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-00117: Wes Oyelaran

52F · MRN47199157 · Cardiology · admitted Sun Oct 25, 2026 05:35 PM · discharged Mon Nov 02, 2026 11:56 AM · attending Dr. Wes Merriweather · resident Dr. Priya Thorne · 158 cm, 53.1 kg

Documented diagnoses (current)

Principal: “chronic systolic heart failure” · I50.22 Chronic systolic (congestive) heart failure
“anemia” · D64.9 Anemia, unspecified
“stage 4 sacral pressure ulcer” · L89.154 Pressure ulcer of sacral region, stage 4

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 293.

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=1.043, 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=1.043, t.ratio_s3=3.0, creat_peak=0.98, 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=1.043, 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 (D64.9).

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=10.13, 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=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=True, acute_fall=False	false
outcome: anaemia_only	`anaemic and hgb_drop < t.drop_min and prbc_units == 0`	anaemic=True, hgb_drop=0.4, t.drop_min=1.0, prbc_units=0	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=300, t.chronic_days=90	true
derived: staging_egfr	`max(egfr_early, egfr_late)`	egfr_early=75.9, egfr_late=73.0	75.9
derived: both_below_60	`egfr_early < t.g2 and egfr_late < t.g2`	egfr_early=75.9, t.g2=60, egfr_late=73.0	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=75.9, 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=75.9, egfr_late=73.0, t.g2=60	false
outcome: g1_g2	`staging_egfr >= t.g2`	staging_egfr=75.9, t.g2=60	true

Heart failure

Criteria met

No gap

Supported as documented (I50.22).

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=32.0, t.bnp=100, ntprobnp_max=unknown, t.ntprobnp=300	false
derived: acute_count	`count(iv_loop_diuretic, np_elevated, new_o2)`	iv_loop_diuretic=False, np_elevated=False, new_o2=False	0
derived: hf_type	`case(lvef <= t.ref, 'systolic', lvef >= t.pres, 'diastolic', 'midrange')`	lvef=23.0, 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=23.0, 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=0, hf_history=True	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=chronic	false
outcome: sys_acute	`hf_type == 'systolic' and acuity == 'acute'`	hf_type=systolic, acuity=chronic	false
outcome: sys_chronic	`hf_type == 'systolic' and acuity == 'chronic'`	hf_type=systolic, acuity=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=52, t.adult=20	false
outcome: class3	`bmi >= t.c3`	bmi=21.3, t.c3=40	false
outcome: class2	`bmi >= t.c2`	bmi=21.3, t.c2=35	false
outcome: class1	`bmi >= t.c1`	bmi=21.3, t.c1=30	false
outcome: not_met	`bmi < t.c1`	bmi=21.3, t.c1=30	true

Pressure injury

Criteria met

Clinical validation gap

Documented “stage 4 sacral pressure ulcer” (L89.154) conflicts with what the criteria support (Pressure injury of sacral region, stage 2, 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

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=36.7, t.t_lo=36	false
derived: sirs_hr	`coalesce(hr_max_48h > t.hr, false)`	hr_max_48h=81.0, 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=20.0, 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=7.07, t.wbc_hi=12, wbc_min_48h=5.73, 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=187.0	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=0.54	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=74.0	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=0.96	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=0.94	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 (49)

Labs (pre-admission rows are outpatient values)
Row	When	Test	Value
LAB-003985	Fri Oct 10, 2025 09:15 AM	creatinine	0.91 mg/dL
LAB-003986	Thu Aug 06, 2026 10:05 AM	creatinine	0.94 mg/dL
LAB-003987	Sun Oct 25, 2026 06:35 PM	creatinine	0.96 mg/dL
LAB-003996	Sun Oct 25, 2026 06:35 PM	bnp	32.0 pg/mL
LAB-003997	Sun Oct 25, 2026 06:35 PM	sodium	140.0 mmol/L
LAB-004006	Sun Oct 25, 2026 06:35 PM	hemoglobin	10.28 g/dL
LAB-004015	Sun Oct 25, 2026 06:35 PM	wbc	5.73 x10^3/uL
LAB-004016	Sun Oct 25, 2026 06:35 PM	platelets	240.0 x10^3/uL
LAB-004033	Sun Oct 25, 2026 06:35 PM	bilirubin	0.54 mg/dL
LAB-003988	Mon Oct 26, 2026 05:00 AM	creatinine	0.96 mg/dL
LAB-003998	Mon Oct 26, 2026 05:00 AM	sodium	140.0 mmol/L
LAB-004007	Mon Oct 26, 2026 05:00 AM	hemoglobin	10.49 g/dL
LAB-004017	Mon Oct 26, 2026 05:00 AM	wbc	6.52 x10^3/uL
LAB-004018	Mon Oct 26, 2026 05:00 AM	platelets	274.0 x10^3/uL
LAB-003989	Tue Oct 27, 2026 05:00 AM	creatinine	0.93 mg/dL
LAB-003999	Tue Oct 27, 2026 05:00 AM	sodium	141.0 mmol/L
LAB-004008	Tue Oct 27, 2026 05:00 AM	hemoglobin	10.23 g/dL
LAB-004019	Tue Oct 27, 2026 05:00 AM	wbc	7.07 x10^3/uL
LAB-004020	Tue Oct 27, 2026 05:00 AM	platelets	187.0 x10^3/uL
LAB-003990	Wed Oct 28, 2026 05:00 AM	creatinine	0.94 mg/dL
LAB-004000	Wed Oct 28, 2026 05:00 AM	sodium	142.0 mmol/L
LAB-004009	Wed Oct 28, 2026 05:00 AM	hemoglobin	10.21 g/dL
LAB-004021	Wed Oct 28, 2026 05:00 AM	wbc	7.31 x10^3/uL
LAB-004022	Wed Oct 28, 2026 05:00 AM	platelets	295.0 x10^3/uL
LAB-003991	Thu Oct 29, 2026 05:00 AM	creatinine	0.98 mg/dL
LAB-004001	Thu Oct 29, 2026 05:00 AM	sodium	140.0 mmol/L
LAB-004010	Thu Oct 29, 2026 05:00 AM	hemoglobin	10.36 g/dL
LAB-004023	Thu Oct 29, 2026 05:00 AM	wbc	6.26 x10^3/uL
LAB-004024	Thu Oct 29, 2026 05:00 AM	platelets	294.0 x10^3/uL
LAB-003992	Fri Oct 30, 2026 05:00 AM	creatinine	0.98 mg/dL
LAB-004002	Fri Oct 30, 2026 05:00 AM	sodium	142.0 mmol/L
LAB-004011	Fri Oct 30, 2026 05:00 AM	hemoglobin	10.29 g/dL
LAB-004025	Fri Oct 30, 2026 05:00 AM	wbc	5.79 x10^3/uL
LAB-004026	Fri Oct 30, 2026 05:00 AM	platelets	257.0 x10^3/uL
LAB-003993	Sat Oct 31, 2026 05:00 AM	creatinine	0.95 mg/dL
LAB-004003	Sat Oct 31, 2026 05:00 AM	sodium	136.0 mmol/L
LAB-004012	Sat Oct 31, 2026 05:00 AM	hemoglobin	10.13 g/dL
LAB-004027	Sat Oct 31, 2026 05:00 AM	wbc	9.74 x10^3/uL
LAB-004028	Sat Oct 31, 2026 05:00 AM	platelets	253.0 x10^3/uL
LAB-003994	Sun Nov 01, 2026 05:00 AM	creatinine	0.93 mg/dL
LAB-004004	Sun Nov 01, 2026 05:00 AM	sodium	138.0 mmol/L
LAB-004013	Sun Nov 01, 2026 05:00 AM	hemoglobin	10.27 g/dL
LAB-004029	Sun Nov 01, 2026 05:00 AM	wbc	8.36 x10^3/uL
LAB-004030	Sun Nov 01, 2026 05:00 AM	platelets	209.0 x10^3/uL
LAB-003995	Mon Nov 02, 2026 05:00 AM	creatinine	0.97 mg/dL
LAB-004005	Mon Nov 02, 2026 05:00 AM	sodium	142.0 mmol/L
LAB-004014	Mon Nov 02, 2026 05:00 AM	hemoglobin	10.27 g/dL
LAB-004031	Mon Nov 02, 2026 05:00 AM	wbc	9.04 x10^3/uL
LAB-004032	Mon Nov 02, 2026 05:00 AM	platelets	198.0 x10^3/uL

Vitals (144)

Vitals
Row	When	Kind	Value	Detail
VIT-011436	Sun Oct 25, 2026 05:55 PM	spo2	94.0	room air
VIT-011437	Sun Oct 25, 2026 05:55 PM	rr	17.0
VIT-011484	Sun Oct 25, 2026 05:55 PM	temp_c	37.3
VIT-011485	Sun Oct 25, 2026 05:55 PM	hr	81.0
VIT-011486	Sun Oct 25, 2026 05:55 PM	map	81.0
VIT-011487	Sun Oct 25, 2026 05:55 PM	gcs	15.0
VIT-011438	Mon Oct 26, 2026 01:55 AM	spo2	94.0	room air
VIT-011439	Mon Oct 26, 2026 01:55 AM	rr	20.0
VIT-011488	Mon Oct 26, 2026 01:55 AM	temp_c	36.8
VIT-011489	Mon Oct 26, 2026 01:55 AM	hr	73.0
VIT-011490	Mon Oct 26, 2026 01:55 AM	map	75.0
VIT-011491	Mon Oct 26, 2026 01:55 AM	gcs	15.0
VIT-011440	Mon Oct 26, 2026 09:55 AM	spo2	96.0	room air
VIT-011441	Mon Oct 26, 2026 09:55 AM	rr	17.0
VIT-011492	Mon Oct 26, 2026 09:55 AM	temp_c	36.7
VIT-011493	Mon Oct 26, 2026 09:55 AM	hr	71.0
VIT-011494	Mon Oct 26, 2026 09:55 AM	map	76.0
VIT-011495	Mon Oct 26, 2026 09:55 AM	gcs	15.0
VIT-011442	Mon Oct 26, 2026 05:55 PM	spo2	98.0	room air
VIT-011443	Mon Oct 26, 2026 05:55 PM	rr	18.0
VIT-011496	Mon Oct 26, 2026 05:55 PM	temp_c	37.3
VIT-011497	Mon Oct 26, 2026 05:55 PM	hr	73.0
VIT-011498	Mon Oct 26, 2026 05:55 PM	map	84.0
VIT-011499	Mon Oct 26, 2026 05:55 PM	gcs	15.0
VIT-011444	Tue Oct 27, 2026 01:55 AM	spo2	96.0	room air
VIT-011445	Tue Oct 27, 2026 01:55 AM	rr	16.0
VIT-011500	Tue Oct 27, 2026 01:55 AM	temp_c	37.5
VIT-011501	Tue Oct 27, 2026 01:55 AM	hr	69.0
VIT-011502	Tue Oct 27, 2026 01:55 AM	map	86.0
VIT-011503	Tue Oct 27, 2026 01:55 AM	gcs	15.0
VIT-011446	Tue Oct 27, 2026 09:55 AM	spo2	96.0	room air
VIT-011447	Tue Oct 27, 2026 09:55 AM	rr	18.0
VIT-011504	Tue Oct 27, 2026 09:55 AM	temp_c	36.8
VIT-011505	Tue Oct 27, 2026 09:55 AM	hr	68.0
VIT-011506	Tue Oct 27, 2026 09:55 AM	map	74.0
VIT-011507	Tue Oct 27, 2026 09:55 AM	gcs	15.0
VIT-011448	Tue Oct 27, 2026 05:55 PM	spo2	94.0	room air
VIT-011449	Tue Oct 27, 2026 05:55 PM	rr	20.0
VIT-011508	Tue Oct 27, 2026 05:55 PM	temp_c	37.3
VIT-011509	Tue Oct 27, 2026 05:55 PM	hr	79.0
VIT-011510	Tue Oct 27, 2026 05:55 PM	map	79.0
VIT-011511	Tue Oct 27, 2026 05:55 PM	gcs	15.0
VIT-011450	Wed Oct 28, 2026 01:55 AM	spo2	97.0	room air
VIT-011451	Wed Oct 28, 2026 01:55 AM	rr	17.0
VIT-011512	Wed Oct 28, 2026 01:55 AM	temp_c	37.2
VIT-011513	Wed Oct 28, 2026 01:55 AM	hr	90.0
VIT-011514	Wed Oct 28, 2026 01:55 AM	map	75.0
VIT-011515	Wed Oct 28, 2026 01:55 AM	gcs	15.0
VIT-011452	Wed Oct 28, 2026 09:55 AM	spo2	96.0	room air
VIT-011453	Wed Oct 28, 2026 09:55 AM	rr	17.0
VIT-011516	Wed Oct 28, 2026 09:55 AM	temp_c	36.7
VIT-011517	Wed Oct 28, 2026 09:55 AM	hr	81.0
VIT-011518	Wed Oct 28, 2026 09:55 AM	map	88.0
VIT-011519	Wed Oct 28, 2026 09:55 AM	gcs	15.0
VIT-011454	Wed Oct 28, 2026 05:55 PM	spo2	97.0	room air
VIT-011455	Wed Oct 28, 2026 05:55 PM	rr	19.0
VIT-011520	Wed Oct 28, 2026 05:55 PM	temp_c	37.4
VIT-011521	Wed Oct 28, 2026 05:55 PM	hr	84.0
VIT-011522	Wed Oct 28, 2026 05:55 PM	map	83.0
VIT-011523	Wed Oct 28, 2026 05:55 PM	gcs	15.0
VIT-011456	Thu Oct 29, 2026 01:55 AM	spo2	98.0	room air
VIT-011457	Thu Oct 29, 2026 01:55 AM	rr	17.0
VIT-011524	Thu Oct 29, 2026 01:55 AM	temp_c	37.4
VIT-011525	Thu Oct 29, 2026 01:55 AM	hr	83.0
VIT-011526	Thu Oct 29, 2026 01:55 AM	map	80.0
VIT-011527	Thu Oct 29, 2026 01:55 AM	gcs	15.0
VIT-011458	Thu Oct 29, 2026 09:55 AM	spo2	94.0	room air
VIT-011459	Thu Oct 29, 2026 09:55 AM	rr	15.0
VIT-011528	Thu Oct 29, 2026 09:55 AM	temp_c	37.3
VIT-011529	Thu Oct 29, 2026 09:55 AM	hr	89.0
VIT-011530	Thu Oct 29, 2026 09:55 AM	map	89.0
VIT-011531	Thu Oct 29, 2026 09:55 AM	gcs	15.0
VIT-011460	Thu Oct 29, 2026 05:55 PM	spo2	99.0	room air
VIT-011461	Thu Oct 29, 2026 05:55 PM	rr	17.0
VIT-011532	Thu Oct 29, 2026 05:55 PM	temp_c	37.4
VIT-011533	Thu Oct 29, 2026 05:55 PM	hr	86.0
VIT-011534	Thu Oct 29, 2026 05:55 PM	map	90.0
VIT-011535	Thu Oct 29, 2026 05:55 PM	gcs	15.0
VIT-011462	Fri Oct 30, 2026 01:55 AM	spo2	96.0	room air
VIT-011463	Fri Oct 30, 2026 01:55 AM	rr	14.0
VIT-011536	Fri Oct 30, 2026 01:55 AM	temp_c	36.6
VIT-011537	Fri Oct 30, 2026 01:55 AM	hr	70.0
VIT-011538	Fri Oct 30, 2026 01:55 AM	map	77.0
VIT-011539	Fri Oct 30, 2026 01:55 AM	gcs	15.0
VIT-011464	Fri Oct 30, 2026 09:55 AM	spo2	99.0	room air
VIT-011465	Fri Oct 30, 2026 09:55 AM	rr	16.0
VIT-011540	Fri Oct 30, 2026 09:55 AM	temp_c	36.8
VIT-011541	Fri Oct 30, 2026 09:55 AM	hr	77.0
VIT-011542	Fri Oct 30, 2026 09:55 AM	map	88.0
VIT-011543	Fri Oct 30, 2026 09:55 AM	gcs	15.0
VIT-011466	Fri Oct 30, 2026 05:55 PM	spo2	95.0	room air
VIT-011467	Fri Oct 30, 2026 05:55 PM	rr	19.0
VIT-011544	Fri Oct 30, 2026 05:55 PM	temp_c	37.5
VIT-011545	Fri Oct 30, 2026 05:55 PM	hr	72.0
VIT-011546	Fri Oct 30, 2026 05:55 PM	map	90.0
VIT-011547	Fri Oct 30, 2026 05:55 PM	gcs	15.0
VIT-011468	Sat Oct 31, 2026 01:55 AM	spo2	95.0	room air
VIT-011469	Sat Oct 31, 2026 01:55 AM	rr	15.0
VIT-011548	Sat Oct 31, 2026 01:55 AM	temp_c	36.9
VIT-011549	Sat Oct 31, 2026 01:55 AM	hr	83.0
VIT-011550	Sat Oct 31, 2026 01:55 AM	map	78.0
VIT-011551	Sat Oct 31, 2026 01:55 AM	gcs	15.0
VIT-011470	Sat Oct 31, 2026 09:55 AM	spo2	96.0	room air
VIT-011471	Sat Oct 31, 2026 09:55 AM	rr	18.0
VIT-011552	Sat Oct 31, 2026 09:55 AM	temp_c	37.4
VIT-011553	Sat Oct 31, 2026 09:55 AM	hr	87.0
VIT-011554	Sat Oct 31, 2026 09:55 AM	map	85.0
VIT-011555	Sat Oct 31, 2026 09:55 AM	gcs	15.0
VIT-011472	Sat Oct 31, 2026 05:55 PM	spo2	94.0	room air
VIT-011473	Sat Oct 31, 2026 05:55 PM	rr	14.0
VIT-011556	Sat Oct 31, 2026 05:55 PM	temp_c	37.5
VIT-011557	Sat Oct 31, 2026 05:55 PM	hr	76.0
VIT-011558	Sat Oct 31, 2026 05:55 PM	map	84.0
VIT-011559	Sat Oct 31, 2026 05:55 PM	gcs	15.0
VIT-011474	Sun Nov 01, 2026 01:55 AM	spo2	98.0	room air
VIT-011475	Sun Nov 01, 2026 01:55 AM	rr	15.0
VIT-011560	Sun Nov 01, 2026 01:55 AM	temp_c	37.0
VIT-011561	Sun Nov 01, 2026 01:55 AM	hr	76.0
VIT-011562	Sun Nov 01, 2026 01:55 AM	map	80.0
VIT-011563	Sun Nov 01, 2026 01:55 AM	gcs	15.0
VIT-011476	Sun Nov 01, 2026 09:55 AM	spo2	94.0	room air
VIT-011477	Sun Nov 01, 2026 09:55 AM	rr	18.0
VIT-011564	Sun Nov 01, 2026 09:55 AM	temp_c	36.8
VIT-011565	Sun Nov 01, 2026 09:55 AM	hr	77.0
VIT-011566	Sun Nov 01, 2026 09:55 AM	map	90.0
VIT-011567	Sun Nov 01, 2026 09:55 AM	gcs	15.0
VIT-011478	Sun Nov 01, 2026 05:55 PM	spo2	97.0	room air
VIT-011479	Sun Nov 01, 2026 05:55 PM	rr	17.0
VIT-011568	Sun Nov 01, 2026 05:55 PM	temp_c	37.6
VIT-011569	Sun Nov 01, 2026 05:55 PM	hr	91.0
VIT-011570	Sun Nov 01, 2026 05:55 PM	map	83.0
VIT-011571	Sun Nov 01, 2026 05:55 PM	gcs	15.0
VIT-011480	Mon Nov 02, 2026 01:55 AM	spo2	98.0	room air
VIT-011481	Mon Nov 02, 2026 01:55 AM	rr	19.0
VIT-011572	Mon Nov 02, 2026 01:55 AM	temp_c	37.6
VIT-011573	Mon Nov 02, 2026 01:55 AM	hr	68.0
VIT-011574	Mon Nov 02, 2026 01:55 AM	map	92.0
VIT-011575	Mon Nov 02, 2026 01:55 AM	gcs	15.0
VIT-011482	Mon Nov 02, 2026 09:55 AM	spo2	98.0	room air
VIT-011483	Mon Nov 02, 2026 09:55 AM	rr	14.0
VIT-011576	Mon Nov 02, 2026 09:55 AM	temp_c	36.8
VIT-011577	Mon Nov 02, 2026 09:55 AM	hr	92.0
VIT-011578	Mon Nov 02, 2026 09:55 AM	map	86.0
VIT-011579	Mon Nov 02, 2026 09:55 AM	gcs	15.0

Medications, orders, echo, history (5)

MED-000463 10-25 09:35 furosemide 40 mg PO
MED-000464 10-26 09:00 furosemide 40 mg PO
MED-000465 10-27 09:00 furosemide 40 mg PO
ECH-000057 2026-05-21 echo LVEF 23.0%
HX-000046 history: heart failure with reduced ejection fraction

Notes

History and physical · DOC-000397 · Dr. Priya Thorne (resident) · Sun Oct 25, 2026 08:35 PM

Source document DOC-000397: History and physical (synthetic)

HISTORY AND PHYSICAL
Patient: Wes Oyelaran   MRN: MRN47199157   Admitted: 2026-10-25 17:35
Service: Cardiology   Attending: Dr. Wes Merriweather

History of present illness: 52-year-old woman admitted with chronic systolic heart failure. 
Past medical history: heart failure with reduced ejection fraction.
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.

Nutrition assessment · DOC-000395 · Vera Pemberton, RD (dietitian) · Mon Oct 26, 2026 07:35 PM

Cited facts from this note (5)

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

Show source for fat_loss

… MRN: MRN47199157 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: Wes Oyelaran MRN: MRN47199157 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: Wes Oyelaran MRN: MRN47199157 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-000395: Nutrition assessment (synthetic)

NUTRITION ASSESSMENT (Registered Dietitian)
Patient: Wes Oyelaran   MRN: MRN47199157

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.

Wound care note · DOC-000396 · Elena Jessup, RN, CWOCN (wound_nurse) · Tue Oct 27, 2026 01:35 AM

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: Wes Oyelaran MRN: MRN47199157 Location: sacrum Stage: 2 (NPIAP) Description: partial-thickness skin loss with exposed dermis. Size: 3.6 x 3.2 x 0.3 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: Wes Oyelaran MRN: MRN47199157 Location: sacrum Stage: 2 (NPIAP) Description: partial-thickness skin loss with exposed dermis. Size: 3.6 x 3.2 x 0.3 cm. Plan: offloading every 2 hours, foam dressing, nutrition consul …

Source document DOC-000396: Wound care note (synthetic)

WOUND CARE NOTE
Patient: Wes Oyelaran   MRN: MRN47199157

Location: sacrum
Stage: 2 (NPIAP)
Description: partial-thickness skin loss with exposed dermis.
Size: 3.6 x 3.2 x 0.3 cm.
Plan: offloading every 2 hours, foam dressing, nutrition consult.

Progress note · DOC-000398 · Dr. Priya Thorne (resident) · Tue Oct 27, 2026 08:35 PM

Source document DOC-000398: Progress note (synthetic)

PROGRESS NOTE (Resident)
Patient: Wes Oyelaran   MRN: MRN47199157   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. Anemia: trend hemoglobin.
3. Stage 4 sacral pressure ulcer: wound care following, offloading.

Resident: Dr. Priya Thorne   Attending cosign: completed

Discharge summary · DOC-000399 · Dr. Wes Merriweather (attending) · Mon Nov 02, 2026 11:56 AM

Source document DOC-000399: Discharge summary (synthetic)

DISCHARGE SUMMARY
Patient: Wes Oyelaran   MRN: MRN47199157
Admitted 2026-10-25; discharged 2026-11-02.

Discharge diagnoses:
- chronic systolic heart failure
- anemia
- stage 4 sacral pressure ulcer

Disposition: home with follow-up.