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Exact Dx synthetic data · demonstration
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.

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ENC-00123: Dmitri Marlow

79M · MRN94395495 · Hospital Medicine · admitted Thu Oct 29, 2026 08:29 AM · discharged Thu Nov 05, 2026 04:31 PM · attending Dr. Kenji Stavros · resident Dr. Elena Nakashima · 174 cm, 131.4 kg

Documented diagnoses (current)

  • Principal: “community-acquired pneumonia” · J18.9 Pneumonia, unspecified organism
  • “morbid obesity” · E66.01 Morbid (severe) obesity due to excess calories
  • “acute hypoxic respiratory failure” · J96.01 Acute respiratory failure with hypoxia
  • “hyperlipidemia” · E78.5 Hyperlipidemia, unspecified

Illustrative grouping now: MS-DRG 193 Simple pneumonia and pleurisy with MCC. If every open specificity/validation gap were answered as the criteria suggest: MS-DRG 193.

Queries and events

No queries yet.

All rules applied

Every rule's outcome for this encounter (clean results included)
RuleCriteriaFindingOutcome
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)
StepExpressionInputs and thresholds readResult
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=1.059, t.ratio_s1=1.5, creat_rise_48h=0.04, 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=1.059, t.ratio_s3=3.0, creat_peak=1.08, 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=1.059, 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=0.04, 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)
StepExpressionInputs and thresholds readResult
derived: anaemic case(sex == 'M', hgb_nadir < t.hb_m, sex == 'F', hgb_nadir < t.hb_f, null) sex=M, hgb_nadir=13.45, 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=0.0, 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=0.0, t.drop_min=1.0, prbc_units=0 false
outcome: not_anaemic present(hgb_nadir) and not anaemic hgb_nadir=13.45, 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)
StepExpressionInputs and thresholds readResult
derived: chronic egfr_n >= 2 and egfr_span_days >= t.chronic_days egfr_n=2, egfr_span_days=212, t.chronic_days=90 true
derived: staging_egfr max(egfr_early, egfr_late) egfr_early=78.4, egfr_late=74.8 78.4
derived: both_below_60 egfr_early < t.g2 and egfr_late < t.g2 egfr_early=78.4, t.g2=60, egfr_late=74.8 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=78.4, 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=78.4, egfr_late=74.8, t.g2=60 false
outcome: g1_g2 staging_egfr >= t.g2 staging_egfr=78.4, t.g2=60 true
Heart failure Clinical judgement required No gap Not documented; only one acute indicator; acuity needs clinical judgement.
Trace
Rule trace (rule heart_failure v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
StepExpressionInputs and thresholds readResult
derived: np_elevated coalesce(bnp_max >= t.bnp, false) or coalesce(ntprobnp_max >= t.ntprobnp, false) bnp_max=unknown, 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=True 1
derived: hf_type case(lvef <= t.ref, 'systolic', lvef >= t.pres, 'diastolic', 'midrange') lvef=unknown, t.ref=40, t.pres=50 unknown
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=unknown, t.improved_rise=10 false
derived: acuity case(acute_count >= 2 and hf_history, 'acute on chronic', acute_count >= 2, 'acute', acute_count == 0 and hf_history, 'chronic', null) acute_count=1, hf_history=False unknown
outcome: improved_ef improved improved=False false
outcome: midrange hf_type == 'midrange' hf_type=unknown unknown
outcome: sys_aoc hf_type == 'systolic' and acuity == 'acute on chronic' hf_type=unknown, acuity=unknown unknown
outcome: sys_acute hf_type == 'systolic' and acuity == 'acute' hf_type=unknown, acuity=unknown unknown
outcome: sys_chronic hf_type == 'systolic' and acuity == 'chronic' hf_type=unknown, acuity=unknown unknown
outcome: dia_aoc hf_type == 'diastolic' and acuity == 'acute on chronic' hf_type=unknown, acuity=unknown unknown
outcome: dia_acute hf_type == 'diastolic' and acuity == 'acute' hf_type=unknown, acuity=unknown unknown
outcome: dia_chronic hf_type == 'diastolic' and acuity == 'chronic' hf_type=unknown, acuity=unknown unknown
outcome: one_indicator acute_count == 1 acute_count=1 true
Hyponatraemia Criteria met Specificity gap Criteria support Hyponatraemia (profound) (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)
StepExpressionInputs and thresholds readResult
derived: severity case(na_min < t.profound, 'profound', na_min < t.moderate, 'moderate', na_min < t.low, 'mild', 'none') na_min=123.0, t.profound=125, t.moderate=130, t.low=135 profound
outcome: met na_min < t.low and na_low_count >= t.repeat and na_treated na_min=123.0, 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)
StepExpressionInputs and thresholds readResult
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 (E66.813).
Trace
Rule trace (rule obesity v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
StepExpressionInputs and thresholds readResult
outcome: not_adult age < t.adult age=79, t.adult=20 false
outcome: class3 bmi >= t.c3 bmi=43.4, t.c3=40 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)
StepExpressionInputs and thresholds readResult
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 met No gap Supported as documented (J96.01).
Trace
Rule trace (rule respiratory_failure v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
StepExpressionInputs and thresholds readResult
derived: measured present(spo2_min_ra) or present(pao2_min_ra) or present(pf_min) spo2_min_ra=84.0, pao2_min_ra=55.0, pf_min=262 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=84.0, t.spo2_ra=88, pao2_min_ra=55.0, t.pao2=60, pf_min=262, t.pf=300 true
derived: distress coalesce(rr_max >= t.rr_distress, false) or coalesce(wob_increased, false) or adv_resp_support rr_max=34.0, t.rr_distress=28, wob_increased=True, adv_resp_support=False true
outcome: chronic_baseline home_o2 and hypoxemia home_o2=False, hypoxemia=True false
outcome: met hypoxemia and distress hypoxemia=True, distress=True true
Sepsis Criteria met No gap Criteria support Sepsis (Sepsis-3); not documented (this rule does not prompt for an undocumented diagnosis).
Trace
Rule trace (rule sepsis v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
StepExpressionInputs and thresholds readResult
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=36.6, t.t_lo=36 false
derived: sirs_hr coalesce(hr_max_48h > t.hr, false) hr_max_48h=90.0, t.hr=90 false
derived: sirs_rr coalesce(rr_max_48h > t.rr, false) or coalesce(paco2_min_48h < t.paco2, false) rr_max_48h=34.0, 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=8.84, t.wbc_hi=12, wbc_min_48h=7.32, 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=262, adv_resp_support=False 2
derived: sofa_coag coalesce(case(platelets_min_48h < 20, 4, platelets_min_48h < 50, 3, platelets_min_48h < 100, 2, platelets_min_48h < 150, 1, 0), 0) platelets_min_48h=228.0 0
derived: sofa_liver coalesce(case(bili_max_48h >= 12, 4, bili_max_48h >= 6, 3, bili_max_48h >= 2, 2, bili_max_48h >= 1.2, 1, 0), 0) bili_max_48h=0.72 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=1.06 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=1.02 0
derived: sofa_delta sofa_resp + sofa_coag + sofa_liver + sofa_cardio + sofa_cns + sofa_renal - sofa_renal_baseline sofa_resp=2, sofa_coag=0, sofa_liver=0, sofa_cardio=0, sofa_cns=0, sofa_renal=0, sofa_renal_baseline=0 2
derived: sepsis3 infection_documented and sofa_delta >= t.sofa_delta infection_documented=True, sofa_delta=2, t.sofa_delta=2 true
derived: sepsis2 infection_documented and sirs_count >= t.sirs_min infection_documented=True, 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=True, norepi_max_48h=0.0, lactate_max_48h=unknown, t.lactate=2 false
outcome: no_infection not infection_documented infection_documented=True false
outcome: septic_shock shock shock=False false
outcome: both sepsis3 and sepsis2 sepsis3=True, sepsis2=False false
outcome: sepsis3_only sepsis3 sepsis3=True true

Structured data

Labs (45)
Labs (pre-admission rows are outpatient values)
RowWhenTestValue
LAB-004168Thu Dec 25, 2025 09:15 AMcreatinine0.98 mg/dL
LAB-004169Sun Jul 26, 2026 10:05 AMcreatinine1.02 mg/dL
LAB-004178Thu Oct 29, 2026 08:54 AMpao255.0 mmHg
LAB-004179Thu Oct 29, 2026 08:54 AMfio221.0 %
LAB-004170Thu Oct 29, 2026 09:29 AMcreatinine1.06 mg/dL
LAB-004180Thu Oct 29, 2026 09:29 AMsodium125.0 mmol/L
LAB-004188Thu Oct 29, 2026 09:29 AMhemoglobin13.45 g/dL
LAB-004196Thu Oct 29, 2026 09:29 AMwbc7.32 x10^3/uL
LAB-004197Thu Oct 29, 2026 09:29 AMplatelets236.0 x10^3/uL
LAB-004212Thu Oct 29, 2026 09:29 AMbilirubin0.72 mg/dL
LAB-004171Fri Oct 30, 2026 05:00 AMcreatinine1.01 mg/dL
LAB-004181Fri Oct 30, 2026 05:00 AMsodium123.0 mmol/L
LAB-004189Fri Oct 30, 2026 05:00 AMhemoglobin13.5 g/dL
LAB-004198Fri Oct 30, 2026 05:00 AMwbc8.84 x10^3/uL
LAB-004199Fri Oct 30, 2026 05:00 AMplatelets307.0 x10^3/uL
LAB-004172Sat Oct 31, 2026 05:00 AMcreatinine1.04 mg/dL
LAB-004182Sat Oct 31, 2026 05:00 AMsodium124.0 mmol/L
LAB-004190Sat Oct 31, 2026 05:00 AMhemoglobin13.79 g/dL
LAB-004200Sat Oct 31, 2026 05:00 AMwbc8.76 x10^3/uL
LAB-004201Sat Oct 31, 2026 05:00 AMplatelets228.0 x10^3/uL
LAB-004173Sun Nov 01, 2026 05:00 AMcreatinine1.05 mg/dL
LAB-004183Sun Nov 01, 2026 05:00 AMsodium127.0 mmol/L
LAB-004191Sun Nov 01, 2026 05:00 AMhemoglobin13.77 g/dL
LAB-004202Sun Nov 01, 2026 05:00 AMwbc8.79 x10^3/uL
LAB-004203Sun Nov 01, 2026 05:00 AMplatelets236.0 x10^3/uL
LAB-004174Mon Nov 02, 2026 05:00 AMcreatinine1.04 mg/dL
LAB-004184Mon Nov 02, 2026 05:00 AMsodium129.0 mmol/L
LAB-004192Mon Nov 02, 2026 05:00 AMhemoglobin13.64 g/dL
LAB-004204Mon Nov 02, 2026 05:00 AMwbc7.17 x10^3/uL
LAB-004205Mon Nov 02, 2026 05:00 AMplatelets171.0 x10^3/uL
LAB-004175Tue Nov 03, 2026 05:00 AMcreatinine1.07 mg/dL
LAB-004185Tue Nov 03, 2026 05:00 AMsodium134.0 mmol/L
LAB-004193Tue Nov 03, 2026 05:00 AMhemoglobin13.58 g/dL
LAB-004206Tue Nov 03, 2026 05:00 AMwbc9.44 x10^3/uL
LAB-004207Tue Nov 03, 2026 05:00 AMplatelets308.0 x10^3/uL
LAB-004176Wed Nov 04, 2026 05:00 AMcreatinine1.08 mg/dL
LAB-004186Wed Nov 04, 2026 05:00 AMsodium136.0 mmol/L
LAB-004194Wed Nov 04, 2026 05:00 AMhemoglobin13.47 g/dL
LAB-004208Wed Nov 04, 2026 05:00 AMwbc5.86 x10^3/uL
LAB-004209Wed Nov 04, 2026 05:00 AMplatelets171.0 x10^3/uL
LAB-004177Thu Nov 05, 2026 05:00 AMcreatinine1.02 mg/dL
LAB-004187Thu Nov 05, 2026 05:00 AMsodium137.0 mmol/L
LAB-004195Thu Nov 05, 2026 05:00 AMhemoglobin13.8 g/dL
LAB-004210Thu Nov 05, 2026 05:00 AMwbc9.19 x10^3/uL
LAB-004211Thu Nov 05, 2026 05:00 AMplatelets266.0 x10^3/uL
Vitals (154)
Vitals
RowWhenKindValueDetail
VIT-011921Thu Oct 29, 2026 08:49 AMspo284.0room air
VIT-011922Thu Oct 29, 2026 08:49 AMrr34.0
VIT-011987Thu Oct 29, 2026 08:49 AMtemp_c37.3
VIT-011988Thu Oct 29, 2026 08:49 AMhr89.0
VIT-011989Thu Oct 29, 2026 08:49 AMmap86.0
VIT-011990Thu Oct 29, 2026 08:49 AMgcs15.0
VIT-011923Thu Oct 29, 2026 08:59 AMo2_lpm4.0nasal cannula
VIT-011924Thu Oct 29, 2026 04:49 PMspo294.0nasal cannula
VIT-011925Thu Oct 29, 2026 04:49 PMrr22.0
VIT-011926Thu Oct 29, 2026 04:49 PMo2_lpm3.0nasal cannula
VIT-011991Thu Oct 29, 2026 04:49 PMtemp_c37.1
VIT-011992Thu Oct 29, 2026 04:49 PMhr90.0
VIT-011993Thu Oct 29, 2026 04:49 PMmap75.0
VIT-011994Thu Oct 29, 2026 04:49 PMgcs15.0
VIT-011927Fri Oct 30, 2026 12:49 AMspo293.0nasal cannula
VIT-011928Fri Oct 30, 2026 12:49 AMrr21.0
VIT-011929Fri Oct 30, 2026 12:49 AMo2_lpm3.0nasal cannula
VIT-011995Fri Oct 30, 2026 12:49 AMtemp_c37.3
VIT-011996Fri Oct 30, 2026 12:49 AMhr69.0
VIT-011997Fri Oct 30, 2026 12:49 AMmap78.0
VIT-011998Fri Oct 30, 2026 12:49 AMgcs15.0
VIT-011930Fri Oct 30, 2026 08:49 AMspo291.0nasal cannula
VIT-011931Fri Oct 30, 2026 08:49 AMrr20.0
VIT-011932Fri Oct 30, 2026 08:49 AMo2_lpm2.0nasal cannula
VIT-011999Fri Oct 30, 2026 08:49 AMtemp_c36.6
VIT-012000Fri Oct 30, 2026 08:49 AMhr86.0
VIT-012001Fri Oct 30, 2026 08:49 AMmap79.0
VIT-012002Fri Oct 30, 2026 08:49 AMgcs15.0
VIT-011933Fri Oct 30, 2026 04:49 PMspo292.0nasal cannula
VIT-011934Fri Oct 30, 2026 04:49 PMrr23.0
VIT-011935Fri Oct 30, 2026 04:49 PMo2_lpm4.0nasal cannula
VIT-012003Fri Oct 30, 2026 04:49 PMtemp_c37.5
VIT-012004Fri Oct 30, 2026 04:49 PMhr85.0
VIT-012005Fri Oct 30, 2026 04:49 PMmap86.0
VIT-012006Fri Oct 30, 2026 04:49 PMgcs15.0
VIT-011936Sat Oct 31, 2026 12:49 AMspo294.0nasal cannula
VIT-011937Sat Oct 31, 2026 12:49 AMrr23.0
VIT-011938Sat Oct 31, 2026 12:49 AMo2_lpm3.0nasal cannula
VIT-012007Sat Oct 31, 2026 12:49 AMtemp_c36.9
VIT-012008Sat Oct 31, 2026 12:49 AMhr78.0
VIT-012009Sat Oct 31, 2026 12:49 AMmap74.0
VIT-012010Sat Oct 31, 2026 12:49 AMgcs15.0
VIT-011939Sat Oct 31, 2026 08:49 AMspo293.0nasal cannula
VIT-011940Sat Oct 31, 2026 08:49 AMrr22.0
VIT-011941Sat Oct 31, 2026 08:49 AMo2_lpm3.0nasal cannula
VIT-012011Sat Oct 31, 2026 08:49 AMtemp_c36.9
VIT-012012Sat Oct 31, 2026 08:49 AMhr74.0
VIT-012013Sat Oct 31, 2026 08:49 AMmap91.0
VIT-012014Sat Oct 31, 2026 08:49 AMgcs15.0
VIT-011942Sat Oct 31, 2026 04:49 PMspo292.0nasal cannula
VIT-011943Sat Oct 31, 2026 04:49 PMrr23.0
VIT-011944Sat Oct 31, 2026 04:49 PMo2_lpm4.0nasal cannula
VIT-012015Sat Oct 31, 2026 04:49 PMtemp_c36.5
VIT-012016Sat Oct 31, 2026 04:49 PMhr91.0
VIT-012017Sat Oct 31, 2026 04:49 PMmap83.0
VIT-012018Sat Oct 31, 2026 04:49 PMgcs15.0
VIT-011945Sun Nov 01, 2026 12:49 AMspo295.0nasal cannula
VIT-011946Sun Nov 01, 2026 12:49 AMrr26.0
VIT-011947Sun Nov 01, 2026 12:49 AMo2_lpm2.0nasal cannula
VIT-012019Sun Nov 01, 2026 12:49 AMtemp_c37.2
VIT-012020Sun Nov 01, 2026 12:49 AMhr77.0
VIT-012021Sun Nov 01, 2026 12:49 AMmap79.0
VIT-012022Sun Nov 01, 2026 12:49 AMgcs15.0
VIT-011948Sun Nov 01, 2026 08:49 AMspo291.0nasal cannula
VIT-011949Sun Nov 01, 2026 08:49 AMrr20.0
VIT-011950Sun Nov 01, 2026 08:49 AMo2_lpm2.0nasal cannula
VIT-012023Sun Nov 01, 2026 08:49 AMtemp_c36.8
VIT-012024Sun Nov 01, 2026 08:49 AMhr92.0
VIT-012025Sun Nov 01, 2026 08:49 AMmap88.0
VIT-012026Sun Nov 01, 2026 08:49 AMgcs15.0
VIT-011951Sun Nov 01, 2026 04:49 PMspo292.0nasal cannula
VIT-011952Sun Nov 01, 2026 04:49 PMrr23.0
VIT-011953Sun Nov 01, 2026 04:49 PMo2_lpm2.0nasal cannula
VIT-012027Sun Nov 01, 2026 04:49 PMtemp_c37.0
VIT-012028Sun Nov 01, 2026 04:49 PMhr73.0
VIT-012029Sun Nov 01, 2026 04:49 PMmap80.0
VIT-012030Sun Nov 01, 2026 04:49 PMgcs15.0
VIT-011954Mon Nov 02, 2026 12:49 AMspo294.0nasal cannula
VIT-011955Mon Nov 02, 2026 12:49 AMrr22.0
VIT-011956Mon Nov 02, 2026 12:49 AMo2_lpm4.0nasal cannula
VIT-012031Mon Nov 02, 2026 12:49 AMtemp_c36.6
VIT-012032Mon Nov 02, 2026 12:49 AMhr68.0
VIT-012033Mon Nov 02, 2026 12:49 AMmap89.0
VIT-012034Mon Nov 02, 2026 12:49 AMgcs15.0
VIT-011957Mon Nov 02, 2026 08:49 AMspo293.0nasal cannula
VIT-011958Mon Nov 02, 2026 08:49 AMrr20.0
VIT-011959Mon Nov 02, 2026 08:49 AMo2_lpm3.0nasal cannula
VIT-012035Mon Nov 02, 2026 08:49 AMtemp_c37.2
VIT-012036Mon Nov 02, 2026 08:49 AMhr70.0
VIT-012037Mon Nov 02, 2026 08:49 AMmap91.0
VIT-012038Mon Nov 02, 2026 08:49 AMgcs15.0
VIT-011960Mon Nov 02, 2026 04:49 PMspo295.0nasal cannula
VIT-011961Mon Nov 02, 2026 04:49 PMrr26.0
VIT-011962Mon Nov 02, 2026 04:49 PMo2_lpm4.0nasal cannula
VIT-012039Mon Nov 02, 2026 04:49 PMtemp_c37.1
VIT-012040Mon Nov 02, 2026 04:49 PMhr91.0
VIT-012041Mon Nov 02, 2026 04:49 PMmap75.0
VIT-012042Mon Nov 02, 2026 04:49 PMgcs15.0
VIT-011963Tue Nov 03, 2026 12:49 AMspo293.0nasal cannula
VIT-011964Tue Nov 03, 2026 12:49 AMrr24.0
VIT-011965Tue Nov 03, 2026 12:49 AMo2_lpm4.0nasal cannula
VIT-012043Tue Nov 03, 2026 12:49 AMtemp_c37.5
VIT-012044Tue Nov 03, 2026 12:49 AMhr78.0
VIT-012045Tue Nov 03, 2026 12:49 AMmap74.0
VIT-012046Tue Nov 03, 2026 12:49 AMgcs15.0
VIT-011966Tue Nov 03, 2026 08:49 AMspo293.0nasal cannula
VIT-011967Tue Nov 03, 2026 08:49 AMrr25.0
VIT-011968Tue Nov 03, 2026 08:49 AMo2_lpm3.0nasal cannula
VIT-012047Tue Nov 03, 2026 08:49 AMtemp_c36.9
VIT-012048Tue Nov 03, 2026 08:49 AMhr84.0
VIT-012049Tue Nov 03, 2026 08:49 AMmap86.0
VIT-012050Tue Nov 03, 2026 08:49 AMgcs15.0
VIT-011969Tue Nov 03, 2026 04:49 PMspo294.0nasal cannula
VIT-011970Tue Nov 03, 2026 04:49 PMrr21.0
VIT-011971Tue Nov 03, 2026 04:49 PMo2_lpm4.0nasal cannula
VIT-012051Tue Nov 03, 2026 04:49 PMtemp_c36.9
VIT-012052Tue Nov 03, 2026 04:49 PMhr70.0
VIT-012053Tue Nov 03, 2026 04:49 PMmap75.0
VIT-012054Tue Nov 03, 2026 04:49 PMgcs15.0
VIT-011972Wed Nov 04, 2026 12:49 AMspo292.0nasal cannula
VIT-011973Wed Nov 04, 2026 12:49 AMrr25.0
VIT-011974Wed Nov 04, 2026 12:49 AMo2_lpm3.0nasal cannula
VIT-012055Wed Nov 04, 2026 12:49 AMtemp_c36.8
VIT-012056Wed Nov 04, 2026 12:49 AMhr87.0
VIT-012057Wed Nov 04, 2026 12:49 AMmap77.0
VIT-012058Wed Nov 04, 2026 12:49 AMgcs15.0
VIT-011975Wed Nov 04, 2026 08:49 AMspo294.0nasal cannula
VIT-011976Wed Nov 04, 2026 08:49 AMrr20.0
VIT-011977Wed Nov 04, 2026 08:49 AMo2_lpm4.0nasal cannula
VIT-012059Wed Nov 04, 2026 08:49 AMtemp_c37.6
VIT-012060Wed Nov 04, 2026 08:49 AMhr86.0
VIT-012061Wed Nov 04, 2026 08:49 AMmap78.0
VIT-012062Wed Nov 04, 2026 08:49 AMgcs15.0
VIT-011978Wed Nov 04, 2026 04:49 PMspo293.0nasal cannula
VIT-011979Wed Nov 04, 2026 04:49 PMrr24.0
VIT-011980Wed Nov 04, 2026 04:49 PMo2_lpm2.0nasal cannula
VIT-012063Wed Nov 04, 2026 04:49 PMtemp_c37.2
VIT-012064Wed Nov 04, 2026 04:49 PMhr84.0
VIT-012065Wed Nov 04, 2026 04:49 PMmap75.0
VIT-012066Wed Nov 04, 2026 04:49 PMgcs15.0
VIT-011981Thu Nov 05, 2026 12:49 AMspo295.0nasal cannula
VIT-011982Thu Nov 05, 2026 12:49 AMrr22.0
VIT-011983Thu Nov 05, 2026 12:49 AMo2_lpm2.0nasal cannula
VIT-012067Thu Nov 05, 2026 12:49 AMtemp_c36.6
VIT-012068Thu Nov 05, 2026 12:49 AMhr76.0
VIT-012069Thu Nov 05, 2026 12:49 AMmap75.0
VIT-012070Thu Nov 05, 2026 12:49 AMgcs15.0
VIT-011984Thu Nov 05, 2026 08:49 AMspo292.0nasal cannula
VIT-011985Thu Nov 05, 2026 08:49 AMrr26.0
VIT-011986Thu Nov 05, 2026 08:49 AMo2_lpm4.0nasal cannula
VIT-012071Thu Nov 05, 2026 08:49 AMtemp_c36.5
VIT-012072Thu Nov 05, 2026 08:49 AMhr81.0
VIT-012073Thu Nov 05, 2026 08:49 AMmap77.0
VIT-012074Thu Nov 05, 2026 08:49 AMgcs15.0
Medications, orders, echo, history (6)

Notes

History and physical · DOC-000415 · Dr. Elena Nakashima (resident) · Thu Oct 29, 2026 11:29 AM

Cited facts from this note (2)
infection_source
left lower lobe pneumonia · cited p. 1, line 5 · confidence 0.85
Show source for infection_source
… ce: Hospital Medicine Attending: Dr. Kenji Stavros History of present illness: 79-year-old man admitted with community-acquired pneumonia. Chest x-ray shows left lower lobe pneumonia; blood cultures drawn and ceftriaxone started. Past medical history: hyperlipidemia. Review of systems otherwise negative. Exam: Lungs: increased work of breat …
work_of_breathing
increased · cited p. 1, line 8 · confidence 0.90
Show source for work_of_breathing
… ft lower lobe pneumonia; blood cultures drawn and ceftriaxone started. Past medical history: hyperlipidemia. Review of systems otherwise negative. Exam: Lungs: increased work of breathing with accessory muscle use. Assessment and plan: 1. Community-acquired pneumonia: antibiotics.
Source document DOC-000415: History and physical (synthetic)
HISTORY AND PHYSICAL
Patient: Dmitri Marlow   MRN: MRN94395495   Admitted: 2026-10-29 08:29
Service: Hospital Medicine   Attending: Dr. Kenji Stavros

History of present illness: 79-year-old man admitted with community-acquired pneumonia. Chest x-ray shows left lower lobe pneumonia; blood cultures drawn and ceftriaxone started.
Past medical history: hyperlipidemia.
Review of systems otherwise negative.
Exam: Lungs: increased work of breathing with accessory muscle use.
Assessment and plan:
1. Community-acquired pneumonia: antibiotics.

Progress note · DOC-000416 · Dr. Elena Nakashima (resident) · Sat Oct 31, 2026 08:29 AM

Source document DOC-000416: Progress note (synthetic)
PROGRESS NOTE (Resident)
Patient: Dmitri Marlow   MRN: MRN94395495   Hospital day 3

Subjective: resting, tolerating diet.
Objective: vitals and labs reviewed in the flowsheet.
Assessment and plan:
1. Community-acquired pneumonia: continue current management.
2. Morbid obesity: counsel on weight.
3. Acute hypoxic respiratory failure: supplemental oxygen, wean as tolerated.

Resident: Dr. Elena Nakashima   Attending cosign: completed

Discharge summary · DOC-000417 · Dr. Kenji Stavros (attending) · Thu Nov 05, 2026 04:31 PM

Source document DOC-000417: Discharge summary (synthetic)
DISCHARGE SUMMARY
Patient: Dmitri Marlow   MRN: MRN94395495
Admitted 2026-10-29; discharged 2026-11-05.

Discharge diagnoses:
- community-acquired pneumonia
- morbid obesity
- acute hypoxic respiratory failure
- hyperlipidemia

Disposition: home with follow-up.