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-00120: Priya Jessup

84F · MRN78503972 · Cardiology · admitted Sun Nov 01, 2026 12:43 PM · discharged Thu Nov 05, 2026 02:30 PM · attending Dr. Isaac Abernath · resident Dr. Elena Nakashima · 152 cm, 50.1 kg

Documented diagnoses (current)

Principal: “acute systolic heart failure” · I50.21 Acute systolic (congestive) heart failure
“type 2 diabetes” · E11.9 Type 2 diabetes mellitus without complications
“hypertension” · I10 Essential (primary) hypertension

Illustrative grouping now: MS-DRG 293 Heart failure and shock without CC/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=1.061, 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=1.061, t.ratio_s3=3.0, creat_peak=0.87, 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=1.061, 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 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=12.42, 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=0.2, 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=0.2, t.drop_min=1.0, prbc_units=0	false
outcome: not_anaemic	`present(hgb_nadir) and not anaemic`	hgb_nadir=12.42, 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=187, t.chronic_days=90	true
derived: staging_egfr	`max(egfr_early, egfr_late)`	egfr_early=69.5, egfr_late=70.5	70.5
derived: both_below_60	`egfr_early < t.g2 and egfr_late < t.g2`	egfr_early=69.5, t.g2=60, egfr_late=70.5	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=70.5, 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=69.5, egfr_late=70.5, t.g2=60	false
outcome: g1_g2	`staging_egfr >= t.g2`	staging_egfr=70.5, t.g2=60	true

Heart failure

Criteria met

No gap

Supported as documented (I50.21).

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=957.0, 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=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=2, hf_history=False	acute
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	false
outcome: sys_acute	`hf_type == 'systolic' and acuity == 'acute'`	hf_type=systolic, acuity=acute	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

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 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=84, t.adult=20	false
outcome: class3	`bmi >= t.c3`	bmi=21.7, t.c3=40	false
outcome: class2	`bmi >= t.c2`	bmi=21.7, t.c2=35	false
outcome: class1	`bmi >= t.c1`	bmi=21.7, t.c1=30	false
outcome: not_met	`bmi < t.c1`	bmi=21.7, 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=36.8, t.t_lo=36	false
derived: sirs_hr	`coalesce(hr_max_48h > t.hr, false)`	hr_max_48h=89.0, 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=7.92, t.wbc_hi=12, wbc_min_48h=5.87, 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=192.0	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=1.0	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=75.0	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=0.86	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=0.82	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 (29)

Labs (pre-admission rows are outpatient values)
Row	When	Test	Value
LAB-004085	Sun Jan 04, 2026 09:15 AM	creatinine	0.83 mg/dL
LAB-004086	Sat Jul 11, 2026 10:05 AM	creatinine	0.82 mg/dL
LAB-004087	Sun Nov 01, 2026 01:43 PM	creatinine	0.81 mg/dL
LAB-004092	Sun Nov 01, 2026 01:43 PM	bnp	957.0 pg/mL
LAB-004093	Sun Nov 01, 2026 01:43 PM	sodium	142.0 mmol/L
LAB-004098	Sun Nov 01, 2026 01:43 PM	hemoglobin	12.59 g/dL
LAB-004103	Sun Nov 01, 2026 01:43 PM	wbc	5.87 x10^3/uL
LAB-004104	Sun Nov 01, 2026 01:43 PM	platelets	253.0 x10^3/uL
LAB-004113	Sun Nov 01, 2026 01:43 PM	bilirubin	1.0 mg/dL
LAB-004088	Mon Nov 02, 2026 05:00 AM	creatinine	0.86 mg/dL
LAB-004094	Mon Nov 02, 2026 05:00 AM	sodium	138.0 mmol/L
LAB-004099	Mon Nov 02, 2026 05:00 AM	hemoglobin	12.42 g/dL
LAB-004105	Mon Nov 02, 2026 05:00 AM	wbc	6.45 x10^3/uL
LAB-004106	Mon Nov 02, 2026 05:00 AM	platelets	229.0 x10^3/uL
LAB-004089	Tue Nov 03, 2026 05:00 AM	creatinine	0.85 mg/dL
LAB-004095	Tue Nov 03, 2026 05:00 AM	sodium	138.0 mmol/L
LAB-004100	Tue Nov 03, 2026 05:00 AM	hemoglobin	12.61 g/dL
LAB-004107	Tue Nov 03, 2026 05:00 AM	wbc	7.92 x10^3/uL
LAB-004108	Tue Nov 03, 2026 05:00 AM	platelets	192.0 x10^3/uL
LAB-004090	Wed Nov 04, 2026 05:00 AM	creatinine	0.87 mg/dL
LAB-004096	Wed Nov 04, 2026 05:00 AM	sodium	136.0 mmol/L
LAB-004101	Wed Nov 04, 2026 05:00 AM	hemoglobin	12.69 g/dL
LAB-004109	Wed Nov 04, 2026 05:00 AM	wbc	7.7 x10^3/uL
LAB-004110	Wed Nov 04, 2026 05:00 AM	platelets	293.0 x10^3/uL
LAB-004091	Thu Nov 05, 2026 05:00 AM	creatinine	0.86 mg/dL
LAB-004097	Thu Nov 05, 2026 05:00 AM	sodium	136.0 mmol/L
LAB-004102	Thu Nov 05, 2026 05:00 AM	hemoglobin	12.58 g/dL
LAB-004111	Thu Nov 05, 2026 05:00 AM	wbc	7.4 x10^3/uL
LAB-004112	Thu Nov 05, 2026 05:00 AM	platelets	296.0 x10^3/uL

Vitals (78)

Vitals
Row	When	Kind	Value	Detail
VIT-011712	Sun Nov 01, 2026 01:03 PM	spo2	97.0	room air
VIT-011713	Sun Nov 01, 2026 01:03 PM	rr	20.0
VIT-011738	Sun Nov 01, 2026 01:03 PM	temp_c	36.9
VIT-011739	Sun Nov 01, 2026 01:03 PM	hr	82.0
VIT-011740	Sun Nov 01, 2026 01:03 PM	map	89.0
VIT-011741	Sun Nov 01, 2026 01:03 PM	gcs	15.0
VIT-011714	Sun Nov 01, 2026 09:03 PM	spo2	98.0	room air
VIT-011715	Sun Nov 01, 2026 09:03 PM	rr	16.0
VIT-011742	Sun Nov 01, 2026 09:03 PM	temp_c	36.9
VIT-011743	Sun Nov 01, 2026 09:03 PM	hr	83.0
VIT-011744	Sun Nov 01, 2026 09:03 PM	map	77.0
VIT-011745	Sun Nov 01, 2026 09:03 PM	gcs	15.0
VIT-011716	Mon Nov 02, 2026 05:03 AM	spo2	94.0	room air
VIT-011717	Mon Nov 02, 2026 05:03 AM	rr	17.0
VIT-011746	Mon Nov 02, 2026 05:03 AM	temp_c	37.0
VIT-011747	Mon Nov 02, 2026 05:03 AM	hr	78.0
VIT-011748	Mon Nov 02, 2026 05:03 AM	map	75.0
VIT-011749	Mon Nov 02, 2026 05:03 AM	gcs	15.0
VIT-011718	Mon Nov 02, 2026 01:03 PM	spo2	99.0	room air
VIT-011719	Mon Nov 02, 2026 01:03 PM	rr	14.0
VIT-011750	Mon Nov 02, 2026 01:03 PM	temp_c	37.5
VIT-011751	Mon Nov 02, 2026 01:03 PM	hr	89.0
VIT-011752	Mon Nov 02, 2026 01:03 PM	map	84.0
VIT-011753	Mon Nov 02, 2026 01:03 PM	gcs	15.0
VIT-011720	Mon Nov 02, 2026 09:03 PM	spo2	94.0	room air
VIT-011721	Mon Nov 02, 2026 09:03 PM	rr	16.0
VIT-011754	Mon Nov 02, 2026 09:03 PM	temp_c	36.8
VIT-011755	Mon Nov 02, 2026 09:03 PM	hr	87.0
VIT-011756	Mon Nov 02, 2026 09:03 PM	map	92.0
VIT-011757	Mon Nov 02, 2026 09:03 PM	gcs	15.0
VIT-011722	Tue Nov 03, 2026 05:03 AM	spo2	96.0	room air
VIT-011723	Tue Nov 03, 2026 05:03 AM	rr	14.0
VIT-011758	Tue Nov 03, 2026 05:03 AM	temp_c	37.0
VIT-011759	Tue Nov 03, 2026 05:03 AM	hr	76.0
VIT-011760	Tue Nov 03, 2026 05:03 AM	map	77.0
VIT-011761	Tue Nov 03, 2026 05:03 AM	gcs	15.0
VIT-011724	Tue Nov 03, 2026 01:03 PM	spo2	97.0	room air
VIT-011725	Tue Nov 03, 2026 01:03 PM	rr	14.0
VIT-011762	Tue Nov 03, 2026 01:03 PM	temp_c	36.6
VIT-011763	Tue Nov 03, 2026 01:03 PM	hr	87.0
VIT-011764	Tue Nov 03, 2026 01:03 PM	map	76.0
VIT-011765	Tue Nov 03, 2026 01:03 PM	gcs	15.0
VIT-011726	Tue Nov 03, 2026 09:03 PM	spo2	96.0	room air
VIT-011727	Tue Nov 03, 2026 09:03 PM	rr	18.0
VIT-011766	Tue Nov 03, 2026 09:03 PM	temp_c	36.9
VIT-011767	Tue Nov 03, 2026 09:03 PM	hr	87.0
VIT-011768	Tue Nov 03, 2026 09:03 PM	map	82.0
VIT-011769	Tue Nov 03, 2026 09:03 PM	gcs	15.0
VIT-011728	Wed Nov 04, 2026 05:03 AM	spo2	95.0	room air
VIT-011729	Wed Nov 04, 2026 05:03 AM	rr	19.0
VIT-011770	Wed Nov 04, 2026 05:03 AM	temp_c	36.8
VIT-011771	Wed Nov 04, 2026 05:03 AM	hr	84.0
VIT-011772	Wed Nov 04, 2026 05:03 AM	map	88.0
VIT-011773	Wed Nov 04, 2026 05:03 AM	gcs	15.0
VIT-011730	Wed Nov 04, 2026 01:03 PM	spo2	94.0	room air
VIT-011731	Wed Nov 04, 2026 01:03 PM	rr	15.0
VIT-011774	Wed Nov 04, 2026 01:03 PM	temp_c	37.5
VIT-011775	Wed Nov 04, 2026 01:03 PM	hr	70.0
VIT-011776	Wed Nov 04, 2026 01:03 PM	map	74.0
VIT-011777	Wed Nov 04, 2026 01:03 PM	gcs	15.0
VIT-011732	Wed Nov 04, 2026 09:03 PM	spo2	97.0	room air
VIT-011733	Wed Nov 04, 2026 09:03 PM	rr	18.0
VIT-011778	Wed Nov 04, 2026 09:03 PM	temp_c	37.4
VIT-011779	Wed Nov 04, 2026 09:03 PM	hr	84.0
VIT-011780	Wed Nov 04, 2026 09:03 PM	map	90.0
VIT-011781	Wed Nov 04, 2026 09:03 PM	gcs	15.0
VIT-011734	Thu Nov 05, 2026 05:03 AM	spo2	98.0	room air
VIT-011735	Thu Nov 05, 2026 05:03 AM	rr	15.0
VIT-011782	Thu Nov 05, 2026 05:03 AM	temp_c	37.4
VIT-011783	Thu Nov 05, 2026 05:03 AM	hr	88.0
VIT-011784	Thu Nov 05, 2026 05:03 AM	map	76.0
VIT-011785	Thu Nov 05, 2026 05:03 AM	gcs	15.0
VIT-011736	Thu Nov 05, 2026 01:03 PM	spo2	96.0	room air
VIT-011737	Thu Nov 05, 2026 01:03 PM	rr	18.0
VIT-011786	Thu Nov 05, 2026 01:03 PM	temp_c	37.4
VIT-011787	Thu Nov 05, 2026 01:03 PM	hr	72.0
VIT-011788	Thu Nov 05, 2026 01:03 PM	map	87.0
VIT-011789	Thu Nov 05, 2026 01:03 PM	gcs	15.0

Medications, orders, echo, history (7)

MED-000469 11-01 08:00 furosemide 40 mg IV
MED-000470 11-01 20:00 furosemide 40 mg IV
MED-000471 11-02 08:00 furosemide 40 mg IV
MED-000472 11-02 20:00 furosemide 40 mg IV
MED-000473 11-03 08:00 furosemide 40 mg IV
MED-000474 11-03 20:00 furosemide 40 mg IV
ECH-000058 2026-11-02 echo LVEF 35.0%

Notes

History and physical · DOC-000406 · Dr. Elena Nakashima (resident) · Sun Nov 01, 2026 03:43 PM

Source document DOC-000406: History and physical (synthetic)

HISTORY AND PHYSICAL
Patient: Priya Jessup   MRN: MRN78503972   Admitted: 2026-11-01 12:43
Service: Cardiology   Attending: Dr. Isaac Abernath

History of present illness: 84-year-old woman admitted with acute systolic heart failure. 
Past medical history: type 2 diabetes, hypertension.
Review of systems otherwise negative.
Exam: Lungs: scattered crackles at the bases, no distress.
Assessment and plan:
1. Acute systolic heart failure: diuresis and daily weights; monitor electrolytes.

Progress note · DOC-000407 · Dr. Elena Nakashima (resident) · Tue Nov 03, 2026 02:43 PM

Source document DOC-000407: Progress note (synthetic)

PROGRESS NOTE (Resident)
Patient: Priya Jessup   MRN: MRN78503972   Hospital day 3

Subjective: resting, tolerating diet.
Objective: vitals and labs reviewed in the flowsheet.
Assessment and plan:
1. Acute systolic heart failure: continue current management.

Resident: Dr. Elena Nakashima   Attending cosign: completed

Discharge summary · DOC-000408 · Dr. Isaac Abernath (attending) · Thu Nov 05, 2026 02:30 PM

Source document DOC-000408: Discharge summary (synthetic)

DISCHARGE SUMMARY
Patient: Priya Jessup   MRN: MRN78503972
Admitted 2026-11-01; discharged 2026-11-05.

Discharge diagnoses:
- acute systolic heart failure
- type 2 diabetes
- hypertension

Disposition: home with follow-up.