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-00108: Odette Elsworth

63F · MRN25963811 · Cardiology · admitted Mon Nov 02, 2026 09:24 AM · discharged Tue Nov 10, 2026 04:49 PM · attending Dr. Jalen Carrow · resident Dr. Greta Kowalczyk · 157 cm, 81.4 kg

Documented diagnoses (current)

“class 1 obesity” · E66.811 Obesity, class 1
“acute kidney injury” · N17.9 Acute kidney failure, unspecified
Principal: “chronic systolic heart failure” · I50.22 Chronic systolic (congestive) heart failure
“acute hypoxic respiratory failure” · J96.01 Acute respiratory failure with hypoxia
“stage 2 sacral pressure injury” · L89.152 Pressure ulcer of sacral region, stage 2
“hypertension” · I10 Essential (primary) hypertension
“hyperlipidemia” · E78.5 Hyperlipidemia, unspecified

Illustrative grouping now: MS-DRG 291 Heart failure and shock with MCC. If every open specificity/validation gap were answered as the criteria suggest: MS-DRG 292.

Queries and events

No queries yet.

All rules applied

Rule Criteria Finding Outcome

Acute kidney injury

Criteria not met

Clinical validation gap

Documented “acute kidney injury” (N17.9) but the criteria are not met: KDIGO creatinine and urine-output criteria not met.

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=1.066, t.ratio_s1=1.5, creat_rise_48h=0.06, 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=1.066, t.ratio_s3=3.0, creat_peak=0.81, 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=1.066, 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=0.06, t.rise_abs=0.3, rrt_started=False	true
outcome: aki_staged	`stage >= 1 and baseline_independent`	stage=0, baseline_independent=True	false
outcome: aki_presumed_baseline	`stage >= 1`	stage=0	false
outcome: not_met	`stage == 0`	stage=0	true

Acute blood loss anaemia

Criteria not met

No gap

Not documented and not supported.

Trace

Rule trace (rule blood_loss_anemia v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
Step	Expression	Inputs and thresholds read	Result
derived: anaemic	`case(sex == 'M', hgb_nadir < t.hb_m, sex == 'F', hgb_nadir < t.hb_f, null)`	sex=F, hgb_nadir=12.52, 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=0.1, 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=0.1, t.drop_min=1.0, prbc_units=0	false
outcome: not_anaemic	`present(hgb_nadir) and not anaemic`	hgb_nadir=12.52, anaemic=False	true

Chronic kidney disease

Clinical judgement required

No gap

Not documented; egfr 60 or above; ckd g1-g2 requires markers of kidney damage, which are not assessed here.

Trace

Rule trace (rule ckd v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
Step	Expression	Inputs and thresholds read	Result
derived: chronic	`egfr_n >= 2 and egfr_span_days >= t.chronic_days`	egfr_n=2, egfr_span_days=242, t.chronic_days=90	true
derived: staging_egfr	`max(egfr_early, egfr_late)`	egfr_early=86.6, egfr_late=88.0	88.0
derived: both_below_60	`egfr_early < t.g2 and egfr_late < t.g2`	egfr_early=86.6, t.g2=60, egfr_late=88.0	false
derived: category	`case(staging_egfr >= t.g2, 'G1-G2', staging_egfr >= t.g3a, 'G3a', staging_egfr >= t.g3b, 'G3b', staging_egfr >= t.g4, 'G4', 'G5')`	staging_egfr=88.0, 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=86.6, egfr_late=88.0, t.g2=60	false
outcome: g1_g2	`staging_egfr >= t.g2`	staging_egfr=88.0, t.g2=60	true

Heart failure

Criteria met

Specificity gap

Documented “chronic systolic heart failure” (I50.22); 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=2223.0, 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=35.0, 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=35.0, 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 met

Specificity gap

Criteria support Hyponatraemia (moderate) (E87.1); no corresponding diagnosis is documented.

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=128.0, 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=128.0, t.low=135, na_low_count=6, t.repeat=2, na_treated=True	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 (E66.811).

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=63, t.adult=20	false
outcome: class3	`bmi >= t.c3`	bmi=33.0, t.c3=40	false
outcome: class2	`bmi >= t.c2`	bmi=33.0, t.c2=35	false
outcome: class1	`bmi >= t.c1`	bmi=33.0, t.c1=30	true

Pressure injury

Criteria met

No gap

Supported as documented (L89.152).

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=2	false
outcome: other_site	`wound_site != 'sacral'`	wound_site=sacral	false
outcome: stage1	`sacral and wound_stage == '1'`	sacral=True, wound_stage=2	false
outcome: stage2	`sacral and wound_stage == '2'`	sacral=True, wound_stage=2	true

Acute respiratory failure

Criteria not met

Clinical validation gap

Documented “acute hypoxic respiratory failure” (J96.01) but the criteria are not met: No hypoxaemia on room air (lowest SpO2 93%), oxygen no more than 2 L/min, no advanced support.

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=93.0, 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=93.0, 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=21.0, 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=2.0, 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=37.4, 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=86.0, 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=21.0, 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=10.42, t.wbc_hi=12, wbc_min_48h=5.8, 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=200.0	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=0.93	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=0.81	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-003643	Sun Jan 04, 2026 09:15 AM	creatinine	0.77 mg/dL
LAB-003644	Fri Sep 04, 2026 10:05 AM	creatinine	0.76 mg/dL
LAB-003645	Mon Nov 02, 2026 10:24 AM	creatinine	0.75 mg/dL
LAB-003654	Mon Nov 02, 2026 10:24 AM	bnp	2223.0 pg/mL
LAB-003655	Mon Nov 02, 2026 10:24 AM	sodium	130.0 mmol/L
LAB-003664	Mon Nov 02, 2026 10:24 AM	hemoglobin	12.63 g/dL
LAB-003673	Mon Nov 02, 2026 10:24 AM	wbc	5.8 x10^3/uL
LAB-003674	Mon Nov 02, 2026 10:24 AM	platelets	297.0 x10^3/uL
LAB-003691	Mon Nov 02, 2026 10:24 AM	bilirubin	0.93 mg/dL
LAB-003646	Tue Nov 03, 2026 05:00 AM	creatinine	0.77 mg/dL
LAB-003656	Tue Nov 03, 2026 05:00 AM	sodium	128.0 mmol/L
LAB-003665	Tue Nov 03, 2026 05:00 AM	hemoglobin	12.52 g/dL
LAB-003675	Tue Nov 03, 2026 05:00 AM	wbc	6.2 x10^3/uL
LAB-003676	Tue Nov 03, 2026 05:00 AM	platelets	304.0 x10^3/uL
LAB-003647	Wed Nov 04, 2026 05:00 AM	creatinine	0.81 mg/dL
LAB-003657	Wed Nov 04, 2026 05:00 AM	sodium	129.0 mmol/L
LAB-003666	Wed Nov 04, 2026 05:00 AM	hemoglobin	12.98 g/dL
LAB-003677	Wed Nov 04, 2026 05:00 AM	wbc	10.42 x10^3/uL
LAB-003678	Wed Nov 04, 2026 05:00 AM	platelets	200.0 x10^3/uL
LAB-003648	Thu Nov 05, 2026 05:00 AM	creatinine	0.8 mg/dL
LAB-003658	Thu Nov 05, 2026 05:00 AM	sodium	132.0 mmol/L
LAB-003667	Thu Nov 05, 2026 05:00 AM	hemoglobin	12.85 g/dL
LAB-003679	Thu Nov 05, 2026 05:00 AM	wbc	8.0 x10^3/uL
LAB-003680	Thu Nov 05, 2026 05:00 AM	platelets	282.0 x10^3/uL
LAB-003649	Fri Nov 06, 2026 05:00 AM	creatinine	0.79 mg/dL
LAB-003659	Fri Nov 06, 2026 05:00 AM	sodium	134.0 mmol/L
LAB-003668	Fri Nov 06, 2026 05:00 AM	hemoglobin	12.74 g/dL
LAB-003681	Fri Nov 06, 2026 05:00 AM	wbc	10.64 x10^3/uL
LAB-003682	Fri Nov 06, 2026 05:00 AM	platelets	273.0 x10^3/uL
LAB-003650	Sat Nov 07, 2026 05:00 AM	creatinine	0.79 mg/dL
LAB-003660	Sat Nov 07, 2026 05:00 AM	sodium	134.0 mmol/L
LAB-003669	Sat Nov 07, 2026 05:00 AM	hemoglobin	12.63 g/dL
LAB-003683	Sat Nov 07, 2026 05:00 AM	wbc	8.41 x10^3/uL
LAB-003684	Sat Nov 07, 2026 05:00 AM	platelets	195.0 x10^3/uL
LAB-003651	Sun Nov 08, 2026 05:00 AM	creatinine	0.75 mg/dL
LAB-003661	Sun Nov 08, 2026 05:00 AM	sodium	136.0 mmol/L
LAB-003670	Sun Nov 08, 2026 05:00 AM	hemoglobin	12.58 g/dL
LAB-003685	Sun Nov 08, 2026 05:00 AM	wbc	8.96 x10^3/uL
LAB-003686	Sun Nov 08, 2026 05:00 AM	platelets	234.0 x10^3/uL
LAB-003652	Mon Nov 09, 2026 05:00 AM	creatinine	0.8 mg/dL
LAB-003662	Mon Nov 09, 2026 05:00 AM	sodium	137.0 mmol/L
LAB-003671	Mon Nov 09, 2026 05:00 AM	hemoglobin	12.88 g/dL
LAB-003687	Mon Nov 09, 2026 05:00 AM	wbc	6.71 x10^3/uL
LAB-003688	Mon Nov 09, 2026 05:00 AM	platelets	196.0 x10^3/uL
LAB-003653	Tue Nov 10, 2026 05:00 AM	creatinine	0.78 mg/dL
LAB-003663	Tue Nov 10, 2026 05:00 AM	sodium	137.0 mmol/L
LAB-003672	Tue Nov 10, 2026 05:00 AM	hemoglobin	12.61 g/dL
LAB-003689	Tue Nov 10, 2026 05:00 AM	wbc	5.9 x10^3/uL
LAB-003690	Tue Nov 10, 2026 05:00 AM	platelets	184.0 x10^3/uL

Vitals (152)

Vitals
Row	When	Kind	Value	Detail
VIT-010458	Mon Nov 02, 2026 09:44 AM	spo2	93.0	room air
VIT-010459	Mon Nov 02, 2026 09:44 AM	rr	17.0
VIT-010510	Mon Nov 02, 2026 09:44 AM	temp_c	36.5
VIT-010511	Mon Nov 02, 2026 09:44 AM	hr	80.0
VIT-010512	Mon Nov 02, 2026 09:44 AM	map	87.0
VIT-010513	Mon Nov 02, 2026 09:44 AM	gcs	15.0
VIT-010460	Mon Nov 02, 2026 05:44 PM	spo2	97.0	room air
VIT-010461	Mon Nov 02, 2026 05:44 PM	rr	16.0
VIT-010514	Mon Nov 02, 2026 05:44 PM	temp_c	37.4
VIT-010515	Mon Nov 02, 2026 05:44 PM	hr	84.0
VIT-010516	Mon Nov 02, 2026 05:44 PM	map	78.0
VIT-010517	Mon Nov 02, 2026 05:44 PM	gcs	15.0
VIT-010462	Mon Nov 02, 2026 05:49 PM	o2_lpm	2.0	nasal cannula
VIT-010463	Tue Nov 03, 2026 01:44 AM	spo2	96.0	room air
VIT-010464	Tue Nov 03, 2026 01:44 AM	rr	18.0
VIT-010518	Tue Nov 03, 2026 01:44 AM	temp_c	36.5
VIT-010519	Tue Nov 03, 2026 01:44 AM	hr	72.0
VIT-010520	Tue Nov 03, 2026 01:44 AM	map	91.0
VIT-010521	Tue Nov 03, 2026 01:44 AM	gcs	15.0
VIT-010465	Tue Nov 03, 2026 01:49 AM	o2_lpm	2.0	nasal cannula
VIT-010466	Tue Nov 03, 2026 09:44 AM	spo2	96.0	room air
VIT-010467	Tue Nov 03, 2026 09:44 AM	rr	21.0
VIT-010522	Tue Nov 03, 2026 09:44 AM	temp_c	37.3
VIT-010523	Tue Nov 03, 2026 09:44 AM	hr	69.0
VIT-010524	Tue Nov 03, 2026 09:44 AM	map	80.0
VIT-010525	Tue Nov 03, 2026 09:44 AM	gcs	15.0
VIT-010468	Tue Nov 03, 2026 05:44 PM	spo2	97.0	room air
VIT-010469	Tue Nov 03, 2026 05:44 PM	rr	16.0
VIT-010526	Tue Nov 03, 2026 05:44 PM	temp_c	37.4
VIT-010527	Tue Nov 03, 2026 05:44 PM	hr	86.0
VIT-010528	Tue Nov 03, 2026 05:44 PM	map	84.0
VIT-010529	Tue Nov 03, 2026 05:44 PM	gcs	15.0
VIT-010470	Wed Nov 04, 2026 01:44 AM	spo2	94.0	room air
VIT-010471	Wed Nov 04, 2026 01:44 AM	rr	16.0
VIT-010530	Wed Nov 04, 2026 01:44 AM	temp_c	37.2
VIT-010531	Wed Nov 04, 2026 01:44 AM	hr	78.0
VIT-010532	Wed Nov 04, 2026 01:44 AM	map	89.0
VIT-010533	Wed Nov 04, 2026 01:44 AM	gcs	15.0
VIT-010472	Wed Nov 04, 2026 09:44 AM	spo2	94.0	room air
VIT-010473	Wed Nov 04, 2026 09:44 AM	rr	16.0
VIT-010534	Wed Nov 04, 2026 09:44 AM	temp_c	36.5
VIT-010535	Wed Nov 04, 2026 09:44 AM	hr	81.0
VIT-010536	Wed Nov 04, 2026 09:44 AM	map	86.0
VIT-010537	Wed Nov 04, 2026 09:44 AM	gcs	15.0
VIT-010474	Wed Nov 04, 2026 05:44 PM	spo2	96.0	room air
VIT-010475	Wed Nov 04, 2026 05:44 PM	rr	17.0
VIT-010538	Wed Nov 04, 2026 05:44 PM	temp_c	37.6
VIT-010539	Wed Nov 04, 2026 05:44 PM	hr	90.0
VIT-010540	Wed Nov 04, 2026 05:44 PM	map	81.0
VIT-010541	Wed Nov 04, 2026 05:44 PM	gcs	15.0
VIT-010476	Thu Nov 05, 2026 01:44 AM	spo2	95.0	room air
VIT-010477	Thu Nov 05, 2026 01:44 AM	rr	21.0
VIT-010542	Thu Nov 05, 2026 01:44 AM	temp_c	37.0
VIT-010543	Thu Nov 05, 2026 01:44 AM	hr	85.0
VIT-010544	Thu Nov 05, 2026 01:44 AM	map	80.0
VIT-010545	Thu Nov 05, 2026 01:44 AM	gcs	15.0
VIT-010478	Thu Nov 05, 2026 09:44 AM	spo2	96.0	room air
VIT-010479	Thu Nov 05, 2026 09:44 AM	rr	18.0
VIT-010546	Thu Nov 05, 2026 09:44 AM	temp_c	37.6
VIT-010547	Thu Nov 05, 2026 09:44 AM	hr	70.0
VIT-010548	Thu Nov 05, 2026 09:44 AM	map	86.0
VIT-010549	Thu Nov 05, 2026 09:44 AM	gcs	15.0
VIT-010480	Thu Nov 05, 2026 05:44 PM	spo2	94.0	room air
VIT-010481	Thu Nov 05, 2026 05:44 PM	rr	19.0
VIT-010550	Thu Nov 05, 2026 05:44 PM	temp_c	37.3
VIT-010551	Thu Nov 05, 2026 05:44 PM	hr	71.0
VIT-010552	Thu Nov 05, 2026 05:44 PM	map	77.0
VIT-010553	Thu Nov 05, 2026 05:44 PM	gcs	15.0
VIT-010482	Fri Nov 06, 2026 01:44 AM	spo2	95.0	room air
VIT-010483	Fri Nov 06, 2026 01:44 AM	rr	21.0
VIT-010554	Fri Nov 06, 2026 01:44 AM	temp_c	36.6
VIT-010555	Fri Nov 06, 2026 01:44 AM	hr	81.0
VIT-010556	Fri Nov 06, 2026 01:44 AM	map	79.0
VIT-010557	Fri Nov 06, 2026 01:44 AM	gcs	15.0
VIT-010484	Fri Nov 06, 2026 09:44 AM	spo2	94.0	room air
VIT-010485	Fri Nov 06, 2026 09:44 AM	rr	21.0
VIT-010558	Fri Nov 06, 2026 09:44 AM	temp_c	37.6
VIT-010559	Fri Nov 06, 2026 09:44 AM	hr	74.0
VIT-010560	Fri Nov 06, 2026 09:44 AM	map	84.0
VIT-010561	Fri Nov 06, 2026 09:44 AM	gcs	15.0
VIT-010486	Fri Nov 06, 2026 05:44 PM	spo2	95.0	room air
VIT-010487	Fri Nov 06, 2026 05:44 PM	rr	18.0
VIT-010562	Fri Nov 06, 2026 05:44 PM	temp_c	37.1
VIT-010563	Fri Nov 06, 2026 05:44 PM	hr	84.0
VIT-010564	Fri Nov 06, 2026 05:44 PM	map	83.0
VIT-010565	Fri Nov 06, 2026 05:44 PM	gcs	15.0
VIT-010488	Sat Nov 07, 2026 01:44 AM	spo2	95.0	room air
VIT-010489	Sat Nov 07, 2026 01:44 AM	rr	18.0
VIT-010566	Sat Nov 07, 2026 01:44 AM	temp_c	37.5
VIT-010567	Sat Nov 07, 2026 01:44 AM	hr	84.0
VIT-010568	Sat Nov 07, 2026 01:44 AM	map	76.0
VIT-010569	Sat Nov 07, 2026 01:44 AM	gcs	15.0
VIT-010490	Sat Nov 07, 2026 09:44 AM	spo2	96.0	room air
VIT-010491	Sat Nov 07, 2026 09:44 AM	rr	18.0
VIT-010570	Sat Nov 07, 2026 09:44 AM	temp_c	37.3
VIT-010571	Sat Nov 07, 2026 09:44 AM	hr	79.0
VIT-010572	Sat Nov 07, 2026 09:44 AM	map	86.0
VIT-010573	Sat Nov 07, 2026 09:44 AM	gcs	15.0
VIT-010492	Sat Nov 07, 2026 05:44 PM	spo2	96.0	room air
VIT-010493	Sat Nov 07, 2026 05:44 PM	rr	17.0
VIT-010574	Sat Nov 07, 2026 05:44 PM	temp_c	36.7
VIT-010575	Sat Nov 07, 2026 05:44 PM	hr	87.0
VIT-010576	Sat Nov 07, 2026 05:44 PM	map	84.0
VIT-010577	Sat Nov 07, 2026 05:44 PM	gcs	15.0
VIT-010494	Sun Nov 08, 2026 01:44 AM	spo2	94.0	room air
VIT-010495	Sun Nov 08, 2026 01:44 AM	rr	16.0
VIT-010578	Sun Nov 08, 2026 01:44 AM	temp_c	36.8
VIT-010579	Sun Nov 08, 2026 01:44 AM	hr	75.0
VIT-010580	Sun Nov 08, 2026 01:44 AM	map	74.0
VIT-010581	Sun Nov 08, 2026 01:44 AM	gcs	15.0
VIT-010496	Sun Nov 08, 2026 09:44 AM	spo2	97.0	room air
VIT-010497	Sun Nov 08, 2026 09:44 AM	rr	19.0
VIT-010582	Sun Nov 08, 2026 09:44 AM	temp_c	37.4
VIT-010583	Sun Nov 08, 2026 09:44 AM	hr	76.0
VIT-010584	Sun Nov 08, 2026 09:44 AM	map	87.0
VIT-010585	Sun Nov 08, 2026 09:44 AM	gcs	15.0
VIT-010498	Sun Nov 08, 2026 05:44 PM	spo2	93.0	room air
VIT-010499	Sun Nov 08, 2026 05:44 PM	rr	16.0
VIT-010586	Sun Nov 08, 2026 05:44 PM	temp_c	36.7
VIT-010587	Sun Nov 08, 2026 05:44 PM	hr	70.0
VIT-010588	Sun Nov 08, 2026 05:44 PM	map	83.0
VIT-010589	Sun Nov 08, 2026 05:44 PM	gcs	15.0
VIT-010500	Mon Nov 09, 2026 01:44 AM	spo2	94.0	room air
VIT-010501	Mon Nov 09, 2026 01:44 AM	rr	17.0
VIT-010590	Mon Nov 09, 2026 01:44 AM	temp_c	36.5
VIT-010591	Mon Nov 09, 2026 01:44 AM	hr	76.0
VIT-010592	Mon Nov 09, 2026 01:44 AM	map	86.0
VIT-010593	Mon Nov 09, 2026 01:44 AM	gcs	15.0
VIT-010502	Mon Nov 09, 2026 09:44 AM	spo2	96.0	room air
VIT-010503	Mon Nov 09, 2026 09:44 AM	rr	20.0
VIT-010594	Mon Nov 09, 2026 09:44 AM	temp_c	36.9
VIT-010595	Mon Nov 09, 2026 09:44 AM	hr	87.0
VIT-010596	Mon Nov 09, 2026 09:44 AM	map	89.0
VIT-010597	Mon Nov 09, 2026 09:44 AM	gcs	15.0
VIT-010504	Mon Nov 09, 2026 05:44 PM	spo2	93.0	room air
VIT-010505	Mon Nov 09, 2026 05:44 PM	rr	20.0
VIT-010598	Mon Nov 09, 2026 05:44 PM	temp_c	36.6
VIT-010599	Mon Nov 09, 2026 05:44 PM	hr	90.0
VIT-010600	Mon Nov 09, 2026 05:44 PM	map	89.0
VIT-010601	Mon Nov 09, 2026 05:44 PM	gcs	15.0
VIT-010506	Tue Nov 10, 2026 01:44 AM	spo2	93.0	room air
VIT-010507	Tue Nov 10, 2026 01:44 AM	rr	18.0
VIT-010602	Tue Nov 10, 2026 01:44 AM	temp_c	37.0
VIT-010603	Tue Nov 10, 2026 01:44 AM	hr	76.0
VIT-010604	Tue Nov 10, 2026 01:44 AM	map	92.0
VIT-010605	Tue Nov 10, 2026 01:44 AM	gcs	15.0
VIT-010508	Tue Nov 10, 2026 09:44 AM	spo2	93.0	room air
VIT-010509	Tue Nov 10, 2026 09:44 AM	rr	18.0
VIT-010606	Tue Nov 10, 2026 09:44 AM	temp_c	37.6
VIT-010607	Tue Nov 10, 2026 09:44 AM	hr	71.0
VIT-010608	Tue Nov 10, 2026 09:44 AM	map	89.0
VIT-010609	Tue Nov 10, 2026 09:44 AM	gcs	15.0

Medications, orders, echo, history (9)

MED-000424 11-02 08:00 furosemide 40 mg IV
MED-000425 11-02 20:00 furosemide 40 mg IV
MED-000426 11-03 08:00 furosemide 40 mg IV
MED-000427 11-03 20:00 furosemide 40 mg IV
MED-000428 11-04 08:00 furosemide 40 mg IV
MED-000429 11-04 20:00 furosemide 40 mg IV
ORD-000093 11-02 12:24 fluid_restriction: fluid restriction 1.2 L/day
ECH-000052 2026-11-03 echo LVEF 35.0%
HX-000042 history: heart failure with reduced ejection fraction

Notes

History and physical · DOC-000364 · Dr. Greta Kowalczyk (resident) · Mon Nov 02, 2026 12:24 PM

Source document DOC-000364: History and physical (synthetic)

HISTORY AND PHYSICAL
Patient: Odette Elsworth   MRN: MRN25963811   Admitted: 2026-11-02 09:24
Service: Cardiology   Attending: Dr. Jalen Carrow

History of present illness: 63-year-old woman admitted with chronic systolic heart failure. 
Past medical history: heart failure with reduced ejection fraction, hypertension, hyperlipidemia.
Review of systems otherwise negative.
Exam: Lungs: scattered crackles at the bases, no distress.
Assessment and plan:
1. Chronic systolic heart failure: diuresis and daily weights; monitor electrolytes.

Wound care note · DOC-000363 · Ines Ingram, RN, CWOCN (wound_nurse) · Tue Nov 03, 2026 12:24 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: Odette Elsworth MRN: MRN25963811 Location: sacrum Stage: 2 (NPIAP) Description: partial-thickness skin loss with exposed dermis. Size: 3.4 x 2.9 x 1.0 cm. Plan: offloading every 2 hours, foam dressing, nutriti …
wound_stage: 2 · cited p. 1, line 5 · confidence 0.95

Show source for wound_stage

WOUND CARE NOTE Patient: Odette Elsworth MRN: MRN25963811 Location: sacrum Stage: 2 (NPIAP) Description: partial-thickness skin loss with exposed dermis. Size: 3.4 x 2.9 x 1.0 cm. Plan: offloading every 2 hours, foam dressing, nutrition consul …

Source document DOC-000363: Wound care note (synthetic)

WOUND CARE NOTE
Patient: Odette Elsworth   MRN: MRN25963811

Location: sacrum
Stage: 2 (NPIAP)
Description: partial-thickness skin loss with exposed dermis.
Size: 3.4 x 2.9 x 1.0 cm.
Plan: offloading every 2 hours, foam dressing, nutrition consult.

Progress note · DOC-000365 · Dr. Greta Kowalczyk (resident) · Wed Nov 04, 2026 11:24 AM

Source document DOC-000365: Progress note (synthetic)

PROGRESS NOTE (Resident)
Patient: Odette Elsworth   MRN: MRN25963811   Hospital day 3

Subjective: resting, tolerating diet.
Objective: vitals and labs reviewed in the flowsheet.
Assessment and plan:
1. Chronic systolic heart failure: continue current management.
2. Class 1 obesity: counsel on weight.
3. Acute kidney injury: trend creatinine, hold nephrotoxins, strict intake and output.
4. Acute hypoxic respiratory failure: supplemental oxygen, wean as tolerated.
5. Stage 2 sacral pressure injury: wound care following, offloading.

Resident: Dr. Greta Kowalczyk   Attending cosign: completed

Discharge summary · DOC-000366 · Dr. Jalen Carrow (attending) · Tue Nov 10, 2026 04:49 PM

Source document DOC-000366: Discharge summary (synthetic)

DISCHARGE SUMMARY
Patient: Odette Elsworth   MRN: MRN25963811
Admitted 2026-11-02; discharged 2026-11-10.

Discharge diagnoses:
- class 1 obesity
- acute kidney injury
- chronic systolic heart failure
- acute hypoxic respiratory failure
- stage 2 sacral pressure injury
- hypertension
- hyperlipidemia

Disposition: home with follow-up.