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-00093: Dario Fairbanks

65M · MRN23869043 · Hospital Medicine · admitted Tue Nov 03, 2026 08:42 AM · discharged Fri Nov 06, 2026 01:36 PM · attending Dr. Cyrus Ellingham · resident Dr. Greta Kowalczyk · 161 cm, 80.8 kg

Documented diagnoses (current)

Principal: “urinary tract infection” · N39.0 Urinary tract infection, site not specified
“CKD” · N18.9 Chronic kidney disease, unspecified
“heart failure” · I50.9 Heart failure, unspecified
“type 2 diabetes” · E11.9 Type 2 diabetes mellitus without complications
“hyperlipidemia” · E78.5 Hyperlipidemia, unspecified

Illustrative grouping now: MS-DRG 690 Kidney and urinary tract infections without MCC. If every open specificity/validation gap were answered as the criteria suggest: MS-DRG 690.

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=1.045, t.ratio_s1=1.5, creat_rise_48h=0.12, 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=1.045, t.ratio_s3=3.0, creat_peak=2.79, 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=1.045, 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=0.12, 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=13.81, 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=13.81, anaemic=False	true

Chronic kidney disease

Criteria met

Specificity gap

Documented “CKD” (N18.9); criteria support the more specific Chronic kidney disease stage 4 (N18.4).

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=314, t.chronic_days=90	true
derived: staging_egfr	`max(egfr_early, egfr_late)`	egfr_early=25.5, egfr_late=25.7	25.7
derived: both_below_60	`egfr_early < t.g2 and egfr_late < t.g2`	egfr_early=25.5, t.g2=60, egfr_late=25.7	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=25.7, 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=25.5, egfr_late=25.7, t.g2=60	false
outcome: g1_g2	`staging_egfr >= t.g2`	staging_egfr=25.7, 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

Clinical judgement required

Clinical judgement required: Only one acute indicator; acuity needs clinical judgement.

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=69.0, t.bnp=100, ntprobnp_max=unknown, t.ntprobnp=300	false
derived: acute_count	`count(iv_loop_diuretic, np_elevated, new_o2)`	iv_loop_diuretic=True, np_elevated=False, new_o2=False	1
derived: hf_type	`case(lvef <= t.ref, 'systolic', lvef >= t.pres, 'diastolic', 'midrange')`	lvef=60.0, t.ref=40, t.pres=50	diastolic
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=60.0, 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=1, hf_history=True	unknown
outcome: improved_ef	`improved`	improved=False	false
outcome: midrange	`hf_type == 'midrange'`	hf_type=diastolic	false
outcome: sys_aoc	`hf_type == 'systolic' and acuity == 'acute on chronic'`	hf_type=diastolic, acuity=unknown	false
outcome: sys_acute	`hf_type == 'systolic' and acuity == 'acute'`	hf_type=diastolic, acuity=unknown	false
outcome: sys_chronic	`hf_type == 'systolic' and acuity == 'chronic'`	hf_type=diastolic, acuity=unknown	false
outcome: dia_aoc	`hf_type == 'diastolic' and acuity == 'acute on chronic'`	hf_type=diastolic, acuity=unknown	unknown
outcome: dia_acute	`hf_type == 'diastolic' and acuity == 'acute'`	hf_type=diastolic, acuity=unknown	unknown
outcome: dia_chronic	`hf_type == 'diastolic' and acuity == 'chronic'`	hf_type=diastolic, acuity=unknown	unknown
outcome: one_indicator	`acute_count == 1`	acute_count=1	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=139.0, 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=139.0, t.low=135, na_low_count=0, t.repeat=2, na_treated=False	false
outcome: untreated	`na_min < t.low`	na_min=139.0, t.low=135	false
outcome: not_met	`na_min >= t.low`	na_min=139.0, 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

Specificity gap

Criteria support Obesity, class 1 (E66.811); no corresponding diagnosis is documented.

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=65, t.adult=20	false
outcome: class3	`bmi >= t.c3`	bmi=31.2, t.c3=40	false
outcome: class2	`bmi >= t.c2`	bmi=31.2, t.c2=35	false
outcome: class1	`bmi >= t.c1`	bmi=31.2, 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=37.5, t.t_hi=38, temp_min_48h=36.5, 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=8.39, t.wbc_hi=12, wbc_min_48h=5.97, 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=228.0	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=0.62	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=2.75	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=2.67	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=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 (24)

Labs (pre-admission rows are outpatient values)
Row	When	Test	Value
LAB-003159	Wed Oct 01, 2025 09:15 AM	creatinine	2.69 mg/dL
LAB-003160	Tue Aug 11, 2026 10:05 AM	creatinine	2.67 mg/dL
LAB-003161	Tue Nov 03, 2026 09:42 AM	creatinine	2.63 mg/dL
LAB-003165	Tue Nov 03, 2026 09:42 AM	bnp	69.0 pg/mL
LAB-003166	Tue Nov 03, 2026 09:42 AM	sodium	139.0 mmol/L
LAB-003170	Tue Nov 03, 2026 09:42 AM	hemoglobin	14.12 g/dL
LAB-003174	Tue Nov 03, 2026 09:42 AM	wbc	8.39 x10^3/uL
LAB-003175	Tue Nov 03, 2026 09:42 AM	platelets	238.0 x10^3/uL
LAB-003182	Tue Nov 03, 2026 09:42 AM	bilirubin	0.62 mg/dL
LAB-003162	Wed Nov 04, 2026 05:00 AM	creatinine	2.68 mg/dL
LAB-003167	Wed Nov 04, 2026 05:00 AM	sodium	140.0 mmol/L
LAB-003171	Wed Nov 04, 2026 05:00 AM	hemoglobin	13.96 g/dL
LAB-003176	Wed Nov 04, 2026 05:00 AM	wbc	5.97 x10^3/uL
LAB-003177	Wed Nov 04, 2026 05:00 AM	platelets	285.0 x10^3/uL
LAB-003163	Thu Nov 05, 2026 05:00 AM	creatinine	2.75 mg/dL
LAB-003168	Thu Nov 05, 2026 05:00 AM	sodium	139.0 mmol/L
LAB-003172	Thu Nov 05, 2026 05:00 AM	hemoglobin	13.81 g/dL
LAB-003178	Thu Nov 05, 2026 05:00 AM	wbc	7.65 x10^3/uL
LAB-003179	Thu Nov 05, 2026 05:00 AM	platelets	228.0 x10^3/uL
LAB-003164	Fri Nov 06, 2026 05:00 AM	creatinine	2.79 mg/dL
LAB-003169	Fri Nov 06, 2026 05:00 AM	sodium	140.0 mmol/L
LAB-003173	Fri Nov 06, 2026 05:00 AM	hemoglobin	13.98 g/dL
LAB-003180	Fri Nov 06, 2026 05:00 AM	wbc	10.1 x10^3/uL
LAB-003181	Fri Nov 06, 2026 05:00 AM	platelets	297.0 x10^3/uL

Vitals (60)

Vitals
Row	When	Kind	Value	Detail
VIT-009113	Tue Nov 03, 2026 09:02 AM	spo2	98.0	room air
VIT-009114	Tue Nov 03, 2026 09:02 AM	rr	18.0
VIT-009133	Tue Nov 03, 2026 09:02 AM	temp_c	36.8
VIT-009134	Tue Nov 03, 2026 09:02 AM	hr	87.0
VIT-009135	Tue Nov 03, 2026 09:02 AM	map	82.0
VIT-009136	Tue Nov 03, 2026 09:02 AM	gcs	15.0
VIT-009115	Tue Nov 03, 2026 05:02 PM	spo2	94.0	room air
VIT-009116	Tue Nov 03, 2026 05:02 PM	rr	15.0
VIT-009137	Tue Nov 03, 2026 05:02 PM	temp_c	37.0
VIT-009138	Tue Nov 03, 2026 05:02 PM	hr	90.0
VIT-009139	Tue Nov 03, 2026 05:02 PM	map	77.0
VIT-009140	Tue Nov 03, 2026 05:02 PM	gcs	15.0
VIT-009117	Wed Nov 04, 2026 01:02 AM	spo2	98.0	room air
VIT-009118	Wed Nov 04, 2026 01:02 AM	rr	19.0
VIT-009141	Wed Nov 04, 2026 01:02 AM	temp_c	36.5
VIT-009142	Wed Nov 04, 2026 01:02 AM	hr	88.0
VIT-009143	Wed Nov 04, 2026 01:02 AM	map	78.0
VIT-009144	Wed Nov 04, 2026 01:02 AM	gcs	15.0
VIT-009119	Wed Nov 04, 2026 09:02 AM	spo2	98.0	room air
VIT-009120	Wed Nov 04, 2026 09:02 AM	rr	14.0
VIT-009145	Wed Nov 04, 2026 09:02 AM	temp_c	37.4
VIT-009146	Wed Nov 04, 2026 09:02 AM	hr	70.0
VIT-009147	Wed Nov 04, 2026 09:02 AM	map	77.0
VIT-009148	Wed Nov 04, 2026 09:02 AM	gcs	15.0
VIT-009121	Wed Nov 04, 2026 05:02 PM	spo2	96.0	room air
VIT-009122	Wed Nov 04, 2026 05:02 PM	rr	15.0
VIT-009149	Wed Nov 04, 2026 05:02 PM	temp_c	37.4
VIT-009150	Wed Nov 04, 2026 05:02 PM	hr	68.0
VIT-009151	Wed Nov 04, 2026 05:02 PM	map	86.0
VIT-009152	Wed Nov 04, 2026 05:02 PM	gcs	15.0
VIT-009123	Thu Nov 05, 2026 01:02 AM	spo2	95.0	room air
VIT-009124	Thu Nov 05, 2026 01:02 AM	rr	18.0
VIT-009153	Thu Nov 05, 2026 01:02 AM	temp_c	37.5
VIT-009154	Thu Nov 05, 2026 01:02 AM	hr	72.0
VIT-009155	Thu Nov 05, 2026 01:02 AM	map	90.0
VIT-009156	Thu Nov 05, 2026 01:02 AM	gcs	15.0
VIT-009125	Thu Nov 05, 2026 09:02 AM	spo2	95.0	room air
VIT-009126	Thu Nov 05, 2026 09:02 AM	rr	19.0
VIT-009157	Thu Nov 05, 2026 09:02 AM	temp_c	37.3
VIT-009158	Thu Nov 05, 2026 09:02 AM	hr	72.0
VIT-009159	Thu Nov 05, 2026 09:02 AM	map	76.0
VIT-009160	Thu Nov 05, 2026 09:02 AM	gcs	15.0
VIT-009127	Thu Nov 05, 2026 05:02 PM	spo2	97.0	room air
VIT-009128	Thu Nov 05, 2026 05:02 PM	rr	17.0
VIT-009161	Thu Nov 05, 2026 05:02 PM	temp_c	37.5
VIT-009162	Thu Nov 05, 2026 05:02 PM	hr	73.0
VIT-009163	Thu Nov 05, 2026 05:02 PM	map	85.0
VIT-009164	Thu Nov 05, 2026 05:02 PM	gcs	15.0
VIT-009129	Fri Nov 06, 2026 01:02 AM	spo2	95.0	room air
VIT-009130	Fri Nov 06, 2026 01:02 AM	rr	20.0
VIT-009165	Fri Nov 06, 2026 01:02 AM	temp_c	37.1
VIT-009166	Fri Nov 06, 2026 01:02 AM	hr	87.0
VIT-009167	Fri Nov 06, 2026 01:02 AM	map	79.0
VIT-009168	Fri Nov 06, 2026 01:02 AM	gcs	15.0
VIT-009131	Fri Nov 06, 2026 09:02 AM	spo2	95.0	room air
VIT-009132	Fri Nov 06, 2026 09:02 AM	rr	14.0
VIT-009169	Fri Nov 06, 2026 09:02 AM	temp_c	37.2
VIT-009170	Fri Nov 06, 2026 09:02 AM	hr	70.0
VIT-009171	Fri Nov 06, 2026 09:02 AM	map	84.0
VIT-009172	Fri Nov 06, 2026 09:02 AM	gcs	15.0

Medications, orders, echo, history (7)

MED-000363 11-03 09:42 piperacillin-tazobactam per protocol IV
MED-000364 11-04 05:00 piperacillin-tazobactam per protocol IV
MED-000365 11-05 05:00 piperacillin-tazobactam per protocol IV
MED-000366 11-03 11:42 furosemide 40 mg IV
ORD-000083 11-03 09:12 blood_culture: blood cultures x2
ECH-000043 2026-11-03 echo LVEF 60.0%
HX-000033 history: heart failure with preserved ejection fraction

Notes

History and physical · DOC-000316 · Dr. Greta Kowalczyk (resident) · Tue Nov 03, 2026 11:42 AM

Cited facts from this note (1)

infection_source: urinary tract infection · cited p. 1, line 5 · confidence 0.85

Show source for infection_source

… MRN23869043 Admitted: 2026-11-03 08:42 Service: Hospital Medicine Attending: Dr. Cyrus Ellingham History of present illness: 65-year-old man admitted with urinary tract infection. Urinalysis with pyuria; treated for acute pyelonephritis with cefepime. Past medical history: heart failure with preserved ejection fraction, type 2 diabetes, …

Source document DOC-000316: History and physical (synthetic)

HISTORY AND PHYSICAL
Patient: Dario Fairbanks   MRN: MRN23869043   Admitted: 2026-11-03 08:42
Service: Hospital Medicine   Attending: Dr. Cyrus Ellingham

History of present illness: 65-year-old man admitted with urinary tract infection. Urinalysis with pyuria; treated for acute pyelonephritis with cefepime.
Past medical history: heart failure with preserved ejection fraction, type 2 diabetes, hyperlipidemia.
Review of systems otherwise negative.
Exam: Lungs: clear to auscultation bilaterally.
Assessment and plan:
1. Urinary tract infection: antibiotics.
2. CKD: renally dose medications.

Progress note · DOC-000317 · Dr. Greta Kowalczyk (resident) · Thu Nov 05, 2026 10:42 AM

Source document DOC-000317: Progress note (synthetic)

PROGRESS NOTE (Resident)
Patient: Dario Fairbanks   MRN: MRN23869043   Hospital day 3

Subjective: resting, tolerating diet.
Objective: vitals and labs reviewed in the flowsheet.
Assessment and plan:
1. Urinary tract infection: continue current management.
2. Heart failure: diuresis and daily weights; monitor electrolytes.

Resident: Dr. Greta Kowalczyk   Attending cosign: completed

Discharge summary · DOC-000318 · Dr. Cyrus Ellingham (attending) · Fri Nov 06, 2026 01:36 PM

Source document DOC-000318: Discharge summary (synthetic)

DISCHARGE SUMMARY
Patient: Dario Fairbanks   MRN: MRN23869043
Admitted 2026-11-03; discharged 2026-11-06.

Discharge diagnoses:
- urinary tract infection
- CKD
- heart failure
- type 2 diabetes
- hyperlipidemia

Disposition: home with follow-up.