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-00109: Mara Delacroix

47F · MRN85934702 · Hospital Medicine · admitted Mon Nov 02, 2026 08:53 PM · discharged Mon Nov 09, 2026 12:22 PM · attending Dr. Jalen Carrow · resident Dr. Camila Oyelaran · 152 cm, 54.9 kg

Documented diagnoses (current)

Principal: “upper GI bleed” · K92.2 Gastrointestinal hemorrhage, unspecified
“chronic diastolic heart failure” · I50.32 Chronic diastolic (congestive) heart failure
“acute blood loss anemia” · D62 Acute posthemorrhagic anemia
“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=1.056, t.ratio_s1=1.5, creat_rise_48h=0.05, 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=1.056, t.ratio_s3=3.0, creat_peak=0.94, 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=1.056, 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=0.05, 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 met

No gap

Supported as documented (D62).

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=8.48, 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=3.4, t.drop_major=2.0, prbc_units=2, t.prbc_major=2	true
outcome: met	`bleeding_documented and anaemic and acute_fall`	bleeding_documented=True, anaemic=True, acute_fall=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=251, t.chronic_days=90	true
derived: staging_egfr	`max(egfr_early, egfr_late)`	egfr_early=81.5, egfr_late=80.4	81.5
derived: both_below_60	`egfr_early < t.g2 and egfr_late < t.g2`	egfr_early=81.5, t.g2=60, egfr_late=80.4	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=81.5, 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=81.5, egfr_late=80.4, t.g2=60	false
outcome: g1_g2	`staging_egfr >= t.g2`	staging_egfr=81.5, t.g2=60	true

Heart failure

Criteria met

Specificity gap

Documented “chronic diastolic heart failure” (I50.32); criteria support the more specific Acute on chronic diastolic (HFpEF) heart failure (I50.33).

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=1983.0, 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=False	2
derived: hf_type	`case(lvef <= t.ref, 'systolic', lvef >= t.pres, 'diastolic', 'midrange')`	lvef=65.0, 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=65.0, 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=2, hf_history=True	acute on chronic
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=acute on chronic	false
outcome: sys_acute	`hf_type == 'systolic' and acuity == 'acute'`	hf_type=diastolic, acuity=acute on chronic	false
outcome: sys_chronic	`hf_type == 'systolic' and acuity == 'chronic'`	hf_type=diastolic, acuity=acute on chronic	false
outcome: dia_aoc	`hf_type == 'diastolic' and acuity == 'acute on chronic'`	hf_type=diastolic, 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=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

Criteria not met

No gap

Not documented and not supported.

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=100.0, t.a_sev_intake_pct=50, intake_days=unknown, t.a_sev_intake_days=5	false
derived: a_mod_intake	`intake_pct < t.a_mod_intake_pct and intake_days > t.a_mod_intake_days`	intake_pct=100.0, t.a_mod_intake_pct=75, intake_days=unknown, t.a_mod_intake_days=7	false
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=100.0, t.c_intake_pct=75, intake_days=unknown, t.c_intake_days=30	false
derived: c_mod_intake	`intake_pct < t.c_intake_pct and intake_days >= t.c_intake_days`	intake_pct=100.0, t.c_intake_pct=75, intake_days=unknown, t.c_intake_days=30	false
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=100.0, wt_loss_pct=unknown, fat_loss=0, muscle_loss=0, fluid=0, grip_reduced=unknown	4
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=acute, a_sev_intake=False, a_sev_wt=unknown, fat_loss=0, muscle_loss=0, fluid=0, grip_reduced=unknown, c_sev_intake=False, c_sev_wt=unknown	0
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=acute, a_sev_intake=False, a_mod_intake=False, a_sev_wt=unknown, a_mod_wt=unknown, fat_loss=0, muscle_loss=0, fluid=0, grip_reduced=unknown, c_sev_intake=False, c_mod_intake=False, c_sev_wt=unknown, c_mod_wt=unknown	0
outcome: severe	`n_severe >= 2`	n_severe=0	false
outcome: moderate	`n_moderate >= 2`	n_moderate=0	false
outcome: one_characteristic	`n_moderate == 1`	n_moderate=0	false
outcome: not_met	`n_moderate == 0 and n_assessed >= 2`	n_moderate=0, n_assessed=4	true

Obesity

Criteria not met

No gap

Not documented and not supported.

Trace

Rule trace (rule obesity v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
Step	Expression	Inputs and thresholds read	Result
outcome: not_adult	`age < t.adult`	age=47, t.adult=20	false
outcome: class3	`bmi >= t.c3`	bmi=23.8, t.c3=40	false
outcome: class2	`bmi >= t.c2`	bmi=23.8, t.c2=35	false
outcome: class1	`bmi >= t.c1`	bmi=23.8, t.c1=30	false
outcome: not_met	`bmi < t.c1`	bmi=23.8, 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=37.1, 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=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=10.72, t.wbc_hi=12, wbc_min_48h=9.03, 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=189.0	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=0.71	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=0.89	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=0.89	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=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=False	true

Structured data

Labs (44)

Labs (pre-admission rows are outpatient values)
Row	When	Test	Value
LAB-003692	Wed Nov 26, 2025 09:15 AM	creatinine	0.88 mg/dL
LAB-003693	Wed Aug 05, 2026 10:05 AM	creatinine	0.89 mg/dL
LAB-003694	Mon Nov 02, 2026 09:53 PM	creatinine	0.89 mg/dL
LAB-003702	Mon Nov 02, 2026 09:53 PM	bnp	1983.0 pg/mL
LAB-003703	Mon Nov 02, 2026 09:53 PM	sodium	141.0 mmol/L
LAB-003711	Mon Nov 02, 2026 09:53 PM	hemoglobin	11.86 g/dL
LAB-003719	Mon Nov 02, 2026 09:53 PM	wbc	9.03 x10^3/uL
LAB-003720	Mon Nov 02, 2026 09:53 PM	platelets	252.0 x10^3/uL
LAB-003735	Mon Nov 02, 2026 09:53 PM	bilirubin	0.71 mg/dL
LAB-003695	Tue Nov 03, 2026 05:00 AM	creatinine	0.87 mg/dL
LAB-003704	Tue Nov 03, 2026 05:00 AM	sodium	141.0 mmol/L
LAB-003712	Tue Nov 03, 2026 05:00 AM	hemoglobin	9.83 g/dL
LAB-003721	Tue Nov 03, 2026 05:00 AM	wbc	10.72 x10^3/uL
LAB-003722	Tue Nov 03, 2026 05:00 AM	platelets	251.0 x10^3/uL
LAB-003696	Wed Nov 04, 2026 05:00 AM	creatinine	0.89 mg/dL
LAB-003705	Wed Nov 04, 2026 05:00 AM	sodium	137.0 mmol/L
LAB-003713	Wed Nov 04, 2026 05:00 AM	hemoglobin	8.48 g/dL
LAB-003723	Wed Nov 04, 2026 05:00 AM	wbc	9.55 x10^3/uL
LAB-003724	Wed Nov 04, 2026 05:00 AM	platelets	189.0 x10^3/uL
LAB-003697	Thu Nov 05, 2026 05:00 AM	creatinine	0.92 mg/dL
LAB-003706	Thu Nov 05, 2026 05:00 AM	sodium	141.0 mmol/L
LAB-003714	Thu Nov 05, 2026 05:00 AM	hemoglobin	9.28 g/dL
LAB-003725	Thu Nov 05, 2026 05:00 AM	wbc	6.14 x10^3/uL
LAB-003726	Thu Nov 05, 2026 05:00 AM	platelets	267.0 x10^3/uL
LAB-003698	Fri Nov 06, 2026 05:00 AM	creatinine	0.94 mg/dL
LAB-003707	Fri Nov 06, 2026 05:00 AM	sodium	136.0 mmol/L
LAB-003715	Fri Nov 06, 2026 05:00 AM	hemoglobin	9.58 g/dL
LAB-003727	Fri Nov 06, 2026 05:00 AM	wbc	7.5 x10^3/uL
LAB-003728	Fri Nov 06, 2026 05:00 AM	platelets	186.0 x10^3/uL
LAB-003699	Sat Nov 07, 2026 05:00 AM	creatinine	0.93 mg/dL
LAB-003708	Sat Nov 07, 2026 05:00 AM	sodium	140.0 mmol/L
LAB-003716	Sat Nov 07, 2026 05:00 AM	hemoglobin	9.68 g/dL
LAB-003729	Sat Nov 07, 2026 05:00 AM	wbc	6.12 x10^3/uL
LAB-003730	Sat Nov 07, 2026 05:00 AM	platelets	258.0 x10^3/uL
LAB-003700	Sun Nov 08, 2026 05:00 AM	creatinine	0.9 mg/dL
LAB-003709	Sun Nov 08, 2026 05:00 AM	sodium	139.0 mmol/L
LAB-003717	Sun Nov 08, 2026 05:00 AM	hemoglobin	9.68 g/dL
LAB-003731	Sun Nov 08, 2026 05:00 AM	wbc	7.21 x10^3/uL
LAB-003732	Sun Nov 08, 2026 05:00 AM	platelets	188.0 x10^3/uL
LAB-003701	Mon Nov 09, 2026 05:00 AM	creatinine	0.92 mg/dL
LAB-003710	Mon Nov 09, 2026 05:00 AM	sodium	139.0 mmol/L
LAB-003718	Mon Nov 09, 2026 05:00 AM	hemoglobin	9.68 g/dL
LAB-003733	Mon Nov 09, 2026 05:00 AM	wbc	5.83 x10^3/uL
LAB-003734	Mon Nov 09, 2026 05:00 AM	platelets	241.0 x10^3/uL

Vitals (120)

Vitals
Row	When	Kind	Value	Detail
VIT-010610	Mon Nov 02, 2026 09:13 PM	spo2	94.0	room air
VIT-010611	Mon Nov 02, 2026 09:13 PM	rr	16.0
VIT-010650	Mon Nov 02, 2026 09:13 PM	temp_c	36.8
VIT-010651	Mon Nov 02, 2026 09:13 PM	hr	75.0
VIT-010652	Mon Nov 02, 2026 09:13 PM	map	84.0
VIT-010653	Mon Nov 02, 2026 09:13 PM	gcs	15.0
VIT-010612	Tue Nov 03, 2026 05:13 AM	spo2	97.0	room air
VIT-010613	Tue Nov 03, 2026 05:13 AM	rr	18.0
VIT-010654	Tue Nov 03, 2026 05:13 AM	temp_c	36.9
VIT-010655	Tue Nov 03, 2026 05:13 AM	hr	86.0
VIT-010656	Tue Nov 03, 2026 05:13 AM	map	85.0
VIT-010657	Tue Nov 03, 2026 05:13 AM	gcs	15.0
VIT-010614	Tue Nov 03, 2026 01:13 PM	spo2	99.0	room air
VIT-010615	Tue Nov 03, 2026 01:13 PM	rr	14.0
VIT-010658	Tue Nov 03, 2026 01:13 PM	temp_c	36.9
VIT-010659	Tue Nov 03, 2026 01:13 PM	hr	69.0
VIT-010660	Tue Nov 03, 2026 01:13 PM	map	90.0
VIT-010661	Tue Nov 03, 2026 01:13 PM	gcs	15.0
VIT-010616	Tue Nov 03, 2026 09:13 PM	spo2	99.0	room air
VIT-010617	Tue Nov 03, 2026 09:13 PM	rr	19.0
VIT-010662	Tue Nov 03, 2026 09:13 PM	temp_c	37.1
VIT-010663	Tue Nov 03, 2026 09:13 PM	hr	74.0
VIT-010664	Tue Nov 03, 2026 09:13 PM	map	87.0
VIT-010665	Tue Nov 03, 2026 09:13 PM	gcs	15.0
VIT-010618	Wed Nov 04, 2026 05:13 AM	spo2	96.0	room air
VIT-010619	Wed Nov 04, 2026 05:13 AM	rr	16.0
VIT-010666	Wed Nov 04, 2026 05:13 AM	temp_c	36.5
VIT-010667	Wed Nov 04, 2026 05:13 AM	hr	85.0
VIT-010668	Wed Nov 04, 2026 05:13 AM	map	81.0
VIT-010669	Wed Nov 04, 2026 05:13 AM	gcs	15.0
VIT-010620	Wed Nov 04, 2026 01:13 PM	spo2	95.0	room air
VIT-010621	Wed Nov 04, 2026 01:13 PM	rr	17.0
VIT-010670	Wed Nov 04, 2026 01:13 PM	temp_c	36.6
VIT-010671	Wed Nov 04, 2026 01:13 PM	hr	78.0
VIT-010672	Wed Nov 04, 2026 01:13 PM	map	77.0
VIT-010673	Wed Nov 04, 2026 01:13 PM	gcs	15.0
VIT-010622	Wed Nov 04, 2026 09:13 PM	spo2	94.0	room air
VIT-010623	Wed Nov 04, 2026 09:13 PM	rr	15.0
VIT-010674	Wed Nov 04, 2026 09:13 PM	temp_c	37.0
VIT-010675	Wed Nov 04, 2026 09:13 PM	hr	73.0
VIT-010676	Wed Nov 04, 2026 09:13 PM	map	74.0
VIT-010677	Wed Nov 04, 2026 09:13 PM	gcs	15.0
VIT-010624	Thu Nov 05, 2026 05:13 AM	spo2	97.0	room air
VIT-010625	Thu Nov 05, 2026 05:13 AM	rr	20.0
VIT-010678	Thu Nov 05, 2026 05:13 AM	temp_c	36.9
VIT-010679	Thu Nov 05, 2026 05:13 AM	hr	82.0
VIT-010680	Thu Nov 05, 2026 05:13 AM	map	74.0
VIT-010681	Thu Nov 05, 2026 05:13 AM	gcs	15.0
VIT-010626	Thu Nov 05, 2026 01:13 PM	spo2	97.0	room air
VIT-010627	Thu Nov 05, 2026 01:13 PM	rr	18.0
VIT-010682	Thu Nov 05, 2026 01:13 PM	temp_c	37.1
VIT-010683	Thu Nov 05, 2026 01:13 PM	hr	71.0
VIT-010684	Thu Nov 05, 2026 01:13 PM	map	88.0
VIT-010685	Thu Nov 05, 2026 01:13 PM	gcs	15.0
VIT-010628	Thu Nov 05, 2026 09:13 PM	spo2	98.0	room air
VIT-010629	Thu Nov 05, 2026 09:13 PM	rr	15.0
VIT-010686	Thu Nov 05, 2026 09:13 PM	temp_c	37.2
VIT-010687	Thu Nov 05, 2026 09:13 PM	hr	84.0
VIT-010688	Thu Nov 05, 2026 09:13 PM	map	86.0
VIT-010689	Thu Nov 05, 2026 09:13 PM	gcs	15.0
VIT-010630	Fri Nov 06, 2026 05:13 AM	spo2	97.0	room air
VIT-010631	Fri Nov 06, 2026 05:13 AM	rr	15.0
VIT-010690	Fri Nov 06, 2026 05:13 AM	temp_c	37.3
VIT-010691	Fri Nov 06, 2026 05:13 AM	hr	73.0
VIT-010692	Fri Nov 06, 2026 05:13 AM	map	83.0
VIT-010693	Fri Nov 06, 2026 05:13 AM	gcs	15.0
VIT-010632	Fri Nov 06, 2026 01:13 PM	spo2	99.0	room air
VIT-010633	Fri Nov 06, 2026 01:13 PM	rr	14.0
VIT-010694	Fri Nov 06, 2026 01:13 PM	temp_c	37.5
VIT-010695	Fri Nov 06, 2026 01:13 PM	hr	73.0
VIT-010696	Fri Nov 06, 2026 01:13 PM	map	74.0
VIT-010697	Fri Nov 06, 2026 01:13 PM	gcs	15.0
VIT-010634	Fri Nov 06, 2026 09:13 PM	spo2	94.0	room air
VIT-010635	Fri Nov 06, 2026 09:13 PM	rr	20.0
VIT-010698	Fri Nov 06, 2026 09:13 PM	temp_c	37.3
VIT-010699	Fri Nov 06, 2026 09:13 PM	hr	88.0
VIT-010700	Fri Nov 06, 2026 09:13 PM	map	91.0
VIT-010701	Fri Nov 06, 2026 09:13 PM	gcs	15.0
VIT-010636	Sat Nov 07, 2026 05:13 AM	spo2	95.0	room air
VIT-010637	Sat Nov 07, 2026 05:13 AM	rr	16.0
VIT-010702	Sat Nov 07, 2026 05:13 AM	temp_c	36.9
VIT-010703	Sat Nov 07, 2026 05:13 AM	hr	73.0
VIT-010704	Sat Nov 07, 2026 05:13 AM	map	74.0
VIT-010705	Sat Nov 07, 2026 05:13 AM	gcs	15.0
VIT-010638	Sat Nov 07, 2026 01:13 PM	spo2	94.0	room air
VIT-010639	Sat Nov 07, 2026 01:13 PM	rr	16.0
VIT-010706	Sat Nov 07, 2026 01:13 PM	temp_c	37.2
VIT-010707	Sat Nov 07, 2026 01:13 PM	hr	77.0
VIT-010708	Sat Nov 07, 2026 01:13 PM	map	77.0
VIT-010709	Sat Nov 07, 2026 01:13 PM	gcs	15.0
VIT-010640	Sat Nov 07, 2026 09:13 PM	spo2	94.0	room air
VIT-010641	Sat Nov 07, 2026 09:13 PM	rr	19.0
VIT-010710	Sat Nov 07, 2026 09:13 PM	temp_c	37.4
VIT-010711	Sat Nov 07, 2026 09:13 PM	hr	88.0
VIT-010712	Sat Nov 07, 2026 09:13 PM	map	82.0
VIT-010713	Sat Nov 07, 2026 09:13 PM	gcs	15.0
VIT-010642	Sun Nov 08, 2026 05:13 AM	spo2	97.0	room air
VIT-010643	Sun Nov 08, 2026 05:13 AM	rr	16.0
VIT-010714	Sun Nov 08, 2026 05:13 AM	temp_c	36.6
VIT-010715	Sun Nov 08, 2026 05:13 AM	hr	92.0
VIT-010716	Sun Nov 08, 2026 05:13 AM	map	84.0
VIT-010717	Sun Nov 08, 2026 05:13 AM	gcs	15.0
VIT-010644	Sun Nov 08, 2026 01:13 PM	spo2	99.0	room air
VIT-010645	Sun Nov 08, 2026 01:13 PM	rr	15.0
VIT-010718	Sun Nov 08, 2026 01:13 PM	temp_c	37.4
VIT-010719	Sun Nov 08, 2026 01:13 PM	hr	92.0
VIT-010720	Sun Nov 08, 2026 01:13 PM	map	74.0
VIT-010721	Sun Nov 08, 2026 01:13 PM	gcs	15.0
VIT-010646	Sun Nov 08, 2026 09:13 PM	spo2	99.0	room air
VIT-010647	Sun Nov 08, 2026 09:13 PM	rr	19.0
VIT-010722	Sun Nov 08, 2026 09:13 PM	temp_c	36.7
VIT-010723	Sun Nov 08, 2026 09:13 PM	hr	78.0
VIT-010724	Sun Nov 08, 2026 09:13 PM	map	76.0
VIT-010725	Sun Nov 08, 2026 09:13 PM	gcs	15.0
VIT-010648	Mon Nov 09, 2026 05:13 AM	spo2	96.0	room air
VIT-010649	Mon Nov 09, 2026 05:13 AM	rr	17.0
VIT-010726	Mon Nov 09, 2026 05:13 AM	temp_c	37.0
VIT-010727	Mon Nov 09, 2026 05:13 AM	hr	77.0
VIT-010728	Mon Nov 09, 2026 05:13 AM	map	76.0
VIT-010729	Mon Nov 09, 2026 05:13 AM	gcs	15.0

Medications, orders, echo, history (9)

MED-000430 11-02 08:00 furosemide 40 mg IV
MED-000431 11-02 20:00 furosemide 40 mg IV
MED-000432 11-03 08:00 furosemide 40 mg IV
MED-000433 11-03 20:00 furosemide 40 mg IV
MED-000434 11-04 08:00 furosemide 40 mg IV
MED-000435 11-04 20:00 furosemide 40 mg IV
ORD-000094 11-03 09:00 transfusion_prbc: transfuse PRBC
ECH-000053 2026-11-03 echo LVEF 65.0%
HX-000043 history: heart failure with preserved ejection fraction

Notes

History and physical · DOC-000368 · Dr. Camila Oyelaran (resident) · Mon Nov 02, 2026 11:53 PM

Cited facts from this note (1)

bleeding_source: black tarry stools · cited p. 1, line 5 · confidence 0.85

Show source for bleeding_source

… rvice: Hospital Medicine Attending: Dr. Jalen Carrow History of present illness: 47-year-old woman admitted with upper GI bleed. Presented after two days of black tarry stools; GI consulted for endoscopy. Past medical history: heart failure with preserved ejection fraction, hypertension. Review of systems otherwise negative. Exam: Lu …

Source document DOC-000368: History and physical (synthetic)

HISTORY AND PHYSICAL
Patient: Mara Delacroix   MRN: MRN85934702   Admitted: 2026-11-02 20:53
Service: Hospital Medicine   Attending: Dr. Jalen Carrow

History of present illness: 47-year-old woman admitted with upper GI bleed. Presented after two days of black tarry stools; GI consulted for endoscopy.
Past medical history: heart failure with preserved ejection fraction, hypertension.
Review of systems otherwise negative.
Exam: Lungs: scattered crackles at the bases, no distress.
Assessment and plan:
1. Upper GI bleed: PPI, GI following.

Nutrition assessment · DOC-000367 · Dario Larkspur, RD (dietitian) · Wed Nov 04, 2026 12:53 AM

Cited facts from this note (5)

fat_loss: none · cited p. 1, line 7 · confidence 0.90

Show source for fat_loss

… MRN: MRN85934702 Context: acute illness Intake: eating 100% of meals. Weight history: weight stable over the past 3 months. Nutrition-focused physical exam: no loss of subcutaneous fat; no muscle wasting; no fluid accumulation. Assessment: well nourished; no malnutrition identified.
fluid_accumulation: none · cited p. 1, line 7 · confidence 0.90

Show source for fluid_accumulation

… e: eating 100% of meals. Weight history: weight stable over the past 3 months. Nutrition-focused physical exam: no loss of subcutaneous fat; no muscle wasting; no fluid accumulation. Assessment: well nourished; no malnutrition identified.
intake_pct: 100 · cited p. 1, line 5 · confidence 0.90

Show source for intake_pct

NUTRITION ASSESSMENT (Registered Dietitian) Patient: Mara Delacroix MRN: MRN85934702 Context: acute illness Intake: eating 100% of meals. Weight history: weight stable over the past 3 months. Nutrition-focused physical exam: no loss of subcutaneous fat; no muscle wasting; no fluid accumulation. …
muscle_loss: none · cited p. 1, line 7 · confidence 0.90

Show source for muscle_loss

… acute illness Intake: eating 100% of meals. Weight history: weight stable over the past 3 months. Nutrition-focused physical exam: no loss of subcutaneous fat; no muscle wasting; no fluid accumulation. Assessment: well nourished; no malnutrition identified.
nutrition_context: acute · cited p. 1, line 4 · confidence 0.95

Show source for nutrition_context

NUTRITION ASSESSMENT (Registered Dietitian) Patient: Mara Delacroix MRN: MRN85934702 Context: acute illness Intake: eating 100% of meals. Weight history: weight stable over the past 3 months. Nutrition-focused physical exam: no loss of subcutaneous fat; no muscle was …

Source document DOC-000367: Nutrition assessment (synthetic)

NUTRITION ASSESSMENT (Registered Dietitian)
Patient: Mara Delacroix   MRN: MRN85934702

Context: acute illness
Intake: eating 100% of meals.
Weight history: weight stable over the past 3 months.
Nutrition-focused physical exam: no loss of subcutaneous fat; no muscle wasting; no fluid accumulation.
Assessment: well nourished; no malnutrition identified.

Progress note · DOC-000369 · Dr. Camila Oyelaran (resident) · Thu Nov 05, 2026 12:53 AM

Source document DOC-000369: Progress note (synthetic)

PROGRESS NOTE (Resident)
Patient: Mara Delacroix   MRN: MRN85934702   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. Chronic diastolic heart failure: diuresis and daily weights; monitor electrolytes.
3. Acute blood loss anemia: trend hemoglobin, transfuse if needed.

Resident: Dr. Camila Oyelaran   Attending cosign: completed

Discharge summary · DOC-000370 · Dr. Jalen Carrow (attending) · Mon Nov 09, 2026 12:22 PM

Source document DOC-000370: Discharge summary (synthetic)

DISCHARGE SUMMARY
Patient: Mara Delacroix   MRN: MRN85934702
Admitted 2026-11-02; discharged 2026-11-09.

Discharge diagnoses:
- upper GI bleed
- chronic diastolic heart failure
- acute blood loss anemia
- hypertension

Disposition: home with follow-up.