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-00162: Nadia Greaves

65M · MRN47403208 · Hospital Medicine · admitted Mon Oct 26, 2026 09:04 AM · discharged Tue Nov 03, 2026 03:26 PM · attending Dr. Isaac Abernath · resident Dr. Noor Halvorsen · 161 cm, 100.5 kg

Documented diagnoses (current)

Principal: “urinary tract infection” · N39.0 Urinary tract infection, site not specified
“class 2 obesity” · E66.812 Obesity, class 2
“CKD stage 4” · N18.4 Chronic kidney disease, stage 4 (severe)
“acute kidney injury” · N17.9 Acute kidney failure, unspecified
“CHF” · I50.9 Heart failure, unspecified
“hyperlipidemia” · E78.5 Hyperlipidemia, unspecified
“hypertension” · I10 Essential (primary) hypertension

Illustrative grouping now: MS-DRG 690 Kidney and urinary tract infections without MCC. If every open specificity/validation gap were answered as the criteria suggest: MS-DRG 690.

Queries and events

No queries yet.

All rules applied

Rule Criteria Finding Outcome

Acute kidney injury

Criteria met

No gap

Supported as documented (N17.9).

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=3.593, t.ratio_s1=1.5, creat_rise_48h=1.65, 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=3.593, t.ratio_s3=3.0, creat_peak=7.51, t.scr_s3=4.0, rrt_started=True, uo_hours_lt_0_3=unknown, t.uo_s3_h=24, anuria_hours=unknown, t.anuria_h=12	true
derived: stage2	`creat_ratio >= t.ratio_s2 or coalesce(uo_hours_lt_0_5 >= t.uo_s2_h, false)`	creat_ratio=3.593, t.ratio_s2=2.0, uo_hours_lt_0_5=unknown, t.uo_s2_h=12	true
derived: stage	`case(stage3, 3, stage2, 2, meets_definition, 1, 0)`	stage3=True, stage2=True, meets_definition=True	3
derived: baseline_independent	`creat_baseline_known or creat_rise_48h >= t.rise_abs or rrt_started`	creat_baseline_known=True, creat_rise_48h=1.65, t.rise_abs=0.3, rrt_started=True	true
outcome: aki_staged	`stage >= 1 and baseline_independent`	stage=3, baseline_independent=True	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=13.63, 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=0.4, 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=0.4, t.drop_min=1.0, prbc_units=0	false
outcome: not_anaemic	`present(hgb_nadir) and not anaemic`	hgb_nadir=13.63, anaemic=False	true

Chronic kidney disease

Criteria met

Clinical validation gap

Documented “CKD stage 4” (N18.4) conflicts with what the criteria support (Chronic kidney disease stage 3b, N18.32).

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=236, t.chronic_days=90	true
derived: staging_egfr	`max(egfr_early, egfr_late)`	egfr_early=37.2, egfr_late=34.5	37.2
derived: both_below_60	`egfr_early < t.g2 and egfr_late < t.g2`	egfr_early=37.2, t.g2=60, egfr_late=34.5	true
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=37.2, t.g2=60, t.g3a=45, t.g3b=30, t.g4=15	G3b
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=True, egfr_early=37.2, egfr_late=34.5, t.g2=60	false
outcome: g1_g2	`staging_egfr >= t.g2`	staging_egfr=37.2, t.g2=60	false
outcome: g3a	`category == 'G3a'`	category=G3b	false
outcome: g3b	`category == 'G3b'`	category=G3b	true

Heart failure

Clinical judgement required

Clinical judgement required: 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)
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=59.0, t.bnp=100, ntprobnp_max=unknown, t.ntprobnp=300	false
derived: acute_count	`count(iv_loop_diuretic, np_elevated, new_o2)`	iv_loop_diuretic=True, np_elevated=False, new_o2=False	1
derived: hf_type	`case(lvef <= t.ref, 'systolic', lvef >= t.pres, 'diastolic', 'midrange')`	lvef=27.0, 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=27.0, 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=1, hf_history=False	unknown
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=unknown	unknown
outcome: sys_acute	`hf_type == 'systolic' and acuity == 'acute'`	hf_type=systolic, acuity=unknown	unknown
outcome: sys_chronic	`hf_type == 'systolic' and acuity == 'chronic'`	hf_type=systolic, acuity=unknown	unknown
outcome: dia_aoc	`hf_type == 'diastolic' and acuity == 'acute on chronic'`	hf_type=systolic, acuity=unknown	false
outcome: dia_acute	`hf_type == 'diastolic' and acuity == 'acute'`	hf_type=systolic, acuity=unknown	false
outcome: dia_chronic	`hf_type == 'diastolic' and acuity == 'chronic'`	hf_type=systolic, acuity=unknown	false
outcome: one_indicator	`acute_count == 1`	acute_count=1	true

Hyponatraemia

Criteria met

Specificity gap

Criteria support Hyponatraemia (mild) (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)
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=130.0, t.profound=125, t.moderate=130, t.low=135	mild
outcome: met	`na_min < t.low and na_low_count >= t.repeat and na_treated`	na_min=130.0, t.low=135, na_low_count=5, t.repeat=2, na_treated=True	true

Malnutrition

Criteria not met

No gap

Not documented and not supported.

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=100.0, t.a_sev_intake_pct=50, intake_days=unknown, 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=100.0, t.a_mod_intake_pct=75, intake_days=unknown, t.a_mod_intake_days=7	false
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=100.0, t.c_intake_pct=75, intake_days=unknown, 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=100.0, t.c_intake_pct=75, intake_days=unknown, 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=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=100.0, wt_loss_pct=unknown, fat_loss=0, muscle_loss=0, fluid=0, grip_reduced=unknown	4
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=unknown, fat_loss=0, muscle_loss=0, fluid=0, grip_reduced=unknown, c_sev_intake=False, c_sev_wt=unknown	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=False, a_sev_wt=unknown, a_mod_wt=unknown, fat_loss=0, muscle_loss=0, fluid=0, grip_reduced=unknown, c_sev_intake=False, c_mod_intake=False, c_sev_wt=unknown, c_mod_wt=unknown	0
outcome: severe	`n_severe >= 2`	n_severe=0	false
outcome: moderate	`n_moderate >= 2`	n_moderate=0	false
outcome: one_characteristic	`n_moderate == 1`	n_moderate=0	false
outcome: not_met	`n_moderate == 0 and n_assessed >= 2`	n_moderate=0, n_assessed=4	true

Obesity

Criteria met

No gap

Supported as documented (E66.812).

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=38.8, t.c3=40	false
outcome: class2	`bmi >= t.c2`	bmi=38.8, t.c2=35	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 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)
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=36.7, 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=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=9.12, t.wbc_hi=12, wbc_min_48h=7.06, 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=196.0	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=0.51	0
derived: sofa_cardio	`coalesce(case(norepi_max_48h > 0.1, 4, norepi_max_48h > 0, 3, map_min_48h < 70, 1, 0), 0)`	norepi_max_48h=0.0, map_min_48h=75.0	0
derived: sofa_cns	`coalesce(case(gcs_min_48h < 6, 4, gcs_min_48h < 10, 3, gcs_min_48h < 13, 2, gcs_min_48h < 15, 1, 0), 0)`	gcs_min_48h=15.0	0
derived: sofa_renal	`coalesce(case(creat_max_48h >= 5, 4, creat_max_48h >= 3.5, 3, creat_max_48h >= 2, 2, creat_max_48h >= 1.2, 1, 0), 0)`	creat_max_48h=7.51	4
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=2.09	2
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=4, sofa_renal_baseline=2	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=0, 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 (49)

Labs (pre-admission rows are outpatient values)
Row	When	Test	Value
LAB-005514	Sat Nov 29, 2025 09:15 AM	creatinine	1.96 mg/dL
LAB-005515	Fri Jul 24, 2026 10:05 AM	creatinine	2.09 mg/dL
LAB-005516	Mon Oct 26, 2026 10:04 AM	creatinine	5.86 mg/dL
LAB-005525	Mon Oct 26, 2026 10:04 AM	bnp	59.0 pg/mL
LAB-005526	Mon Oct 26, 2026 10:04 AM	sodium	132.0 mmol/L
LAB-005535	Mon Oct 26, 2026 10:04 AM	hemoglobin	14.07 g/dL
LAB-005544	Mon Oct 26, 2026 10:04 AM	wbc	7.06 x10^3/uL
LAB-005545	Mon Oct 26, 2026 10:04 AM	platelets	267.0 x10^3/uL
LAB-005562	Mon Oct 26, 2026 10:04 AM	bilirubin	0.51 mg/dL
LAB-005517	Tue Oct 27, 2026 05:00 AM	creatinine	7.51 mg/dL
LAB-005527	Tue Oct 27, 2026 05:00 AM	sodium	130.0 mmol/L
LAB-005536	Tue Oct 27, 2026 05:00 AM	hemoglobin	14.07 g/dL
LAB-005546	Tue Oct 27, 2026 05:00 AM	wbc	9.12 x10^3/uL
LAB-005547	Tue Oct 27, 2026 05:00 AM	platelets	271.0 x10^3/uL
LAB-005518	Wed Oct 28, 2026 05:00 AM	creatinine	6.76 mg/dL
LAB-005528	Wed Oct 28, 2026 05:00 AM	sodium	131.0 mmol/L
LAB-005537	Wed Oct 28, 2026 05:00 AM	hemoglobin	13.71 g/dL
LAB-005548	Wed Oct 28, 2026 05:00 AM	wbc	7.42 x10^3/uL
LAB-005549	Wed Oct 28, 2026 05:00 AM	platelets	196.0 x10^3/uL
LAB-005519	Thu Oct 29, 2026 05:00 AM	creatinine	5.64 mg/dL
LAB-005529	Thu Oct 29, 2026 05:00 AM	sodium	134.0 mmol/L
LAB-005538	Thu Oct 29, 2026 05:00 AM	hemoglobin	14.04 g/dL
LAB-005550	Thu Oct 29, 2026 05:00 AM	wbc	9.36 x10^3/uL
LAB-005551	Thu Oct 29, 2026 05:00 AM	platelets	189.0 x10^3/uL
LAB-005520	Fri Oct 30, 2026 05:00 AM	creatinine	4.66 mg/dL
LAB-005530	Fri Oct 30, 2026 05:00 AM	sodium	136.0 mmol/L
LAB-005539	Fri Oct 30, 2026 05:00 AM	hemoglobin	13.76 g/dL
LAB-005552	Fri Oct 30, 2026 05:00 AM	wbc	10.04 x10^3/uL
LAB-005553	Fri Oct 30, 2026 05:00 AM	platelets	275.0 x10^3/uL
LAB-005521	Sat Oct 31, 2026 05:00 AM	creatinine	4.13 mg/dL
LAB-005531	Sat Oct 31, 2026 05:00 AM	sodium	134.0 mmol/L
LAB-005540	Sat Oct 31, 2026 05:00 AM	hemoglobin	13.86 g/dL
LAB-005554	Sat Oct 31, 2026 05:00 AM	wbc	7.91 x10^3/uL
LAB-005555	Sat Oct 31, 2026 05:00 AM	platelets	240.0 x10^3/uL
LAB-005522	Sun Nov 01, 2026 05:00 AM	creatinine	3.76 mg/dL
LAB-005532	Sun Nov 01, 2026 05:00 AM	sodium	136.0 mmol/L
LAB-005541	Sun Nov 01, 2026 05:00 AM	hemoglobin	13.63 g/dL
LAB-005556	Sun Nov 01, 2026 05:00 AM	wbc	5.68 x10^3/uL
LAB-005557	Sun Nov 01, 2026 05:00 AM	platelets	267.0 x10^3/uL
LAB-005523	Mon Nov 02, 2026 05:00 AM	creatinine	3.61 mg/dL
LAB-005533	Mon Nov 02, 2026 05:00 AM	sodium	137.0 mmol/L
LAB-005542	Mon Nov 02, 2026 05:00 AM	hemoglobin	13.78 g/dL
LAB-005558	Mon Nov 02, 2026 05:00 AM	wbc	10.25 x10^3/uL
LAB-005559	Mon Nov 02, 2026 05:00 AM	platelets	268.0 x10^3/uL
LAB-005524	Tue Nov 03, 2026 05:00 AM	creatinine	3.53 mg/dL
LAB-005534	Tue Nov 03, 2026 05:00 AM	sodium	137.0 mmol/L
LAB-005543	Tue Nov 03, 2026 05:00 AM	hemoglobin	13.77 g/dL
LAB-005560	Tue Nov 03, 2026 05:00 AM	wbc	7.19 x10^3/uL
LAB-005561	Tue Nov 03, 2026 05:00 AM	platelets	303.0 x10^3/uL

Vitals (150)

Vitals
Row	When	Kind	Value	Detail
VIT-015845	Mon Oct 26, 2026 09:24 AM	spo2	95.0	room air
VIT-015846	Mon Oct 26, 2026 09:24 AM	rr	17.0
VIT-015895	Mon Oct 26, 2026 09:24 AM	temp_c	36.8
VIT-015896	Mon Oct 26, 2026 09:24 AM	hr	79.0
VIT-015897	Mon Oct 26, 2026 09:24 AM	map	87.0
VIT-015898	Mon Oct 26, 2026 09:24 AM	gcs	15.0
VIT-015847	Mon Oct 26, 2026 05:24 PM	spo2	97.0	room air
VIT-015848	Mon Oct 26, 2026 05:24 PM	rr	17.0
VIT-015899	Mon Oct 26, 2026 05:24 PM	temp_c	37.0
VIT-015900	Mon Oct 26, 2026 05:24 PM	hr	90.0
VIT-015901	Mon Oct 26, 2026 05:24 PM	map	83.0
VIT-015902	Mon Oct 26, 2026 05:24 PM	gcs	15.0
VIT-015849	Tue Oct 27, 2026 01:24 AM	spo2	94.0	room air
VIT-015850	Tue Oct 27, 2026 01:24 AM	rr	16.0
VIT-015903	Tue Oct 27, 2026 01:24 AM	temp_c	37.3
VIT-015904	Tue Oct 27, 2026 01:24 AM	hr	86.0
VIT-015905	Tue Oct 27, 2026 01:24 AM	map	76.0
VIT-015906	Tue Oct 27, 2026 01:24 AM	gcs	15.0
VIT-015851	Tue Oct 27, 2026 09:24 AM	spo2	99.0	room air
VIT-015852	Tue Oct 27, 2026 09:24 AM	rr	19.0
VIT-015907	Tue Oct 27, 2026 09:24 AM	temp_c	37.3
VIT-015908	Tue Oct 27, 2026 09:24 AM	hr	85.0
VIT-015909	Tue Oct 27, 2026 09:24 AM	map	84.0
VIT-015910	Tue Oct 27, 2026 09:24 AM	gcs	15.0
VIT-015853	Tue Oct 27, 2026 05:24 PM	spo2	98.0	room air
VIT-015854	Tue Oct 27, 2026 05:24 PM	rr	18.0
VIT-015911	Tue Oct 27, 2026 05:24 PM	temp_c	37.2
VIT-015912	Tue Oct 27, 2026 05:24 PM	hr	68.0
VIT-015913	Tue Oct 27, 2026 05:24 PM	map	83.0
VIT-015914	Tue Oct 27, 2026 05:24 PM	gcs	15.0
VIT-015855	Wed Oct 28, 2026 01:24 AM	spo2	95.0	room air
VIT-015856	Wed Oct 28, 2026 01:24 AM	rr	14.0
VIT-015915	Wed Oct 28, 2026 01:24 AM	temp_c	36.7
VIT-015916	Wed Oct 28, 2026 01:24 AM	hr	86.0
VIT-015917	Wed Oct 28, 2026 01:24 AM	map	75.0
VIT-015918	Wed Oct 28, 2026 01:24 AM	gcs	15.0
VIT-015857	Wed Oct 28, 2026 09:24 AM	spo2	94.0	room air
VIT-015858	Wed Oct 28, 2026 09:24 AM	rr	16.0
VIT-015919	Wed Oct 28, 2026 09:24 AM	temp_c	37.5
VIT-015920	Wed Oct 28, 2026 09:24 AM	hr	90.0
VIT-015921	Wed Oct 28, 2026 09:24 AM	map	79.0
VIT-015922	Wed Oct 28, 2026 09:24 AM	gcs	15.0
VIT-015859	Wed Oct 28, 2026 05:24 PM	spo2	97.0	room air
VIT-015860	Wed Oct 28, 2026 05:24 PM	rr	18.0
VIT-015923	Wed Oct 28, 2026 05:24 PM	temp_c	37.4
VIT-015924	Wed Oct 28, 2026 05:24 PM	hr	84.0
VIT-015925	Wed Oct 28, 2026 05:24 PM	map	75.0
VIT-015926	Wed Oct 28, 2026 05:24 PM	gcs	15.0
VIT-015861	Thu Oct 29, 2026 01:24 AM	spo2	99.0	room air
VIT-015862	Thu Oct 29, 2026 01:24 AM	rr	16.0
VIT-015927	Thu Oct 29, 2026 01:24 AM	temp_c	37.3
VIT-015928	Thu Oct 29, 2026 01:24 AM	hr	91.0
VIT-015929	Thu Oct 29, 2026 01:24 AM	map	74.0
VIT-015930	Thu Oct 29, 2026 01:24 AM	gcs	15.0
VIT-015863	Thu Oct 29, 2026 09:24 AM	spo2	96.0	room air
VIT-015864	Thu Oct 29, 2026 09:24 AM	rr	19.0
VIT-015931	Thu Oct 29, 2026 09:24 AM	temp_c	36.8
VIT-015932	Thu Oct 29, 2026 09:24 AM	hr	72.0
VIT-015933	Thu Oct 29, 2026 09:24 AM	map	90.0
VIT-015934	Thu Oct 29, 2026 09:24 AM	gcs	15.0
VIT-015865	Thu Oct 29, 2026 05:24 PM	spo2	96.0	room air
VIT-015866	Thu Oct 29, 2026 05:24 PM	rr	19.0
VIT-015935	Thu Oct 29, 2026 05:24 PM	temp_c	37.1
VIT-015936	Thu Oct 29, 2026 05:24 PM	hr	89.0
VIT-015937	Thu Oct 29, 2026 05:24 PM	map	82.0
VIT-015938	Thu Oct 29, 2026 05:24 PM	gcs	15.0
VIT-015867	Fri Oct 30, 2026 01:24 AM	spo2	94.0	room air
VIT-015868	Fri Oct 30, 2026 01:24 AM	rr	15.0
VIT-015939	Fri Oct 30, 2026 01:24 AM	temp_c	37.0
VIT-015940	Fri Oct 30, 2026 01:24 AM	hr	80.0
VIT-015941	Fri Oct 30, 2026 01:24 AM	map	83.0
VIT-015942	Fri Oct 30, 2026 01:24 AM	gcs	15.0
VIT-015869	Fri Oct 30, 2026 09:24 AM	spo2	94.0	room air
VIT-015870	Fri Oct 30, 2026 09:24 AM	rr	15.0
VIT-015943	Fri Oct 30, 2026 09:24 AM	temp_c	36.7
VIT-015944	Fri Oct 30, 2026 09:24 AM	hr	79.0
VIT-015945	Fri Oct 30, 2026 09:24 AM	map	80.0
VIT-015946	Fri Oct 30, 2026 09:24 AM	gcs	15.0
VIT-015871	Fri Oct 30, 2026 05:24 PM	spo2	94.0	room air
VIT-015872	Fri Oct 30, 2026 05:24 PM	rr	15.0
VIT-015947	Fri Oct 30, 2026 05:24 PM	temp_c	37.5
VIT-015948	Fri Oct 30, 2026 05:24 PM	hr	92.0
VIT-015949	Fri Oct 30, 2026 05:24 PM	map	88.0
VIT-015950	Fri Oct 30, 2026 05:24 PM	gcs	15.0
VIT-015873	Sat Oct 31, 2026 01:24 AM	spo2	94.0	room air
VIT-015874	Sat Oct 31, 2026 01:24 AM	rr	17.0
VIT-015951	Sat Oct 31, 2026 01:24 AM	temp_c	37.2
VIT-015952	Sat Oct 31, 2026 01:24 AM	hr	85.0
VIT-015953	Sat Oct 31, 2026 01:24 AM	map	91.0
VIT-015954	Sat Oct 31, 2026 01:24 AM	gcs	15.0
VIT-015875	Sat Oct 31, 2026 09:24 AM	spo2	99.0	room air
VIT-015876	Sat Oct 31, 2026 09:24 AM	rr	14.0
VIT-015955	Sat Oct 31, 2026 09:24 AM	temp_c	37.1
VIT-015956	Sat Oct 31, 2026 09:24 AM	hr	86.0
VIT-015957	Sat Oct 31, 2026 09:24 AM	map	77.0
VIT-015958	Sat Oct 31, 2026 09:24 AM	gcs	15.0
VIT-015877	Sat Oct 31, 2026 05:24 PM	spo2	97.0	room air
VIT-015878	Sat Oct 31, 2026 05:24 PM	rr	19.0
VIT-015959	Sat Oct 31, 2026 05:24 PM	temp_c	37.6
VIT-015960	Sat Oct 31, 2026 05:24 PM	hr	85.0
VIT-015961	Sat Oct 31, 2026 05:24 PM	map	81.0
VIT-015962	Sat Oct 31, 2026 05:24 PM	gcs	15.0
VIT-015879	Sun Nov 01, 2026 01:24 AM	spo2	99.0	room air
VIT-015880	Sun Nov 01, 2026 01:24 AM	rr	20.0
VIT-015963	Sun Nov 01, 2026 01:24 AM	temp_c	36.7
VIT-015964	Sun Nov 01, 2026 01:24 AM	hr	71.0
VIT-015965	Sun Nov 01, 2026 01:24 AM	map	89.0
VIT-015966	Sun Nov 01, 2026 01:24 AM	gcs	15.0
VIT-015881	Sun Nov 01, 2026 09:24 AM	spo2	94.0	room air
VIT-015882	Sun Nov 01, 2026 09:24 AM	rr	15.0
VIT-015967	Sun Nov 01, 2026 09:24 AM	temp_c	36.8
VIT-015968	Sun Nov 01, 2026 09:24 AM	hr	82.0
VIT-015969	Sun Nov 01, 2026 09:24 AM	map	76.0
VIT-015970	Sun Nov 01, 2026 09:24 AM	gcs	15.0
VIT-015883	Sun Nov 01, 2026 05:24 PM	spo2	97.0	room air
VIT-015884	Sun Nov 01, 2026 05:24 PM	rr	16.0
VIT-015971	Sun Nov 01, 2026 05:24 PM	temp_c	36.8
VIT-015972	Sun Nov 01, 2026 05:24 PM	hr	92.0
VIT-015973	Sun Nov 01, 2026 05:24 PM	map	83.0
VIT-015974	Sun Nov 01, 2026 05:24 PM	gcs	15.0
VIT-015885	Mon Nov 02, 2026 01:24 AM	spo2	99.0	room air
VIT-015886	Mon Nov 02, 2026 01:24 AM	rr	20.0
VIT-015975	Mon Nov 02, 2026 01:24 AM	temp_c	37.5
VIT-015976	Mon Nov 02, 2026 01:24 AM	hr	73.0
VIT-015977	Mon Nov 02, 2026 01:24 AM	map	83.0
VIT-015978	Mon Nov 02, 2026 01:24 AM	gcs	15.0
VIT-015887	Mon Nov 02, 2026 09:24 AM	spo2	94.0	room air
VIT-015888	Mon Nov 02, 2026 09:24 AM	rr	14.0
VIT-015979	Mon Nov 02, 2026 09:24 AM	temp_c	37.4
VIT-015980	Mon Nov 02, 2026 09:24 AM	hr	87.0
VIT-015981	Mon Nov 02, 2026 09:24 AM	map	84.0
VIT-015982	Mon Nov 02, 2026 09:24 AM	gcs	15.0
VIT-015889	Mon Nov 02, 2026 05:24 PM	spo2	99.0	room air
VIT-015890	Mon Nov 02, 2026 05:24 PM	rr	16.0
VIT-015983	Mon Nov 02, 2026 05:24 PM	temp_c	36.7
VIT-015984	Mon Nov 02, 2026 05:24 PM	hr	68.0
VIT-015985	Mon Nov 02, 2026 05:24 PM	map	91.0
VIT-015986	Mon Nov 02, 2026 05:24 PM	gcs	15.0
VIT-015891	Tue Nov 03, 2026 01:24 AM	spo2	98.0	room air
VIT-015892	Tue Nov 03, 2026 01:24 AM	rr	17.0
VIT-015987	Tue Nov 03, 2026 01:24 AM	temp_c	37.2
VIT-015988	Tue Nov 03, 2026 01:24 AM	hr	75.0
VIT-015989	Tue Nov 03, 2026 01:24 AM	map	87.0
VIT-015990	Tue Nov 03, 2026 01:24 AM	gcs	15.0
VIT-015893	Tue Nov 03, 2026 09:24 AM	spo2	97.0	room air
VIT-015894	Tue Nov 03, 2026 09:24 AM	rr	18.0
VIT-015991	Tue Nov 03, 2026 09:24 AM	temp_c	37.3
VIT-015992	Tue Nov 03, 2026 09:24 AM	hr	86.0
VIT-015993	Tue Nov 03, 2026 09:24 AM	map	82.0
VIT-015994	Tue Nov 03, 2026 09:24 AM	gcs	15.0

Medications, orders, echo, history (8)

MED-000656 10-26 10:04 ceftriaxone per protocol IV
MED-000657 10-27 05:00 ceftriaxone per protocol IV
MED-000658 10-28 05:00 cefepime per protocol IV
MED-000659 10-26 12:04 furosemide 40 mg IV
ORD-000140 10-26 09:34 blood_culture: blood cultures x2
ORD-000141 10-27 08:00 dialysis: hemodialysis catheter and session
ORD-000142 10-26 12:04 fluid_restriction: fluid restriction 1.2 L/day
ECH-000077 2026-10-27 echo LVEF 27.0%

Notes

History and physical · DOC-000546 · Dr. Noor Halvorsen (resident) · Mon Oct 26, 2026 12:04 PM

Cited facts from this note (1)

infection_source: urinary tract infection · cited p. 1, line 5 · confidence 0.85

Show source for infection_source

… MRN47403208 Admitted: 2026-10-26 09:04 Service: Hospital Medicine Attending: Dr. Isaac Abernath History of present illness: 65-year-old man admitted with urinary tract infection. Urinalysis with pyuria; treated for acute pyelonephritis with cefepime. Past medical history: hyperlipidemia, hypertension. Review of systems otherwise negati …

Source document DOC-000546: History and physical (synthetic)

HISTORY AND PHYSICAL
Patient: Nadia Greaves   MRN: MRN47403208   Admitted: 2026-10-26 09:04
Service: Hospital Medicine   Attending: Dr. Isaac Abernath

History of present illness: 65-year-old man admitted with urinary tract infection. Urinalysis with pyuria; treated for acute pyelonephritis with cefepime.
Past medical history: hyperlipidemia, hypertension.
Review of systems otherwise negative.
Exam: Lungs: clear to auscultation bilaterally.
Assessment and plan:
1. Urinary tract infection: antibiotics.
2. CKD stage 4: renally dose medications.

Nutrition assessment · DOC-000545 · Viggo Ravensworth, RD (dietitian) · Tue Oct 27, 2026 12:04 PM

Cited facts from this note (5)

fat_loss: none · cited p. 1, line 7 · confidence 0.90

Show source for fat_loss

… MRN: MRN47403208 Context: acute illness Intake: eating 100% of meals. Weight history: weight stable over the past 3 months. Nutrition-focused physical exam: no loss of subcutaneous fat; no muscle wasting; no fluid accumulation. Assessment: well nourished; no malnutrition identified.
fluid_accumulation: none · cited p. 1, line 7 · confidence 0.90

Show source for fluid_accumulation

… e: eating 100% of meals. Weight history: weight stable over the past 3 months. Nutrition-focused physical exam: no loss of subcutaneous fat; no muscle wasting; no fluid accumulation. Assessment: well nourished; no malnutrition identified.
intake_pct: 100 · cited p. 1, line 5 · confidence 0.90

Show source for intake_pct

NUTRITION ASSESSMENT (Registered Dietitian) Patient: Nadia Greaves MRN: MRN47403208 Context: acute illness Intake: eating 100% of meals. Weight history: weight stable over the past 3 months. Nutrition-focused physical exam: no loss of subcutaneous fat; no muscle wasting; no fluid accumulation. …
muscle_loss: none · cited p. 1, line 7 · confidence 0.90

Show source for muscle_loss

… acute illness Intake: eating 100% of meals. Weight history: weight stable over the past 3 months. Nutrition-focused physical exam: no loss of subcutaneous fat; no muscle wasting; no fluid accumulation. Assessment: well nourished; no malnutrition identified.
nutrition_context: acute · cited p. 1, line 4 · confidence 0.95

Show source for nutrition_context

NUTRITION ASSESSMENT (Registered Dietitian) Patient: Nadia Greaves MRN: MRN47403208 Context: acute illness Intake: eating 100% of meals. Weight history: weight stable over the past 3 months. Nutrition-focused physical exam: no loss of subcutaneous fat; no muscle was …

Source document DOC-000545: Nutrition assessment (synthetic)

NUTRITION ASSESSMENT (Registered Dietitian)
Patient: Nadia Greaves   MRN: MRN47403208

Context: acute illness
Intake: eating 100% of meals.
Weight history: weight stable over the past 3 months.
Nutrition-focused physical exam: no loss of subcutaneous fat; no muscle wasting; no fluid accumulation.
Assessment: well nourished; no malnutrition identified.

Progress note · DOC-000547 · Dr. Noor Halvorsen (resident) · Wed Oct 28, 2026 11:04 AM

Source document DOC-000547: Progress note (synthetic)

PROGRESS NOTE (Resident)
Patient: Nadia Greaves   MRN: MRN47403208   Hospital day 3

Subjective: resting, tolerating diet.
Objective: vitals and labs reviewed in the flowsheet.
Assessment and plan:
1. Urinary tract infection: continue current management.
2. Class 2 obesity: counsel on weight.
3. Acute kidney injury: trend creatinine, hold nephrotoxins, strict intake and output.
4. CHF: diuresis and daily weights; monitor electrolytes.

Resident: Dr. Noor Halvorsen   Attending cosign: completed

Discharge summary · DOC-000548 · Dr. Isaac Abernath (attending) · Tue Nov 03, 2026 03:26 PM

Source document DOC-000548: Discharge summary (synthetic)

DISCHARGE SUMMARY
Patient: Nadia Greaves   MRN: MRN47403208
Admitted 2026-10-26; discharged 2026-11-03.

Discharge diagnoses:
- urinary tract infection
- class 2 obesity
- CKD stage 4
- acute kidney injury
- CHF
- hyperlipidemia
- hypertension

Disposition: home with follow-up.