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-00140: Luca Vance

65F · MRN10725324 · Pulmonology · admitted Fri Nov 06, 2026 11:53 AM · discharged Thu Nov 12, 2026 10:20 AM · attending Dr. Cyrus Ellingham · 151 cm, 52.4 kg

Documented diagnoses (current)

Principal: “COPD exacerbation” · J44.1 Chronic obstructive pulmonary disease with (acute) exacerbation

Illustrative grouping now: MS-DRG 192 Chronic obstructive pulmonary disease without CC/MCC. If every open specificity/validation gap were answered as the criteria suggest: MS-DRG 192.

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=1.058, t.ratio_s1=1.5, creat_rise_48h=0.07, 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=1.058, t.ratio_s3=3.0, creat_peak=0.91, 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=1.058, 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=0.07, 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=13.23, 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=13.23, 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=234, t.chronic_days=90	true
derived: staging_egfr	`max(egfr_early, egfr_late)`	egfr_early=76.0, egfr_late=74.9	76.0
derived: both_below_60	`egfr_early < t.g2 and egfr_late < t.g2`	egfr_early=76.0, t.g2=60, egfr_late=74.9	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=76.0, 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=76.0, egfr_late=74.9, t.g2=60	false
outcome: g1_g2	`staging_egfr >= t.g2`	staging_egfr=76.0, 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=137.0, 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=137.0, t.low=135, na_low_count=0, t.repeat=2, na_treated=False	false
outcome: untreated	`na_min < t.low`	na_min=137.0, t.low=135	false
outcome: not_met	`na_min >= t.low`	na_min=137.0, 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=65, t.adult=20	false
outcome: class3	`bmi >= t.c3`	bmi=23.0, t.c3=40	false
outcome: class2	`bmi >= t.c2`	bmi=23.0, t.c2=35	false
outcome: class1	`bmi >= t.c1`	bmi=23.0, t.c1=30	false
outcome: not_met	`bmi < t.c1`	bmi=23.0, 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=36.6, 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=19.0, t.rr=20, paco2_min_48h=unknown, t.paco2=32	false
derived: sirs_wbc	`coalesce(wbc_max_48h > t.wbc_hi, false) or coalesce(wbc_min_48h < t.wbc_lo, false) or coalesce(bands_max_48h > t.bands, false)`	wbc_max_48h=10.02, t.wbc_hi=12, wbc_min_48h=7.73, 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=185.0	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=0.53	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=80.0	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=0.87	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=0.86	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 (38)

Labs (pre-admission rows are outpatient values)
Row	When	Test	Value
LAB-004768	Sun Dec 07, 2025 09:15 AM	creatinine	0.85 mg/dL
LAB-004769	Thu Jul 30, 2026 10:05 AM	creatinine	0.86 mg/dL
LAB-004770	Fri Nov 06, 2026 12:53 PM	creatinine	0.87 mg/dL
LAB-004777	Fri Nov 06, 2026 12:53 PM	sodium	142.0 mmol/L
LAB-004784	Fri Nov 06, 2026 12:53 PM	hemoglobin	13.23 g/dL
LAB-004791	Fri Nov 06, 2026 12:53 PM	wbc	7.73 x10^3/uL
LAB-004792	Fri Nov 06, 2026 12:53 PM	platelets	234.0 x10^3/uL
LAB-004805	Fri Nov 06, 2026 12:53 PM	bilirubin	0.53 mg/dL
LAB-004771	Sat Nov 07, 2026 05:00 AM	creatinine	0.85 mg/dL
LAB-004778	Sat Nov 07, 2026 05:00 AM	sodium	140.0 mmol/L
LAB-004785	Sat Nov 07, 2026 05:00 AM	hemoglobin	13.45 g/dL
LAB-004793	Sat Nov 07, 2026 05:00 AM	wbc	7.95 x10^3/uL
LAB-004794	Sat Nov 07, 2026 05:00 AM	platelets	185.0 x10^3/uL
LAB-004772	Sun Nov 08, 2026 05:00 AM	creatinine	0.85 mg/dL
LAB-004779	Sun Nov 08, 2026 05:00 AM	sodium	138.0 mmol/L
LAB-004786	Sun Nov 08, 2026 05:00 AM	hemoglobin	13.79 g/dL
LAB-004795	Sun Nov 08, 2026 05:00 AM	wbc	10.02 x10^3/uL
LAB-004796	Sun Nov 08, 2026 05:00 AM	platelets	277.0 x10^3/uL
LAB-004773	Mon Nov 09, 2026 05:00 AM	creatinine	0.85 mg/dL
LAB-004780	Mon Nov 09, 2026 05:00 AM	sodium	138.0 mmol/L
LAB-004787	Mon Nov 09, 2026 05:00 AM	hemoglobin	13.73 g/dL
LAB-004797	Mon Nov 09, 2026 05:00 AM	wbc	8.67 x10^3/uL
LAB-004798	Mon Nov 09, 2026 05:00 AM	platelets	243.0 x10^3/uL
LAB-004774	Tue Nov 10, 2026 05:00 AM	creatinine	0.84 mg/dL
LAB-004781	Tue Nov 10, 2026 05:00 AM	sodium	142.0 mmol/L
LAB-004788	Tue Nov 10, 2026 05:00 AM	hemoglobin	13.27 g/dL
LAB-004799	Tue Nov 10, 2026 05:00 AM	wbc	10.6 x10^3/uL
LAB-004800	Tue Nov 10, 2026 05:00 AM	platelets	276.0 x10^3/uL
LAB-004775	Wed Nov 11, 2026 05:00 AM	creatinine	0.89 mg/dL
LAB-004782	Wed Nov 11, 2026 05:00 AM	sodium	141.0 mmol/L
LAB-004789	Wed Nov 11, 2026 05:00 AM	hemoglobin	13.43 g/dL
LAB-004801	Wed Nov 11, 2026 05:00 AM	wbc	9.18 x10^3/uL
LAB-004802	Wed Nov 11, 2026 05:00 AM	platelets	299.0 x10^3/uL
LAB-004776	Thu Nov 12, 2026 05:00 AM	creatinine	0.91 mg/dL
LAB-004783	Thu Nov 12, 2026 05:00 AM	sodium	137.0 mmol/L
LAB-004790	Thu Nov 12, 2026 05:00 AM	hemoglobin	13.23 g/dL
LAB-004803	Thu Nov 12, 2026 05:00 AM	wbc	5.8 x10^3/uL
LAB-004804	Thu Nov 12, 2026 05:00 AM	platelets	183.0 x10^3/uL

Vitals (108)

Vitals
Row	When	Kind	Value	Detail
VIT-013707	Fri Nov 06, 2026 12:13 PM	spo2	96.0	room air
VIT-013708	Fri Nov 06, 2026 12:13 PM	rr	14.0
VIT-013743	Fri Nov 06, 2026 12:13 PM	temp_c	36.6
VIT-013744	Fri Nov 06, 2026 12:13 PM	hr	87.0
VIT-013745	Fri Nov 06, 2026 12:13 PM	map	86.0
VIT-013746	Fri Nov 06, 2026 12:13 PM	gcs	15.0
VIT-013709	Fri Nov 06, 2026 08:13 PM	spo2	95.0	room air
VIT-013710	Fri Nov 06, 2026 08:13 PM	rr	15.0
VIT-013747	Fri Nov 06, 2026 08:13 PM	temp_c	36.7
VIT-013748	Fri Nov 06, 2026 08:13 PM	hr	72.0
VIT-013749	Fri Nov 06, 2026 08:13 PM	map	84.0
VIT-013750	Fri Nov 06, 2026 08:13 PM	gcs	15.0
VIT-013711	Sat Nov 07, 2026 04:13 AM	spo2	95.0	room air
VIT-013712	Sat Nov 07, 2026 04:13 AM	rr	17.0
VIT-013751	Sat Nov 07, 2026 04:13 AM	temp_c	36.8
VIT-013752	Sat Nov 07, 2026 04:13 AM	hr	68.0
VIT-013753	Sat Nov 07, 2026 04:13 AM	map	89.0
VIT-013754	Sat Nov 07, 2026 04:13 AM	gcs	15.0
VIT-013713	Sat Nov 07, 2026 12:13 PM	spo2	97.0	room air
VIT-013714	Sat Nov 07, 2026 12:13 PM	rr	19.0
VIT-013755	Sat Nov 07, 2026 12:13 PM	temp_c	36.7
VIT-013756	Sat Nov 07, 2026 12:13 PM	hr	74.0
VIT-013757	Sat Nov 07, 2026 12:13 PM	map	80.0
VIT-013758	Sat Nov 07, 2026 12:13 PM	gcs	15.0
VIT-013715	Sat Nov 07, 2026 08:13 PM	spo2	97.0	room air
VIT-013716	Sat Nov 07, 2026 08:13 PM	rr	19.0
VIT-013759	Sat Nov 07, 2026 08:13 PM	temp_c	37.5
VIT-013760	Sat Nov 07, 2026 08:13 PM	hr	70.0
VIT-013761	Sat Nov 07, 2026 08:13 PM	map	81.0
VIT-013762	Sat Nov 07, 2026 08:13 PM	gcs	15.0
VIT-013717	Sun Nov 08, 2026 04:13 AM	spo2	98.0	room air
VIT-013718	Sun Nov 08, 2026 04:13 AM	rr	18.0
VIT-013763	Sun Nov 08, 2026 04:13 AM	temp_c	36.6
VIT-013764	Sun Nov 08, 2026 04:13 AM	hr	71.0
VIT-013765	Sun Nov 08, 2026 04:13 AM	map	87.0
VIT-013766	Sun Nov 08, 2026 04:13 AM	gcs	15.0
VIT-013719	Sun Nov 08, 2026 12:13 PM	spo2	95.0	room air
VIT-013720	Sun Nov 08, 2026 12:13 PM	rr	16.0
VIT-013767	Sun Nov 08, 2026 12:13 PM	temp_c	37.1
VIT-013768	Sun Nov 08, 2026 12:13 PM	hr	76.0
VIT-013769	Sun Nov 08, 2026 12:13 PM	map	78.0
VIT-013770	Sun Nov 08, 2026 12:13 PM	gcs	15.0
VIT-013721	Sun Nov 08, 2026 08:13 PM	spo2	94.0	room air
VIT-013722	Sun Nov 08, 2026 08:13 PM	rr	19.0
VIT-013771	Sun Nov 08, 2026 08:13 PM	temp_c	36.7
VIT-013772	Sun Nov 08, 2026 08:13 PM	hr	84.0
VIT-013773	Sun Nov 08, 2026 08:13 PM	map	80.0
VIT-013774	Sun Nov 08, 2026 08:13 PM	gcs	15.0
VIT-013723	Mon Nov 09, 2026 04:13 AM	spo2	96.0	room air
VIT-013724	Mon Nov 09, 2026 04:13 AM	rr	16.0
VIT-013775	Mon Nov 09, 2026 04:13 AM	temp_c	37.1
VIT-013776	Mon Nov 09, 2026 04:13 AM	hr	75.0
VIT-013777	Mon Nov 09, 2026 04:13 AM	map	76.0
VIT-013778	Mon Nov 09, 2026 04:13 AM	gcs	15.0
VIT-013725	Mon Nov 09, 2026 12:13 PM	spo2	94.0	room air
VIT-013726	Mon Nov 09, 2026 12:13 PM	rr	17.0
VIT-013779	Mon Nov 09, 2026 12:13 PM	temp_c	36.7
VIT-013780	Mon Nov 09, 2026 12:13 PM	hr	73.0
VIT-013781	Mon Nov 09, 2026 12:13 PM	map	75.0
VIT-013782	Mon Nov 09, 2026 12:13 PM	gcs	15.0
VIT-013727	Mon Nov 09, 2026 08:13 PM	spo2	94.0	room air
VIT-013728	Mon Nov 09, 2026 08:13 PM	rr	14.0
VIT-013783	Mon Nov 09, 2026 08:13 PM	temp_c	36.6
VIT-013784	Mon Nov 09, 2026 08:13 PM	hr	74.0
VIT-013785	Mon Nov 09, 2026 08:13 PM	map	91.0
VIT-013786	Mon Nov 09, 2026 08:13 PM	gcs	15.0
VIT-013729	Tue Nov 10, 2026 04:13 AM	spo2	95.0	room air
VIT-013730	Tue Nov 10, 2026 04:13 AM	rr	18.0
VIT-013787	Tue Nov 10, 2026 04:13 AM	temp_c	37.0
VIT-013788	Tue Nov 10, 2026 04:13 AM	hr	83.0
VIT-013789	Tue Nov 10, 2026 04:13 AM	map	84.0
VIT-013790	Tue Nov 10, 2026 04:13 AM	gcs	15.0
VIT-013731	Tue Nov 10, 2026 12:13 PM	spo2	97.0	room air
VIT-013732	Tue Nov 10, 2026 12:13 PM	rr	20.0
VIT-013791	Tue Nov 10, 2026 12:13 PM	temp_c	36.9
VIT-013792	Tue Nov 10, 2026 12:13 PM	hr	73.0
VIT-013793	Tue Nov 10, 2026 12:13 PM	map	82.0
VIT-013794	Tue Nov 10, 2026 12:13 PM	gcs	15.0
VIT-013733	Tue Nov 10, 2026 08:13 PM	spo2	97.0	room air
VIT-013734	Tue Nov 10, 2026 08:13 PM	rr	19.0
VIT-013795	Tue Nov 10, 2026 08:13 PM	temp_c	36.7
VIT-013796	Tue Nov 10, 2026 08:13 PM	hr	87.0
VIT-013797	Tue Nov 10, 2026 08:13 PM	map	90.0
VIT-013798	Tue Nov 10, 2026 08:13 PM	gcs	15.0
VIT-013735	Wed Nov 11, 2026 04:13 AM	spo2	96.0	room air
VIT-013736	Wed Nov 11, 2026 04:13 AM	rr	20.0
VIT-013799	Wed Nov 11, 2026 04:13 AM	temp_c	36.8
VIT-013800	Wed Nov 11, 2026 04:13 AM	hr	92.0
VIT-013801	Wed Nov 11, 2026 04:13 AM	map	92.0
VIT-013802	Wed Nov 11, 2026 04:13 AM	gcs	15.0
VIT-013737	Wed Nov 11, 2026 12:13 PM	spo2	96.0	room air
VIT-013738	Wed Nov 11, 2026 12:13 PM	rr	15.0
VIT-013803	Wed Nov 11, 2026 12:13 PM	temp_c	37.3
VIT-013804	Wed Nov 11, 2026 12:13 PM	hr	68.0
VIT-013805	Wed Nov 11, 2026 12:13 PM	map	82.0
VIT-013806	Wed Nov 11, 2026 12:13 PM	gcs	15.0
VIT-013739	Wed Nov 11, 2026 08:13 PM	spo2	97.0	room air
VIT-013740	Wed Nov 11, 2026 08:13 PM	rr	17.0
VIT-013807	Wed Nov 11, 2026 08:13 PM	temp_c	36.9
VIT-013808	Wed Nov 11, 2026 08:13 PM	hr	72.0
VIT-013809	Wed Nov 11, 2026 08:13 PM	map	89.0
VIT-013810	Wed Nov 11, 2026 08:13 PM	gcs	15.0
VIT-013741	Thu Nov 12, 2026 04:13 AM	spo2	98.0	room air
VIT-013742	Thu Nov 12, 2026 04:13 AM	rr	15.0
VIT-013811	Thu Nov 12, 2026 04:13 AM	temp_c	36.5
VIT-013812	Thu Nov 12, 2026 04:13 AM	hr	81.0
VIT-013813	Thu Nov 12, 2026 04:13 AM	map	83.0
VIT-013814	Thu Nov 12, 2026 04:13 AM	gcs	15.0

Medications, orders, echo, history (0)

Notes

History and physical · DOC-000472 · Dr. Cyrus Ellingham (attending) · Fri Nov 06, 2026 02:53 PM

Source document DOC-000472: History and physical (synthetic)

HISTORY AND PHYSICAL
Patient: Luca Vance   MRN: MRN10725324   Admitted: 2026-11-06 11:53
Service: Pulmonology   Attending: Dr. Cyrus Ellingham

History of present illness: 65-year-old woman admitted with COPD exacerbation. 
Past medical history: none significant.
Review of systems otherwise negative.
Exam: Lungs: clear to auscultation bilaterally.
Assessment and plan:
1. COPD exacerbation: bronchodilators and steroids.

Progress note · DOC-000473 · Dr. Cyrus Ellingham (attending) · Sun Nov 08, 2026 12:53 PM

Source document DOC-000473: Progress note (synthetic)

PROGRESS NOTE (Attending)
Patient: Luca Vance   MRN: MRN10725324   Hospital day 3

Subjective: resting, tolerating diet.
Objective: vitals and labs reviewed in the flowsheet.
Assessment and plan:
1. COPD exacerbation: continue current management.

Attending: Dr. Cyrus Ellingham

Discharge summary · DOC-000474 · Dr. Cyrus Ellingham (attending) · Thu Nov 12, 2026 10:20 AM

Source document DOC-000474: Discharge summary (synthetic)

DISCHARGE SUMMARY
Patient: Luca Vance   MRN: MRN10725324
Admitted 2026-11-06; discharged 2026-11-12.

Discharge diagnoses:
- COPD exacerbation

Disposition: home with follow-up.