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-00127: Odette Brightwater

51M · MRN67944095 · Hospital Medicine · admitted Wed Oct 28, 2026 08:16 AM · discharged Thu Nov 05, 2026 02:58 PM · attending Dr. Isaac Abernath · resident Dr. Greta Kowalczyk · 170 cm, 59.2 kg

Documented diagnoses (current)

Principal: “sepsis” · A41.9 Sepsis, unspecified organism
“community-acquired pneumonia” · J18.9 Pneumonia, unspecified organism
“moderate protein-calorie malnutrition” · E44.0 Moderate protein-calorie malnutrition
“anemia” · D64.9 Anemia, unspecified
“type 2 diabetes” · E11.9 Type 2 diabetes mellitus without complications

Illustrative grouping now: MS-DRG 871 Septicemia or severe sepsis without MV >96 hours with MCC. If every open specificity/validation gap were answered as the criteria suggest: MS-DRG 194.

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=1.025, t.ratio_s1=1.5, creat_rise_48h=0.01, 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=1.025, t.ratio_s3=3.0, creat_peak=1.25, 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=1.025, 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=0.01, 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

Specificity gap

Documented “anemia” (D64.9); criteria support the more specific Acute blood loss anemia (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=M, hgb_nadir=9.2, 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=3.5, 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=324, t.chronic_days=90	true
derived: staging_egfr	`max(egfr_early, egfr_late)`	egfr_early=71.1, egfr_late=71.8	71.8
derived: both_below_60	`egfr_early < t.g2 and egfr_late < t.g2`	egfr_early=71.1, t.g2=60, egfr_late=71.8	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=71.8, 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=71.1, egfr_late=71.8, t.g2=60	false
outcome: g1_g2	`staging_egfr >= t.g2`	staging_egfr=71.8, t.g2=60	true

Heart failure

Insufficient data

No gap

Insufficient data: the criteria could not be applied.

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=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=False	0
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=0, 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=0	false

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 met

No gap

Supported as documented (E44.0).

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=70.0, t.a_sev_intake_pct=50, intake_days=13.0, 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=70.0, t.a_mod_intake_pct=75, intake_days=13.0, t.a_mod_intake_days=7	true
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=30.0, wt_loss_pct=5.0	false
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=30.0, wt_loss_pct=5.0	true
derived: c_sev_intake	`intake_pct <= t.c_intake_pct and intake_days >= t.c_intake_days`	intake_pct=70.0, t.c_intake_pct=75, intake_days=13.0, 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=70.0, t.c_intake_pct=75, intake_days=13.0, 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=30.0, wt_loss_pct=5.0	false
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=30.0, wt_loss_pct=5.0	true
derived: n_assessed	`known(intake_pct, wt_loss_pct, fat_loss, muscle_loss, fluid, grip_reduced)`	intake_pct=70.0, wt_loss_pct=5.0, fat_loss=1, muscle_loss=1, fluid=0, grip_reduced=unknown	5
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=False, fat_loss=1, muscle_loss=1, fluid=0, grip_reduced=unknown, c_sev_intake=False, c_sev_wt=False	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=True, a_sev_wt=False, a_mod_wt=True, fat_loss=1, muscle_loss=1, fluid=0, grip_reduced=unknown, c_sev_intake=False, c_mod_intake=False, c_sev_wt=False, c_mod_wt=True	4
outcome: severe	`n_severe >= 2`	n_severe=0	false
outcome: moderate	`n_moderate >= 2`	n_moderate=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=51, t.adult=20	false
outcome: class3	`bmi >= t.c3`	bmi=20.5, t.c3=40	false
outcome: class2	`bmi >= t.c2`	bmi=20.5, t.c2=35	false
outcome: class1	`bmi >= t.c1`	bmi=20.5, t.c1=30	false
outcome: not_met	`bmi < t.c1`	bmi=20.5, 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

Clinical validation gap

Documented “sepsis” (A41.9) but the criteria are not met: Neither definition met: 0 SIRS criteria, SOFA change 0.

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=37.6, 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=87.0, 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=9.3, t.wbc_hi=12, wbc_min_48h=8.24, 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=207.0	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=0.66	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=1.25	1
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=1.22	1
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=1, sofa_renal_baseline=1	0
derived: sepsis3	`infection_documented and sofa_delta >= t.sofa_delta`	infection_documented=True, sofa_delta=0, t.sofa_delta=2	false
derived: sepsis2	`infection_documented and sirs_count >= t.sirs_min`	infection_documented=True, 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=True	false
outcome: septic_shock	`shock`	shock=False	false
outcome: both	`sepsis3 and sepsis2`	sepsis3=False, sepsis2=False	false
outcome: sepsis3_only	`sepsis3`	sepsis3=False	false
outcome: definitions_disagree	`sepsis2`	sepsis2=False	false
outcome: neither	`true`	—	true

Structured data

Labs (48)

Labs (pre-admission rows are outpatient values)
Row	When	Test	Value
LAB-004296	Tue Oct 07, 2025 09:15 AM	creatinine	1.23 mg/dL
LAB-004297	Thu Aug 27, 2026 10:05 AM	creatinine	1.22 mg/dL
LAB-004298	Wed Oct 28, 2026 09:16 AM	creatinine	1.24 mg/dL
LAB-004307	Wed Oct 28, 2026 09:16 AM	sodium	136.0 mmol/L
LAB-004316	Wed Oct 28, 2026 09:16 AM	hemoglobin	12.7 g/dL
LAB-004325	Wed Oct 28, 2026 09:16 AM	wbc	8.24 x10^3/uL
LAB-004326	Wed Oct 28, 2026 09:16 AM	platelets	251.0 x10^3/uL
LAB-004343	Wed Oct 28, 2026 09:16 AM	bilirubin	0.66 mg/dL
LAB-004299	Thu Oct 29, 2026 05:00 AM	creatinine	1.25 mg/dL
LAB-004308	Thu Oct 29, 2026 05:00 AM	sodium	141.0 mmol/L
LAB-004317	Thu Oct 29, 2026 05:00 AM	hemoglobin	10.6 g/dL
LAB-004327	Thu Oct 29, 2026 05:00 AM	wbc	9.3 x10^3/uL
LAB-004328	Thu Oct 29, 2026 05:00 AM	platelets	210.0 x10^3/uL
LAB-004300	Fri Oct 30, 2026 05:00 AM	creatinine	1.25 mg/dL
LAB-004309	Fri Oct 30, 2026 05:00 AM	sodium	142.0 mmol/L
LAB-004318	Fri Oct 30, 2026 05:00 AM	hemoglobin	9.2 g/dL
LAB-004329	Fri Oct 30, 2026 05:00 AM	wbc	8.36 x10^3/uL
LAB-004330	Fri Oct 30, 2026 05:00 AM	platelets	207.0 x10^3/uL
LAB-004301	Sat Oct 31, 2026 05:00 AM	creatinine	1.25 mg/dL
LAB-004310	Sat Oct 31, 2026 05:00 AM	sodium	142.0 mmol/L
LAB-004319	Sat Oct 31, 2026 05:00 AM	hemoglobin	10.0 g/dL
LAB-004331	Sat Oct 31, 2026 05:00 AM	wbc	9.61 x10^3/uL
LAB-004332	Sat Oct 31, 2026 05:00 AM	platelets	183.0 x10^3/uL
LAB-004302	Sun Nov 01, 2026 05:00 AM	creatinine	1.24 mg/dL
LAB-004311	Sun Nov 01, 2026 05:00 AM	sodium	140.0 mmol/L
LAB-004320	Sun Nov 01, 2026 05:00 AM	hemoglobin	10.3 g/dL
LAB-004333	Sun Nov 01, 2026 05:00 AM	wbc	9.24 x10^3/uL
LAB-004334	Sun Nov 01, 2026 05:00 AM	platelets	305.0 x10^3/uL
LAB-004303	Mon Nov 02, 2026 05:00 AM	creatinine	1.21 mg/dL
LAB-004312	Mon Nov 02, 2026 05:00 AM	sodium	136.0 mmol/L
LAB-004321	Mon Nov 02, 2026 05:00 AM	hemoglobin	10.4 g/dL
LAB-004335	Mon Nov 02, 2026 05:00 AM	wbc	9.03 x10^3/uL
LAB-004336	Mon Nov 02, 2026 05:00 AM	platelets	231.0 x10^3/uL
LAB-004304	Tue Nov 03, 2026 05:00 AM	creatinine	1.2 mg/dL
LAB-004313	Tue Nov 03, 2026 05:00 AM	sodium	141.0 mmol/L
LAB-004322	Tue Nov 03, 2026 05:00 AM	hemoglobin	10.4 g/dL
LAB-004337	Tue Nov 03, 2026 05:00 AM	wbc	8.3 x10^3/uL
LAB-004338	Tue Nov 03, 2026 05:00 AM	platelets	169.0 x10^3/uL
LAB-004305	Wed Nov 04, 2026 05:00 AM	creatinine	1.2 mg/dL
LAB-004314	Wed Nov 04, 2026 05:00 AM	sodium	140.0 mmol/L
LAB-004323	Wed Nov 04, 2026 05:00 AM	hemoglobin	10.4 g/dL
LAB-004339	Wed Nov 04, 2026 05:00 AM	wbc	8.84 x10^3/uL
LAB-004340	Wed Nov 04, 2026 05:00 AM	platelets	251.0 x10^3/uL
LAB-004306	Thu Nov 05, 2026 05:00 AM	creatinine	1.21 mg/dL
LAB-004315	Thu Nov 05, 2026 05:00 AM	sodium	140.0 mmol/L
LAB-004324	Thu Nov 05, 2026 05:00 AM	hemoglobin	10.4 g/dL
LAB-004341	Thu Nov 05, 2026 05:00 AM	wbc	10.41 x10^3/uL
LAB-004342	Thu Nov 05, 2026 05:00 AM	platelets	221.0 x10^3/uL

Vitals (150)

Vitals
Row	When	Kind	Value	Detail
VIT-012329	Wed Oct 28, 2026 08:36 AM	spo2	98.0	room air
VIT-012330	Wed Oct 28, 2026 08:36 AM	rr	14.0
VIT-012379	Wed Oct 28, 2026 08:36 AM	temp_c	36.8
VIT-012380	Wed Oct 28, 2026 08:36 AM	hr	77.0
VIT-012381	Wed Oct 28, 2026 08:36 AM	map	85.0
VIT-012382	Wed Oct 28, 2026 08:36 AM	gcs	15.0
VIT-012331	Wed Oct 28, 2026 04:36 PM	spo2	98.0	room air
VIT-012332	Wed Oct 28, 2026 04:36 PM	rr	20.0
VIT-012383	Wed Oct 28, 2026 04:36 PM	temp_c	36.8
VIT-012384	Wed Oct 28, 2026 04:36 PM	hr	72.0
VIT-012385	Wed Oct 28, 2026 04:36 PM	map	87.0
VIT-012386	Wed Oct 28, 2026 04:36 PM	gcs	15.0
VIT-012333	Thu Oct 29, 2026 12:36 AM	spo2	97.0	room air
VIT-012334	Thu Oct 29, 2026 12:36 AM	rr	18.0
VIT-012387	Thu Oct 29, 2026 12:36 AM	temp_c	37.1
VIT-012388	Thu Oct 29, 2026 12:36 AM	hr	78.0
VIT-012389	Thu Oct 29, 2026 12:36 AM	map	78.0
VIT-012390	Thu Oct 29, 2026 12:36 AM	gcs	15.0
VIT-012335	Thu Oct 29, 2026 08:36 AM	spo2	95.0	room air
VIT-012336	Thu Oct 29, 2026 08:36 AM	rr	20.0
VIT-012391	Thu Oct 29, 2026 08:36 AM	temp_c	37.1
VIT-012392	Thu Oct 29, 2026 08:36 AM	hr	87.0
VIT-012393	Thu Oct 29, 2026 08:36 AM	map	86.0
VIT-012394	Thu Oct 29, 2026 08:36 AM	gcs	15.0
VIT-012337	Thu Oct 29, 2026 04:36 PM	spo2	98.0	room air
VIT-012338	Thu Oct 29, 2026 04:36 PM	rr	16.0
VIT-012395	Thu Oct 29, 2026 04:36 PM	temp_c	37.5
VIT-012396	Thu Oct 29, 2026 04:36 PM	hr	87.0
VIT-012397	Thu Oct 29, 2026 04:36 PM	map	77.0
VIT-012398	Thu Oct 29, 2026 04:36 PM	gcs	15.0
VIT-012339	Fri Oct 30, 2026 12:36 AM	spo2	95.0	room air
VIT-012340	Fri Oct 30, 2026 12:36 AM	rr	16.0
VIT-012399	Fri Oct 30, 2026 12:36 AM	temp_c	37.6
VIT-012400	Fri Oct 30, 2026 12:36 AM	hr	83.0
VIT-012401	Fri Oct 30, 2026 12:36 AM	map	77.0
VIT-012402	Fri Oct 30, 2026 12:36 AM	gcs	15.0
VIT-012341	Fri Oct 30, 2026 08:36 AM	spo2	97.0	room air
VIT-012342	Fri Oct 30, 2026 08:36 AM	rr	18.0
VIT-012403	Fri Oct 30, 2026 08:36 AM	temp_c	37.0
VIT-012404	Fri Oct 30, 2026 08:36 AM	hr	79.0
VIT-012405	Fri Oct 30, 2026 08:36 AM	map	83.0
VIT-012406	Fri Oct 30, 2026 08:36 AM	gcs	15.0
VIT-012343	Fri Oct 30, 2026 04:36 PM	spo2	94.0	room air
VIT-012344	Fri Oct 30, 2026 04:36 PM	rr	15.0
VIT-012407	Fri Oct 30, 2026 04:36 PM	temp_c	37.2
VIT-012408	Fri Oct 30, 2026 04:36 PM	hr	80.0
VIT-012409	Fri Oct 30, 2026 04:36 PM	map	87.0
VIT-012410	Fri Oct 30, 2026 04:36 PM	gcs	15.0
VIT-012345	Sat Oct 31, 2026 12:36 AM	spo2	99.0	room air
VIT-012346	Sat Oct 31, 2026 12:36 AM	rr	14.0
VIT-012411	Sat Oct 31, 2026 12:36 AM	temp_c	37.5
VIT-012412	Sat Oct 31, 2026 12:36 AM	hr	86.0
VIT-012413	Sat Oct 31, 2026 12:36 AM	map	75.0
VIT-012414	Sat Oct 31, 2026 12:36 AM	gcs	15.0
VIT-012347	Sat Oct 31, 2026 08:36 AM	spo2	97.0	room air
VIT-012348	Sat Oct 31, 2026 08:36 AM	rr	19.0
VIT-012415	Sat Oct 31, 2026 08:36 AM	temp_c	37.5
VIT-012416	Sat Oct 31, 2026 08:36 AM	hr	75.0
VIT-012417	Sat Oct 31, 2026 08:36 AM	map	74.0
VIT-012418	Sat Oct 31, 2026 08:36 AM	gcs	15.0
VIT-012349	Sat Oct 31, 2026 04:36 PM	spo2	97.0	room air
VIT-012350	Sat Oct 31, 2026 04:36 PM	rr	18.0
VIT-012419	Sat Oct 31, 2026 04:36 PM	temp_c	37.0
VIT-012420	Sat Oct 31, 2026 04:36 PM	hr	74.0
VIT-012421	Sat Oct 31, 2026 04:36 PM	map	84.0
VIT-012422	Sat Oct 31, 2026 04:36 PM	gcs	15.0
VIT-012351	Sun Nov 01, 2026 12:36 AM	spo2	96.0	room air
VIT-012352	Sun Nov 01, 2026 12:36 AM	rr	15.0
VIT-012423	Sun Nov 01, 2026 12:36 AM	temp_c	37.3
VIT-012424	Sun Nov 01, 2026 12:36 AM	hr	81.0
VIT-012425	Sun Nov 01, 2026 12:36 AM	map	80.0
VIT-012426	Sun Nov 01, 2026 12:36 AM	gcs	15.0
VIT-012353	Sun Nov 01, 2026 08:36 AM	spo2	98.0	room air
VIT-012354	Sun Nov 01, 2026 08:36 AM	rr	19.0
VIT-012427	Sun Nov 01, 2026 08:36 AM	temp_c	37.2
VIT-012428	Sun Nov 01, 2026 08:36 AM	hr	77.0
VIT-012429	Sun Nov 01, 2026 08:36 AM	map	92.0
VIT-012430	Sun Nov 01, 2026 08:36 AM	gcs	15.0
VIT-012355	Sun Nov 01, 2026 04:36 PM	spo2	94.0	room air
VIT-012356	Sun Nov 01, 2026 04:36 PM	rr	15.0
VIT-012431	Sun Nov 01, 2026 04:36 PM	temp_c	36.9
VIT-012432	Sun Nov 01, 2026 04:36 PM	hr	86.0
VIT-012433	Sun Nov 01, 2026 04:36 PM	map	78.0
VIT-012434	Sun Nov 01, 2026 04:36 PM	gcs	15.0
VIT-012357	Mon Nov 02, 2026 12:36 AM	spo2	98.0	room air
VIT-012358	Mon Nov 02, 2026 12:36 AM	rr	20.0
VIT-012435	Mon Nov 02, 2026 12:36 AM	temp_c	37.4
VIT-012436	Mon Nov 02, 2026 12:36 AM	hr	86.0
VIT-012437	Mon Nov 02, 2026 12:36 AM	map	92.0
VIT-012438	Mon Nov 02, 2026 12:36 AM	gcs	15.0
VIT-012359	Mon Nov 02, 2026 08:36 AM	spo2	99.0	room air
VIT-012360	Mon Nov 02, 2026 08:36 AM	rr	19.0
VIT-012439	Mon Nov 02, 2026 08:36 AM	temp_c	37.1
VIT-012440	Mon Nov 02, 2026 08:36 AM	hr	78.0
VIT-012441	Mon Nov 02, 2026 08:36 AM	map	76.0
VIT-012442	Mon Nov 02, 2026 08:36 AM	gcs	15.0
VIT-012361	Mon Nov 02, 2026 04:36 PM	spo2	96.0	room air
VIT-012362	Mon Nov 02, 2026 04:36 PM	rr	14.0
VIT-012443	Mon Nov 02, 2026 04:36 PM	temp_c	36.6
VIT-012444	Mon Nov 02, 2026 04:36 PM	hr	75.0
VIT-012445	Mon Nov 02, 2026 04:36 PM	map	84.0
VIT-012446	Mon Nov 02, 2026 04:36 PM	gcs	15.0
VIT-012363	Tue Nov 03, 2026 12:36 AM	spo2	99.0	room air
VIT-012364	Tue Nov 03, 2026 12:36 AM	rr	14.0
VIT-012447	Tue Nov 03, 2026 12:36 AM	temp_c	37.3
VIT-012448	Tue Nov 03, 2026 12:36 AM	hr	87.0
VIT-012449	Tue Nov 03, 2026 12:36 AM	map	77.0
VIT-012450	Tue Nov 03, 2026 12:36 AM	gcs	15.0
VIT-012365	Tue Nov 03, 2026 08:36 AM	spo2	96.0	room air
VIT-012366	Tue Nov 03, 2026 08:36 AM	rr	15.0
VIT-012451	Tue Nov 03, 2026 08:36 AM	temp_c	37.5
VIT-012452	Tue Nov 03, 2026 08:36 AM	hr	72.0
VIT-012453	Tue Nov 03, 2026 08:36 AM	map	89.0
VIT-012454	Tue Nov 03, 2026 08:36 AM	gcs	15.0
VIT-012367	Tue Nov 03, 2026 04:36 PM	spo2	94.0	room air
VIT-012368	Tue Nov 03, 2026 04:36 PM	rr	15.0
VIT-012455	Tue Nov 03, 2026 04:36 PM	temp_c	37.3
VIT-012456	Tue Nov 03, 2026 04:36 PM	hr	81.0
VIT-012457	Tue Nov 03, 2026 04:36 PM	map	87.0
VIT-012458	Tue Nov 03, 2026 04:36 PM	gcs	15.0
VIT-012369	Wed Nov 04, 2026 12:36 AM	spo2	99.0	room air
VIT-012370	Wed Nov 04, 2026 12:36 AM	rr	18.0
VIT-012459	Wed Nov 04, 2026 12:36 AM	temp_c	36.6
VIT-012460	Wed Nov 04, 2026 12:36 AM	hr	77.0
VIT-012461	Wed Nov 04, 2026 12:36 AM	map	78.0
VIT-012462	Wed Nov 04, 2026 12:36 AM	gcs	15.0
VIT-012371	Wed Nov 04, 2026 08:36 AM	spo2	94.0	room air
VIT-012372	Wed Nov 04, 2026 08:36 AM	rr	14.0
VIT-012463	Wed Nov 04, 2026 08:36 AM	temp_c	36.9
VIT-012464	Wed Nov 04, 2026 08:36 AM	hr	74.0
VIT-012465	Wed Nov 04, 2026 08:36 AM	map	87.0
VIT-012466	Wed Nov 04, 2026 08:36 AM	gcs	15.0
VIT-012373	Wed Nov 04, 2026 04:36 PM	spo2	94.0	room air
VIT-012374	Wed Nov 04, 2026 04:36 PM	rr	16.0
VIT-012467	Wed Nov 04, 2026 04:36 PM	temp_c	37.6
VIT-012468	Wed Nov 04, 2026 04:36 PM	hr	83.0
VIT-012469	Wed Nov 04, 2026 04:36 PM	map	91.0
VIT-012470	Wed Nov 04, 2026 04:36 PM	gcs	15.0
VIT-012375	Thu Nov 05, 2026 12:36 AM	spo2	99.0	room air
VIT-012376	Thu Nov 05, 2026 12:36 AM	rr	17.0
VIT-012471	Thu Nov 05, 2026 12:36 AM	temp_c	37.1
VIT-012472	Thu Nov 05, 2026 12:36 AM	hr	81.0
VIT-012473	Thu Nov 05, 2026 12:36 AM	map	87.0
VIT-012474	Thu Nov 05, 2026 12:36 AM	gcs	15.0
VIT-012377	Thu Nov 05, 2026 08:36 AM	spo2	97.0	room air
VIT-012378	Thu Nov 05, 2026 08:36 AM	rr	20.0
VIT-012475	Thu Nov 05, 2026 08:36 AM	temp_c	37.6
VIT-012476	Thu Nov 05, 2026 08:36 AM	hr	76.0
VIT-012477	Thu Nov 05, 2026 08:36 AM	map	78.0
VIT-012478	Thu Nov 05, 2026 08:36 AM	gcs	15.0

Medications, orders, echo, history (5)

MED-000500 10-28 09:16 cefepime per protocol IV
MED-000501 10-29 05:00 cefepime per protocol IV
MED-000502 10-30 05:00 piperacillin-tazobactam per protocol IV
ORD-000107 10-28 08:46 blood_culture: blood cultures x2
ORD-000108 10-29 09:00 transfusion_prbc: transfuse PRBC

Notes

History and physical · DOC-000430 · Dr. Greta Kowalczyk (resident) · Wed Oct 28, 2026 11:16 AM

Cited facts from this note (2)

bleeding_source: bright red blood per rectum · cited p. 1, line 5 · confidence 0.85

Show source for bleeding_source

… ess: 51-year-old man admitted with sepsis. Chest x-ray shows multifocal pneumonia; blood cultures drawn and ceftriaxone started. Hospital course complicated by bright red blood per rectum. Past medical history: type 2 diabetes. Review of systems otherwise negative. Exam: Lungs: scattered crackles at the bases, no distress. Assessment and plan: 1 …
infection_source: multifocal pneumonia · cited p. 1, line 5 · confidence 0.85

Show source for infection_source

… 026-10-28 08:16 Service: Hospital Medicine Attending: Dr. Isaac Abernath History of present illness: 51-year-old man admitted with sepsis. Chest x-ray shows multifocal pneumonia; blood cultures drawn and ceftriaxone started. Hospital course complicated by bright red blood per rectum. Past medical history: type 2 diabetes. Review of sys …

Source document DOC-000430: History and physical (synthetic)

HISTORY AND PHYSICAL
Patient: Odette Brightwater   MRN: MRN67944095   Admitted: 2026-10-28 08:16
Service: Hospital Medicine   Attending: Dr. Isaac Abernath

History of present illness: 51-year-old man admitted with sepsis. Chest x-ray shows multifocal pneumonia; blood cultures drawn and ceftriaxone started. Hospital course complicated by bright red blood per rectum.
Past medical history: type 2 diabetes.
Review of systems otherwise negative.
Exam: Lungs: scattered crackles at the bases, no distress.
Assessment and plan:
1. Sepsis: antibiotics, fluids.
2. Community-acquired pneumonia: antibiotics.

Nutrition assessment · DOC-000429 · Vera Pemberton, RD (dietitian) · Thu Oct 29, 2026 01:16 PM

Cited facts from this note (8)

fat_loss: mild · cited p. 1, line 7 · confidence 0.90

Show source for fat_loss

… ontext: acute illness Intake: estimated energy intake 70% of needs for 13 days. Weight history: 5.0% weight loss over 30 days. Nutrition-focused physical exam: mild loss of subcutaneous fat; mild muscle wasting; no fluid accumulation. Recommendations: high-protein oral supplement; calorie counts; weekly weights.
fluid_accumulation: none · cited p. 1, line 7 · confidence 0.90

Show source for fluid_accumulation

… e 70% of needs for 13 days. Weight history: 5.0% weight loss over 30 days. Nutrition-focused physical exam: mild loss of subcutaneous fat; mild muscle wasting; no fluid accumulation. Recommendations: high-protein oral supplement; calorie counts; weekly weights.
intake_days: 13 · cited p. 1, line 5 · confidence 0.95

Show source for intake_days

NUTRITION ASSESSMENT (Registered Dietitian) Patient: Odette Brightwater MRN: MRN67944095 Context: acute illness Intake: estimated energy intake 70% of needs for 13 days. Weight history: 5.0% weight loss over 30 days. Nutrition-focused physical exam: mild loss of subcutaneous fat; mild muscle wasting; no fluid accumulation. Rec …
intake_pct: 70 · cited p. 1, line 5 · confidence 0.95

Show source for intake_pct

NUTRITION ASSESSMENT (Registered Dietitian) Patient: Odette Brightwater MRN: MRN67944095 Context: acute illness Intake: estimated energy intake 70% of needs for 13 days. Weight history: 5.0% weight loss over 30 days. Nutrition-focused physical exam: mild loss of subcutaneous fat; mild muscle wasting; no fluid accumulation. Rec …
muscle_loss: mild · cited p. 1, line 7 · confidence 0.90

Show source for muscle_loss

… stimated energy intake 70% of needs for 13 days. Weight history: 5.0% weight loss over 30 days. Nutrition-focused physical exam: mild loss of subcutaneous fat; mild muscle wasting; no fluid accumulation. Recommendations: high-protein oral supplement; calorie counts; weekly weights.
nutrition_context: acute · cited p. 1, line 4 · confidence 0.95

Show source for nutrition_context

NUTRITION ASSESSMENT (Registered Dietitian) Patient: Odette Brightwater MRN: MRN67944095 Context: acute illness Intake: estimated energy intake 70% of needs for 13 days. Weight history: 5.0% weight loss over 30 days. Nutrition-focused physical exam: mild loss of subcutan …
weight_loss_days: 30 · cited p. 1, line 6 · confidence 0.95

Show source for weight_loss_days

… red Dietitian) Patient: Odette Brightwater MRN: MRN67944095 Context: acute illness Intake: estimated energy intake 70% of needs for 13 days. Weight history: 5.0% weight loss over 30 days. Nutrition-focused physical exam: mild loss of subcutaneous fat; mild muscle wasting; no fluid accumulation. Recommendations: high-protein oral supplement; cal …
weight_loss_pct: 5 · cited p. 1, line 6 · confidence 0.95

Show source for weight_loss_pct

… red Dietitian) Patient: Odette Brightwater MRN: MRN67944095 Context: acute illness Intake: estimated energy intake 70% of needs for 13 days. Weight history: 5.0% weight loss over 30 days. Nutrition-focused physical exam: mild loss of subcutaneous fat; mild muscle wasting; no fluid accumulation. Recommendations: high-protein oral supplement; cal …

Source document DOC-000429: Nutrition assessment (synthetic)

NUTRITION ASSESSMENT (Registered Dietitian)
Patient: Odette Brightwater   MRN: MRN67944095

Context: acute illness
Intake: estimated energy intake 70% of needs for 13 days.
Weight history: 5.0% weight loss over 30 days.
Nutrition-focused physical exam: mild loss of subcutaneous fat; mild muscle wasting; no fluid accumulation.
Recommendations: high-protein oral supplement; calorie counts; weekly weights.

Progress note · DOC-000431 · Dr. Greta Kowalczyk (resident) · Fri Oct 30, 2026 09:16 AM

Source document DOC-000431: Progress note (synthetic)

PROGRESS NOTE (Resident)
Patient: Odette Brightwater   MRN: MRN67944095   Hospital day 3

Subjective: resting, tolerating diet.
Objective: vitals and labs reviewed in the flowsheet.
Assessment and plan:
1. Sepsis: continue current management.
2. Moderate protein-calorie malnutrition: dietitian following, supplements.
3. Anemia: trend hemoglobin.

Resident: Dr. Greta Kowalczyk   Attending cosign: completed

Discharge summary · DOC-000432 · Dr. Isaac Abernath (attending) · Thu Nov 05, 2026 02:58 PM

Source document DOC-000432: Discharge summary (synthetic)

DISCHARGE SUMMARY
Patient: Odette Brightwater   MRN: MRN67944095
Admitted 2026-10-28; discharged 2026-11-05.

Discharge diagnoses:
- sepsis
- community-acquired pneumonia
- moderate protein-calorie malnutrition
- anemia
- type 2 diabetes

Disposition: home with follow-up.