05:00 AM	wbc	17.28 x10^3/uL
LAB-003145	Sun Nov 01, 2026 05:00 AM	platelets	225.0 x10^3/uL
LAB-003120	Mon Nov 02, 2026 05:00 AM	creatinine	2.51 mg/dL
LAB-003128	Mon Nov 02, 2026 05:00 AM	sodium	138.0 mmol/L
LAB-003136	Mon Nov 02, 2026 05:00 AM	hemoglobin	13.31 g/dL
LAB-003146	Mon Nov 02, 2026 05:00 AM	wbc	18.6 x10^3/uL
LAB-003147	Mon Nov 02, 2026 05:00 AM	platelets	237.0 x10^3/uL
LAB-003121	Tue Nov 03, 2026 05:00 AM	creatinine	2.54 mg/dL
LAB-003129	Tue Nov 03, 2026 05:00 AM	sodium	140.0 mmol/L
LAB-003137	Tue Nov 03, 2026 05:00 AM	hemoglobin	13.56 g/dL
LAB-003148	Tue Nov 03, 2026 05:00 AM	wbc	9.45 x10^3/uL
LAB-003149	Tue Nov 03, 2026 05:00 AM	platelets	278.0 x10^3/uL
LAB-003122	Wed Nov 04, 2026 05:00 AM	creatinine	2.5 mg/dL
LAB-003130	Wed Nov 04, 2026 05:00 AM	sodium	140.0 mmol/L
LAB-003138	Wed Nov 04, 2026 05:00 AM	hemoglobin	13.71 g/dL
LAB-003150	Wed Nov 04, 2026 05:00 AM	wbc	6.11 x10^3/uL
LAB-003151	Wed Nov 04, 2026 05:00 AM	platelets	168.0 x10^3/uL
LAB-003123	Thu Nov 05, 2026 05:00 AM	creatinine	2.52 mg/dL
LAB-003131	Thu Nov 05, 2026 05:00 AM	sodium	137.0 mmol/L
LAB-003139	Thu Nov 05, 2026 05:00 AM	hemoglobin	13.61 g/dL
LAB-003152	Thu Nov 05, 2026 05:00 AM	wbc	9.14 x10^3/uL
LAB-003153	Thu Nov 05, 2026 05:00 AM	platelets	221.0 x10^3/uL
LAB-003124	Fri Nov 06, 2026 05:00 AM	creatinine	2.67 mg/dL
LAB-003132	Fri Nov 06, 2026 05:00 AM	sodium	139.0 mmol/L
LAB-003140	Fri Nov 06, 2026 05:00 AM	hemoglobin	13.82 g/dL
LAB-003154	Fri Nov 06, 2026 05:00 AM	wbc	10.01 x10^3/uL
LAB-003155	Fri Nov 06, 2026 05:00 AM	platelets	280.0 x10^3/uL
LAB-003125	Sat Nov 07, 2026 05:00 AM	creatinine	2.5 mg/dL
LAB-003133	Sat Nov 07, 2026 05:00 AM	sodium	141.0 mmol/L
LAB-003141	Sat Nov 07, 2026 05:00 AM	hemoglobin	13.47 g/dL
LAB-003156	Sat Nov 07, 2026 05:00 AM	wbc	6.98 x10^3/uL
LAB-003157	Sat Nov 07, 2026 05:00 AM	platelets	306.0 x10^3/uL

Vitals (132)

Vitals
Row	When	Kind	Value	Detail
VIT-008981	Sat Oct 31, 2026 11:24 AM	spo2	98.0	room air
VIT-008982	Sat Oct 31, 2026 11:24 AM	rr	18.0
VIT-009025	Sat Oct 31, 2026 11:24 AM	temp_c	38.9
VIT-009026	Sat Oct 31, 2026 11:24 AM	hr	103.0
VIT-009027	Sat Oct 31, 2026 11:24 AM	map	87.0
VIT-009028	Sat Oct 31, 2026 11:24 AM	gcs	15.0
VIT-008983	Sat Oct 31, 2026 07:24 PM	spo2	99.0	room air
VIT-008984	Sat Oct 31, 2026 07:24 PM	rr	15.0
VIT-009029	Sat Oct 31, 2026 07:24 PM	temp_c	39.1
VIT-009030	Sat Oct 31, 2026 07:24 PM	hr	116.0
VIT-009031	Sat Oct 31, 2026 07:24 PM	map	81.0
VIT-009032	Sat Oct 31, 2026 07:24 PM	gcs	15.0
VIT-008985	Sun Nov 01, 2026 03:24 AM	spo2	95.0	room air
VIT-008986	Sun Nov 01, 2026 03:24 AM	rr	15.0
VIT-009033	Sun Nov 01, 2026 03:24 AM	temp_c	38.9
VIT-009034	Sun Nov 01, 2026 03:24 AM	hr	120.0
VIT-009035	Sun Nov 01, 2026 03:24 AM	map	85.0
VIT-009036	Sun Nov 01, 2026 03:24 AM	gcs	15.0
VIT-008987	Sun Nov 01, 2026 11:24 AM	spo2	96.0	room air
VIT-008988	Sun Nov 01, 2026 11:24 AM	rr	16.0
VIT-009037	Sun Nov 01, 2026 11:24 AM	temp_c	39.2
VIT-009038	Sun Nov 01, 2026 11:24 AM	hr	114.0
VIT-009039	Sun Nov 01, 2026 11:24 AM	map	89.0
VIT-009040	Sun Nov 01, 2026 11:24 AM	gcs	15.0
VIT-008989	Sun Nov 01, 2026 07:24 PM	spo2	97.0	room air
VIT-008990	Sun Nov 01, 2026 07:24 PM	rr	14.0
VIT-009041	Sun Nov 01, 2026 07:24 PM	temp_c	38.7
VIT-009042	Sun Nov 01, 2026 07:24 PM	hr	121.0
VIT-009043	Sun Nov 01, 2026 07:24 PM	map	86.0
VIT-009044	Sun Nov 01, 2026 07:24 PM	gcs	15.0
VIT-008991	Mon Nov 02, 2026 03:24 AM	spo2	97.0	room air
VIT-008992	Mon Nov 02, 2026 03:24 AM	rr	15.0
VIT-009045	Mon Nov 02, 2026 03:24 AM	temp_c	39.1
VIT-009046	Mon Nov 02, 2026 03:24 AM	hr	102.0
VIT-009047	Mon Nov 02, 2026 03:24 AM	map	82.0
VIT-009048	Mon Nov 02, 2026 03:24 AM	gcs	15.0
VIT-008993	Mon Nov 02, 2026 11:24 AM	spo2	94.0	room air
VIT-008994	Mon Nov 02, 2026 11:24 AM	rr	14.0
VIT-009049	Mon Nov 02, 2026 11:24 AM	temp_c	36.8
VIT-009050	Mon Nov 02, 2026 11:24 AM	hr	81.0
VIT-009051	Mon Nov 02, 2026 11:24 AM	map	79.0
VIT-009052	Mon Nov 02, 2026 11:24 AM	gcs	15.0
VIT-008995	Mon Nov 02, 2026 07:24 PM	spo2	96.0	room air
VIT-008996	Mon Nov 02, 2026 07:24 PM	rr	20.0
VIT-009053	Mon Nov 02, 2026 07:24 PM	temp_c	37.5
VIT-009054	Mon Nov 02, 2026 07:24 PM	hr	87.0
VIT-009055	Mon Nov 02, 2026 07:24 PM	map	83.0
VIT-009056	Mon Nov 02, 2026 07:24 PM	gcs	15.0
VIT-008997	Tue Nov 03, 2026 03:24 AM	spo2	97.0	room air
VIT-008998	Tue Nov 03, 2026 03:24 AM	rr	18.0
VIT-009057	Tue Nov 03, 2026 03:24 AM	temp_c	37.1
VIT-009058	Tue Nov 03, 2026 03:24 AM	hr	77.0
VIT-009059	Tue Nov 03, 2026 03:24 AM	map	82.0
VIT-009060	Tue Nov 03, 2026 03:24 AM	gcs	15.0
VIT-008999	Tue Nov 03, 2026 11:24 AM	spo2	96.0	room air
VIT-009000	Tue Nov 03, 2026 11:24 AM	rr	14.0
VIT-009061	Tue Nov 03, 2026 11:24 AM	temp_c	37.2
VIT-009062	Tue Nov 03, 2026 11:24 AM	hr	83.0
VIT-009063	Tue Nov 03, 2026 11:24 AM	map	75.0
VIT-009064	Tue Nov 03, 2026 11:24 AM	gcs	15.0
VIT-009001	Tue Nov 03, 2026 07:24 PM	spo2	99.0	room air
VIT-009002	Tue Nov 03, 2026 07:24 PM	rr	18.0
VIT-009065	Tue Nov 03, 2026 07:24 PM	temp_c	37.3
VIT-009066	Tue Nov 03, 2026 07:24 PM	hr	92.0
VIT-009067	Tue Nov 03, 2026 07:24 PM	map	85.0
VIT-009068	Tue Nov 03, 2026 07:24 PM	gcs	15.0
VIT-009003	Wed Nov 04, 2026 03:24 AM	spo2	97.0	room air
VIT-009004	Wed Nov 04, 2026 03:24 AM	rr	14.0
VIT-009069	Wed Nov 04, 2026 03:24 AM	temp_c	37.4
VIT-009070	Wed Nov 04, 2026 03:24 AM	hr	74.0
VIT-009071	Wed Nov 04, 2026 03:24 AM	map	90.0
VIT-009072	Wed Nov 04, 2026 03:24 AM	gcs	15.0
VIT-009005	Wed Nov 04, 2026 11:24 AM	spo2	95.0	room air
VIT-009006	Wed Nov 04, 2026 11:24 AM	rr	19.0
VIT-009073	Wed Nov 04, 2026 11:24 AM	temp_c	36.6
VIT-009074	Wed Nov 04, 2026 11:24 AM	hr	69.0
VIT-009075	Wed Nov 04, 2026 11:24 AM	map	88.0
VIT-009076	Wed Nov 04, 2026 11:24 AM	gcs	15.0
VIT-009007	Wed Nov 04, 2026 07:24 PM	spo2	94.0	room air
VIT-009008	Wed Nov 04, 2026 07:24 PM	rr	17.0
VIT-009077	Wed Nov 04, 2026 07:24 PM	temp_c	37.0
VIT-009078	Wed Nov 04, 2026 07:24 PM	hr	81.0
VIT-009079	Wed Nov 04, 2026 07:24 PM	map	78.0
VIT-009080	Wed Nov 04, 2026 07:24 PM	gcs	15.0
VIT-009009	Thu Nov 05, 2026 03:24 AM	spo2	96.0	room air
VIT-009010	Thu Nov 05, 2026 03:24 AM	rr	17.0
VIT-009081	Thu Nov 05, 2026 03:24 AM	temp_c	36.8
VIT-009082	Thu Nov 05, 2026 03:24 AM	hr	80.0
VIT-009083	Thu Nov 05, 2026 03:24 AM	map	88.0
VIT-009084	Thu Nov 05, 2026 03:24 AM	gcs	15.0
VIT-009011	Thu Nov 05, 2026 11:24 AM	spo2	95.0	room air
VIT-009012	Thu Nov 05, 2026 11:24 AM	rr	20.0
VIT-009085	Thu Nov 05, 2026 11:24 AM	temp_c	36.6
VIT-009086	Thu Nov 05, 2026 11:24 AM	hr	81.0
VIT-009087	Thu Nov 05, 2026 11:24 AM	map	77.0
VIT-009088	Thu Nov 05, 2026 11:24 AM	gcs	15.0
VIT-009013	Thu Nov 05, 2026 07:24 PM	spo2	95.0	room air
VIT-009014	Thu Nov 05, 2026 07:24 PM	rr	20.0
VIT-009089	Thu Nov 05, 2026 07:24 PM	temp_c	36.8
VIT-009090	Thu Nov 05, 2026 07:24 PM	hr	73.0
VIT-009091	Thu Nov 05, 2026 07:24 PM	map	77.0
VIT-009092	Thu Nov 05, 2026 07:24 PM	gcs	15.0
VIT-009015	Fri Nov 06, 2026 03:24 AM	spo2	95.0	room air
VIT-009016	Fri Nov 06, 2026 03:24 AM	rr	17.0
VIT-009093	Fri Nov 06, 2026 03:24 AM	temp_c	36.7
VIT-009094	Fri Nov 06, 2026 03:24 AM	hr	78.0
VIT-009095	Fri Nov 06, 2026 03:24 AM	map	90.0
VIT-009096	Fri Nov 06, 2026 03:24 AM	gcs	15.0
VIT-009017	Fri Nov 06, 2026 11:24 AM	spo2	95.0	room air
VIT-009018	Fri Nov 06, 2026 11:24 AM	rr	14.0
VIT-009097	Fri Nov 06, 2026 11:24 AM	temp_c	36.6
VIT-009098	Fri Nov 06, 2026 11:24 AM	hr	85.0
VIT-009099	Fri Nov 06, 2026 11:24 AM	map	89.0
VIT-009100	Fri Nov 06, 2026 11:24 AM	gcs	15.0
VIT-009019	Fri Nov 06, 2026 07:24 PM	spo2	99.0	room air
VIT-009020	Fri Nov 06, 2026 07:24 PM	rr	16.0
VIT-009101	Fri Nov 06, 2026 07:24 PM	temp_c	36.6
VIT-009102	Fri Nov 06, 2026 07:24 PM	hr	92.0
VIT-009103	Fri Nov 06, 2026 07:24 PM	map	80.0
VIT-009104	Fri Nov 06, 2026 07:24 PM	gcs	15.0
VIT-009021	Sat Nov 07, 2026 03:24 AM	spo2	95.0	room air
VIT-009022	Sat Nov 07, 2026 03:24 AM	rr	17.0
VIT-009105	Sat Nov 07, 2026 03:24 AM	temp_c	36.9
VIT-009106	Sat Nov 07, 2026 03:24 AM	hr	87.0
VIT-009107	Sat Nov 07, 2026 03:24 AM	map	74.0
VIT-009108	Sat Nov 07, 2026 03:24 AM	gcs	15.0
VIT-009023	Sat Nov 07, 2026 11:24 AM	spo2	97.0	room air
VIT-009024	Sat Nov 07, 2026 11:24 AM	rr	15.0
VIT-009109	Sat Nov 07, 2026 11:24 AM	temp_c	37.5
VIT-009110	Sat Nov 07, 2026 11:24 AM	hr	91.0
VIT-009111	Sat Nov 07, 2026 11:24 AM	map	88.0
VIT-009112	Sat Nov 07, 2026 11:24 AM	gcs	15.0

Medications, orders, echo, history (4)

MED-000360 10-31 12:04 piperacillin-tazobactam per protocol IV
MED-000361 11-01 05:00 cefepime per protocol IV
MED-000362 11-02 05:00 ceftriaxone per protocol IV
ORD-000082 10-31 11:34 blood_culture: blood cultures x2

Notes

History and physical · DOC-000313 · Dr. Cyrus Ellingham (attending) · Sat Oct 31, 2026 02:04 PM

Cited facts from this note (1)

infection_source: left lower lobe pneumonia · cited p. 1, line 5 · confidence 0.85

Show source for infection_source

… 26-10-31 11:04 Service: Hospital Medicine Attending: Dr. Cyrus Ellingham History of present illness: 78-year-old man admitted with sepsis. Chest x-ray shows left lower lobe pneumonia; blood cultures drawn and ceftriaxone started. Past medical history: type 2 diabetes, hyperlipidemia. Review of systems otherwise negative. Exam: Lungs: clear …

Source document DOC-000313: History and physical (synthetic)

HISTORY AND PHYSICAL
Patient: Pilar Kestrel   MRN: MRN94511993   Admitted: 2026-10-31 11:04
Service: Hospital Medicine   Attending: Dr. Cyrus Ellingham

History of present illness: 78-year-old man admitted with sepsis. Chest x-ray shows left lower lobe pneumonia; blood cultures drawn and ceftriaxone started.
Past medical history: type 2 diabetes, hyperlipidemia.
Review of systems otherwise negative.
Exam: Lungs: clear to auscultation bilaterally.
Assessment and plan:
1. Sepsis: antibiotics, fluids.
2. Community-acquired pneumonia: antibiotics.

Progress note · DOC-000314 · Dr. Cyrus Ellingham (attending) · Mon Nov 02, 2026 12:04 PM

Source document DOC-000314: Progress note (synthetic)

PROGRESS NOTE (Attending)
Patient: Pilar Kestrel   MRN: MRN94511993   Hospital day 3

Subjective: resting, tolerating diet.
Objective: vitals and labs reviewed in the flowsheet.
Assessment and plan:
1. Sepsis: continue current management.
2. Class 3 obesity: counsel on weight.

Attending: Dr. Cyrus Ellingham

Discharge summary · DOC-000315 · Dr. Cyrus Ellingham (attending) · Sat Nov 07, 2026 11:56 AM

Source document DOC-000315: Discharge summary (synthetic)

DISCHARGE SUMMARY
Patient: Pilar Kestrel   MRN: MRN94511993
Admitted 2026-10-31; discharged 2026-11-07.

Discharge diagnoses:
- sepsis
- community-acquired pneumonia
- class 3 obesity
- type 2 diabetes
- hyperlipidemia

Disposition: home with follow-up.