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-00150: Priya Ivers

69M · MRN20392931 · Cardiology · admitted Mon Nov 02, 2026 06:18 PM · discharged Sat Nov 07, 2026 01:16 PM · attending Dr. Rosalind Quillan · 179 cm, 82.5 kg

Documented diagnoses (current)

“acute renal insufficiency” · N28.9 Disorder of kidney and ureter, unspecified (renal insufficiency)
Principal: “chronic systolic heart failure” · I50.22 Chronic systolic (congestive) heart failure
“hyponatremia” · E87.1 Hypo-osmolality and hyponatremia
“GERD” · K21.9 Gastro-esophageal reflux disease without esophagitis
“type 2 diabetes” · E11.9 Type 2 diabetes mellitus without complications
“hyperlipidemia” · E78.5 Hyperlipidemia, unspecified

Illustrative grouping now: MS-DRG 292 Heart failure and shock with CC. 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

Clinical judgement required

Clinical judgement required: AKI criteria met only against a presumed baseline (no pre-admission creatinine on file).

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=1.787, t.ratio_s1=1.5, creat_rise_48h=0.0, t.rise_abs=0.3, uo_hours_lt_0_5=unknown, t.uo_s1_h=6	true
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=True, creat_ratio=1.787, t.ratio_s3=3.0, creat_peak=1.93, 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=1.787, 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=True	1
derived: baseline_independent	`creat_baseline_known or creat_rise_48h >= t.rise_abs or rrt_started`	creat_baseline_known=False, creat_rise_48h=0.0, t.rise_abs=0.3, rrt_started=False	false
outcome: aki_staged	`stage >= 1 and baseline_independent`	stage=1, baseline_independent=False	false
outcome: aki_presumed_baseline	`stage >= 1`	stage=1	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=M, hgb_nadir=14.29, 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=0.3, 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=0.3, t.drop_min=1.0, prbc_units=0	false
outcome: not_anaemic	`present(hgb_nadir) and not anaemic`	hgb_nadir=14.29, anaemic=False	true

Chronic kidney disease

Insufficient data

No gap

Insufficient data: the criteria could not be applied.

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=0, egfr_span_days=unknown, t.chronic_days=90	false
derived: staging_egfr	`max(egfr_early, egfr_late)`	egfr_early=unknown, egfr_late=unknown	unknown
derived: both_below_60	`egfr_early < t.g2 and egfr_late < t.g2`	egfr_early=unknown, t.g2=60, egfr_late=unknown	unknown
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=unknown, t.g2=60, t.g3a=45, t.g3b=30, t.g4=15	unknown
outcome: duration_not_shown	`not chronic`	chronic=False	true

Heart failure

Criteria met

Specificity gap

Documented “chronic systolic heart failure” (I50.22); criteria support the more specific Acute on chronic systolic (HFrEF) heart failure (I50.23).

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=2271.0, 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=True	acute on chronic
outcome: improved_ef	`improved`	improved=False	false
outcome: midrange	`hf_type == 'midrange'`	hf_type=systolic	false
outcome: sys_aoc	`hf_type == 'systolic' and acuity == 'acute on chronic'`	hf_type=systolic, acuity=acute on chronic	true

Hyponatraemia

Criteria not met

Clinical validation gap

Documented “hyponatremia” (E87.1) but the criteria are not met: All sodium values 135 or above (lowest 137).

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=69, t.adult=20	false
outcome: class3	`bmi >= t.c3`	bmi=25.7, t.c3=40	false
outcome: class2	`bmi >= t.c2`	bmi=25.7, t.c2=35	false
outcome: class1	`bmi >= t.c1`	bmi=25.7, t.c1=30	false
outcome: not_met	`bmi < t.c1`	bmi=25.7, 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=37.3, 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=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=10.84, t.wbc_hi=12, wbc_min_48h=7.25, 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=171.0	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=76.0	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=1.93	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=1.08	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=1, sofa_renal_baseline=0	1
derived: sepsis3	`infection_documented and sofa_delta >= t.sofa_delta`	infection_documented=False, sofa_delta=1, 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 (32)

Labs (pre-admission rows are outpatient values)
Row	When	Test	Value
LAB-005135	Mon Nov 02, 2026 07:18 PM	creatinine	1.93 mg/dL
LAB-005141	Mon Nov 02, 2026 07:18 PM	bnp	2271.0 pg/mL
LAB-005142	Mon Nov 02, 2026 07:18 PM	sodium	137.0 mmol/L
LAB-005148	Mon Nov 02, 2026 07:18 PM	hemoglobin	14.43 g/dL
LAB-005154	Mon Nov 02, 2026 07:18 PM	wbc	7.25 x10^3/uL
LAB-005155	Mon Nov 02, 2026 07:18 PM	platelets	226.0 x10^3/uL
LAB-005166	Mon Nov 02, 2026 07:18 PM	bilirubin	0.72 mg/dL
LAB-005136	Tue Nov 03, 2026 05:00 AM	creatinine	1.59 mg/dL
LAB-005143	Tue Nov 03, 2026 05:00 AM	sodium	138.0 mmol/L
LAB-005149	Tue Nov 03, 2026 05:00 AM	hemoglobin	14.63 g/dL
LAB-005156	Tue Nov 03, 2026 05:00 AM	wbc	10.84 x10^3/uL
LAB-005157	Tue Nov 03, 2026 05:00 AM	platelets	171.0 x10^3/uL
LAB-005137	Wed Nov 04, 2026 05:00 AM	creatinine	1.34 mg/dL
LAB-005144	Wed Nov 04, 2026 05:00 AM	sodium	137.0 mmol/L
LAB-005150	Wed Nov 04, 2026 05:00 AM	hemoglobin	14.5 g/dL
LAB-005158	Wed Nov 04, 2026 05:00 AM	wbc	7.96 x10^3/uL
LAB-005159	Wed Nov 04, 2026 05:00 AM	platelets	248.0 x10^3/uL
LAB-005138	Thu Nov 05, 2026 05:00 AM	creatinine	1.19 mg/dL
LAB-005145	Thu Nov 05, 2026 05:00 AM	sodium	139.0 mmol/L
LAB-005151	Thu Nov 05, 2026 05:00 AM	hemoglobin	14.29 g/dL
LAB-005160	Thu Nov 05, 2026 05:00 AM	wbc	6.58 x10^3/uL
LAB-005161	Thu Nov 05, 2026 05:00 AM	platelets	244.0 x10^3/uL
LAB-005139	Fri Nov 06, 2026 05:00 AM	creatinine	1.1 mg/dL
LAB-005146	Fri Nov 06, 2026 05:00 AM	sodium	137.0 mmol/L
LAB-005152	Fri Nov 06, 2026 05:00 AM	hemoglobin	14.55 g/dL
LAB-005162	Fri Nov 06, 2026 05:00 AM	wbc	6.77 x10^3/uL
LAB-005163	Fri Nov 06, 2026 05:00 AM	platelets	306.0 x10^3/uL
LAB-005140	Sat Nov 07, 2026 05:00 AM	creatinine	1.08 mg/dL
LAB-005147	Sat Nov 07, 2026 05:00 AM	sodium	138.0 mmol/L
LAB-005153	Sat Nov 07, 2026 05:00 AM	hemoglobin	14.33 g/dL
LAB-005164	Sat Nov 07, 2026 05:00 AM	wbc	9.05 x10^3/uL
LAB-005165	Sat Nov 07, 2026 05:00 AM	platelets	207.0 x10^3/uL

Vitals (90)

Vitals
Row	When	Kind	Value	Detail
VIT-014777	Mon Nov 02, 2026 06:38 PM	spo2	95.0	room air
VIT-014778	Mon Nov 02, 2026 06:38 PM	rr	20.0
VIT-014807	Mon Nov 02, 2026 06:38 PM	temp_c	36.7
VIT-014808	Mon Nov 02, 2026 06:38 PM	hr	86.0
VIT-014809	Mon Nov 02, 2026 06:38 PM	map	87.0
VIT-014810	Mon Nov 02, 2026 06:38 PM	gcs	15.0
VIT-014779	Tue Nov 03, 2026 02:38 AM	spo2	97.0	room air
VIT-014780	Tue Nov 03, 2026 02:38 AM	rr	20.0
VIT-014811	Tue Nov 03, 2026 02:38 AM	temp_c	36.9
VIT-014812	Tue Nov 03, 2026 02:38 AM	hr	71.0
VIT-014813	Tue Nov 03, 2026 02:38 AM	map	87.0
VIT-014814	Tue Nov 03, 2026 02:38 AM	gcs	15.0
VIT-014781	Tue Nov 03, 2026 10:38 AM	spo2	95.0	room air
VIT-014782	Tue Nov 03, 2026 10:38 AM	rr	16.0
VIT-014815	Tue Nov 03, 2026 10:38 AM	temp_c	36.6
VIT-014816	Tue Nov 03, 2026 10:38 AM	hr	68.0
VIT-014817	Tue Nov 03, 2026 10:38 AM	map	76.0
VIT-014818	Tue Nov 03, 2026 10:38 AM	gcs	15.0
VIT-014783	Tue Nov 03, 2026 06:38 PM	spo2	98.0	room air
VIT-014784	Tue Nov 03, 2026 06:38 PM	rr	20.0
VIT-014819	Tue Nov 03, 2026 06:38 PM	temp_c	37.3
VIT-014820	Tue Nov 03, 2026 06:38 PM	hr	89.0
VIT-014821	Tue Nov 03, 2026 06:38 PM	map	82.0
VIT-014822	Tue Nov 03, 2026 06:38 PM	gcs	15.0
VIT-014785	Wed Nov 04, 2026 02:38 AM	spo2	98.0	room air
VIT-014786	Wed Nov 04, 2026 02:38 AM	rr	16.0
VIT-014823	Wed Nov 04, 2026 02:38 AM	temp_c	36.6
VIT-014824	Wed Nov 04, 2026 02:38 AM	hr	75.0
VIT-014825	Wed Nov 04, 2026 02:38 AM	map	79.0
VIT-014826	Wed Nov 04, 2026 02:38 AM	gcs	15.0
VIT-014787	Wed Nov 04, 2026 10:38 AM	spo2	99.0	room air
VIT-014788	Wed Nov 04, 2026 10:38 AM	rr	17.0
VIT-014827	Wed Nov 04, 2026 10:38 AM	temp_c	36.6
VIT-014828	Wed Nov 04, 2026 10:38 AM	hr	88.0
VIT-014829	Wed Nov 04, 2026 10:38 AM	map	80.0
VIT-014830	Wed Nov 04, 2026 10:38 AM	gcs	15.0
VIT-014789	Wed Nov 04, 2026 06:38 PM	spo2	94.0	room air
VIT-014790	Wed Nov 04, 2026 06:38 PM	rr	14.0
VIT-014831	Wed Nov 04, 2026 06:38 PM	temp_c	36.6
VIT-014832	Wed Nov 04, 2026 06:38 PM	hr	70.0
VIT-014833	Wed Nov 04, 2026 06:38 PM	map	80.0
VIT-014834	Wed Nov 04, 2026 06:38 PM	gcs	15.0
VIT-014791	Thu Nov 05, 2026 02:38 AM	spo2	94.0	room air
VIT-014792	Thu Nov 05, 2026 02:38 AM	rr	15.0
VIT-014835	Thu Nov 05, 2026 02:38 AM	temp_c	37.2
VIT-014836	Thu Nov 05, 2026 02:38 AM	hr	91.0
VIT-014837	Thu Nov 05, 2026 02:38 AM	map	76.0
VIT-014838	Thu Nov 05, 2026 02:38 AM	gcs	15.0
VIT-014793	Thu Nov 05, 2026 10:38 AM	spo2	99.0	room air
VIT-014794	Thu Nov 05, 2026 10:38 AM	rr	16.0
VIT-014839	Thu Nov 05, 2026 10:38 AM	temp_c	37.3
VIT-014840	Thu Nov 05, 2026 10:38 AM	hr	73.0
VIT-014841	Thu Nov 05, 2026 10:38 AM	map	89.0
VIT-014842	Thu Nov 05, 2026 10:38 AM	gcs	15.0
VIT-014795	Thu Nov 05, 2026 06:38 PM	spo2	99.0	room air
VIT-014796	Thu Nov 05, 2026 06:38 PM	rr	17.0
VIT-014843	Thu Nov 05, 2026 06:38 PM	temp_c	37.2
VIT-014844	Thu Nov 05, 2026 06:38 PM	hr	82.0
VIT-014845	Thu Nov 05, 2026 06:38 PM	map	74.0
VIT-014846	Thu Nov 05, 2026 06:38 PM	gcs	15.0
VIT-014797	Fri Nov 06, 2026 02:38 AM	spo2	99.0	room air
VIT-014798	Fri Nov 06, 2026 02:38 AM	rr	17.0
VIT-014847	Fri Nov 06, 2026 02:38 AM	temp_c	36.7
VIT-014848	Fri Nov 06, 2026 02:38 AM	hr	85.0
VIT-014849	Fri Nov 06, 2026 02:38 AM	map	78.0
VIT-014850	Fri Nov 06, 2026 02:38 AM	gcs	15.0
VIT-014799	Fri Nov 06, 2026 10:38 AM	spo2	96.0	room air
VIT-014800	Fri Nov 06, 2026 10:38 AM	rr	16.0
VIT-014851	Fri Nov 06, 2026 10:38 AM	temp_c	37.1
VIT-014852	Fri Nov 06, 2026 10:38 AM	hr	87.0
VIT-014853	Fri Nov 06, 2026 10:38 AM	map	79.0
VIT-014854	Fri Nov 06, 2026 10:38 AM	gcs	15.0
VIT-014801	Fri Nov 06, 2026 06:38 PM	spo2	98.0	room air
VIT-014802	Fri Nov 06, 2026 06:38 PM	rr	19.0
VIT-014855	Fri Nov 06, 2026 06:38 PM	temp_c	37.4
VIT-014856	Fri Nov 06, 2026 06:38 PM	hr	84.0
VIT-014857	Fri Nov 06, 2026 06:38 PM	map	78.0
VIT-014858	Fri Nov 06, 2026 06:38 PM	gcs	15.0
VIT-014803	Sat Nov 07, 2026 02:38 AM	spo2	98.0	room air
VIT-014804	Sat Nov 07, 2026 02:38 AM	rr	19.0
VIT-014859	Sat Nov 07, 2026 02:38 AM	temp_c	37.2
VIT-014860	Sat Nov 07, 2026 02:38 AM	hr	75.0
VIT-014861	Sat Nov 07, 2026 02:38 AM	map	87.0
VIT-014862	Sat Nov 07, 2026 02:38 AM	gcs	15.0
VIT-014805	Sat Nov 07, 2026 10:38 AM	spo2	95.0	room air
VIT-014806	Sat Nov 07, 2026 10:38 AM	rr	15.0
VIT-014863	Sat Nov 07, 2026 10:38 AM	temp_c	37.1
VIT-014864	Sat Nov 07, 2026 10:38 AM	hr	88.0
VIT-014865	Sat Nov 07, 2026 10:38 AM	map	74.0
VIT-014866	Sat Nov 07, 2026 10:38 AM	gcs	15.0

Medications, orders, echo, history (8)

MED-000602 11-02 08:00 furosemide 40 mg IV
MED-000603 11-02 20:00 furosemide 40 mg IV
MED-000604 11-03 08:00 furosemide 40 mg IV
MED-000605 11-03 20:00 furosemide 40 mg IV
MED-000606 11-04 08:00 furosemide 40 mg IV
MED-000607 11-04 20:00 furosemide 40 mg IV
ECH-000071 2026-11-03 echo LVEF 35.0%
HX-000055 history: heart failure with reduced ejection fraction

Notes

History and physical · DOC-000507 · Dr. Rosalind Quillan (attending) · Mon Nov 02, 2026 09:18 PM

Source document DOC-000507: History and physical (synthetic)

HISTORY AND PHYSICAL
Patient: Priya Ivers   MRN: MRN20392931   Admitted: 2026-11-02 18:18
Service: Cardiology   Attending: Dr. Rosalind Quillan

History of present illness: 69-year-old man admitted with chronic systolic heart failure. 
Past medical history: heart failure with reduced ejection fraction, GERD, type 2 diabetes, hyperlipidemia.
Review of systems otherwise negative.
Exam: Lungs: clear to auscultation bilaterally.
Assessment and plan:
1. Chronic systolic heart failure: diuresis and daily weights; monitor electrolytes.

Progress note · DOC-000508 · Dr. Rosalind Quillan (attending) · Wed Nov 04, 2026 07:18 PM

Source document DOC-000508: Progress note (synthetic)

PROGRESS NOTE (Attending)
Patient: Priya Ivers   MRN: MRN20392931   Hospital day 3

Subjective: resting, tolerating diet.
Objective: vitals and labs reviewed in the flowsheet.
Assessment and plan:
1. Chronic systolic heart failure: continue current management.
2. Acute renal insufficiency: trend creatinine, avoid nephrotoxins.
3. Hyponatremia: trend sodium.

Attending: Dr. Rosalind Quillan

Discharge summary · DOC-000509 · Dr. Rosalind Quillan (attending) · Sat Nov 07, 2026 01:16 PM

Source document DOC-000509: Discharge summary (synthetic)

DISCHARGE SUMMARY
Patient: Priya Ivers   MRN: MRN20392931
Admitted 2026-11-02; discharged 2026-11-07.

Discharge diagnoses:
- acute renal insufficiency
- chronic systolic heart failure
- hyponatremia
- GERD
- type 2 diabetes
- hyperlipidemia

Disposition: home with follow-up.