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-00164: Quinn Northam

79F · MRN60095932 · Pulmonology · admitted Fri Oct 30, 2026 08:03 AM · discharged Sat Nov 07, 2026 10:10 AM · attending Dr. Kenji Stavros · 166 cm, 86.7 kg

Documented diagnoses (current)

Principal: “COPD exacerbation” · J44.1 Chronic obstructive pulmonary disease with (acute) exacerbation
“obesity” · E66.9 Obesity, unspecified
“HFrEF” · I50.20 Unspecified systolic (congestive) heart failure
“anemia” · D64.9 Anemia, unspecified
“unstageable sacral pressure injury” · L89.150 Pressure ulcer of sacral region, unstageable
“type 2 diabetes” · E11.9 Type 2 diabetes mellitus without complications
“hyperlipidemia” · E78.5 Hyperlipidemia, unspecified

Illustrative grouping now: MS-DRG 191 Chronic obstructive pulmonary disease with CC. If every open specificity/validation gap were answered as the criteria suggest: MS-DRG 191.

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=1.048, t.ratio_s1=1.5, creat_rise_48h=0.04, t.rise_abs=0.3, uo_hours_lt_0_5=unknown, t.uo_s1_h=6	false
derived: stage3	`meets_definition and (creat_ratio >= t.ratio_s3 or creat_peak >= t.scr_s3 or rrt_started or coalesce(uo_hours_lt_0_3 >= t.uo_s3_h, false) or coalesce(anuria_hours >= t.anuria_h, false))`	meets_definition=False, creat_ratio=1.048, t.ratio_s3=3.0, creat_peak=0.88, 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=1.048, t.ratio_s2=2.0, uo_hours_lt_0_5=unknown, t.uo_s2_h=12	false
derived: stage	`case(stage3, 3, stage2, 2, meets_definition, 1, 0)`	stage3=False, stage2=False, meets_definition=False	0
derived: baseline_independent	`creat_baseline_known or creat_rise_48h >= t.rise_abs or rrt_started`	creat_baseline_known=True, creat_rise_48h=0.04, t.rise_abs=0.3, rrt_started=False	true
outcome: aki_staged	`stage >= 1 and baseline_independent`	stage=0, baseline_independent=True	false
outcome: aki_presumed_baseline	`stage >= 1`	stage=0	false
outcome: not_met	`stage == 0`	stage=0	true

Acute blood loss anaemia

Criteria met

No gap

Supported as documented (D64.9).

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=10.03, 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=0.2, 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=True, acute_fall=False	false
outcome: anaemia_only	`anaemic and hgb_drop < t.drop_min and prbc_units == 0`	anaemic=True, hgb_drop=0.2, t.drop_min=1.0, prbc_units=0	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=331, t.chronic_days=90	true
derived: staging_egfr	`max(egfr_early, egfr_late)`	egfr_early=71.7, egfr_late=70.6	71.7
derived: both_below_60	`egfr_early < t.g2 and egfr_late < t.g2`	egfr_early=71.7, t.g2=60, egfr_late=70.6	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=71.7, 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=71.7, egfr_late=70.6, t.g2=60	false
outcome: g1_g2	`staging_egfr >= t.g2`	staging_egfr=71.7, t.g2=60	true

Heart failure

Criteria met

Specificity gap

Documented “HFrEF” (I50.20); criteria support the more specific Chronic systolic (HFrEF) heart failure (I50.22).

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=69.0, t.bnp=100, ntprobnp_max=unknown, t.ntprobnp=300	false
derived: acute_count	`count(iv_loop_diuretic, np_elevated, new_o2)`	iv_loop_diuretic=False, np_elevated=False, new_o2=False	0
derived: hf_type	`case(lvef <= t.ref, 'systolic', lvef >= t.pres, 'diastolic', 'midrange')`	lvef=22.0, 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=22.0, 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=0, hf_history=True	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=chronic	false
outcome: sys_acute	`hf_type == 'systolic' and acuity == 'acute'`	hf_type=systolic, acuity=chronic	false
outcome: sys_chronic	`hf_type == 'systolic' and acuity == 'chronic'`	hf_type=systolic, acuity=chronic	true

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

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 met

Specificity gap

Documented “obesity” (E66.9); criteria support the more specific Obesity, class 1 (E66.811).

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=79, t.adult=20	false
outcome: class3	`bmi >= t.c3`	bmi=31.5, t.c3=40	false
outcome: class2	`bmi >= t.c2`	bmi=31.5, t.c2=35	false
outcome: class1	`bmi >= t.c1`	bmi=31.5, t.c1=30	true

Pressure injury

Criteria met

No gap

Supported as documented (L89.150).

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=sacral	true
outcome: no_wound_note	`not present(wound_stage)`	wound_stage=unstageable	false
outcome: other_site	`wound_site != 'sacral'`	wound_site=sacral	false
outcome: stage1	`sacral and wound_stage == '1'`	sacral=True, wound_stage=unstageable	false
outcome: stage2	`sacral and wound_stage == '2'`	sacral=True, wound_stage=unstageable	false
outcome: stage3	`sacral and wound_stage == '3'`	sacral=True, wound_stage=unstageable	false
outcome: stage4	`sacral and wound_stage == '4'`	sacral=True, wound_stage=unstageable	false
outcome: unstageable	`sacral and wound_stage == 'unstageable'`	sacral=True, wound_stage=unstageable	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=37.4, 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=8.14, t.wbc_hi=12, wbc_min_48h=6.66, 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=175.0	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=0.94	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=79.0	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=0.88	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=0.84	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 (49)

Labs (pre-admission rows are outpatient values)
Row	When	Test	Value
LAB-005592	Mon Sep 15, 2025 09:15 AM	creatinine	0.83 mg/dL
LAB-005593	Wed Aug 12, 2026 10:05 AM	creatinine	0.84 mg/dL
LAB-005594	Fri Oct 30, 2026 09:03 AM	creatinine	0.84 mg/dL
LAB-005603	Fri Oct 30, 2026 09:03 AM	bnp	69.0 pg/mL
LAB-005604	Fri Oct 30, 2026 09:03 AM	sodium	141.0 mmol/L
LAB-005613	Fri Oct 30, 2026 09:03 AM	hemoglobin	10.15 g/dL
LAB-005622	Fri Oct 30, 2026 09:03 AM	wbc	8.14 x10^3/uL
LAB-005623	Fri Oct 30, 2026 09:03 AM	platelets	270.0 x10^3/uL
LAB-005640	Fri Oct 30, 2026 09:03 AM	bilirubin	0.94 mg/dL
LAB-005595	Sat Oct 31, 2026 05:00 AM	creatinine	0.86 mg/dL
LAB-005605	Sat Oct 31, 2026 05:00 AM	sodium	140.0 mmol/L
LAB-005614	Sat Oct 31, 2026 05:00 AM	hemoglobin	10.14 g/dL
LAB-005624	Sat Oct 31, 2026 05:00 AM	wbc	7.94 x10^3/uL
LAB-005625	Sat Oct 31, 2026 05:00 AM	platelets	175.0 x10^3/uL
LAB-005596	Sun Nov 01, 2026 05:00 AM	creatinine	0.88 mg/dL
LAB-005606	Sun Nov 01, 2026 05:00 AM	sodium	136.0 mmol/L
LAB-005615	Sun Nov 01, 2026 05:00 AM	hemoglobin	10.26 g/dL
LAB-005626	Sun Nov 01, 2026 05:00 AM	wbc	6.66 x10^3/uL
LAB-005627	Sun Nov 01, 2026 05:00 AM	platelets	190.0 x10^3/uL
LAB-005597	Mon Nov 02, 2026 05:00 AM	creatinine	0.86 mg/dL
LAB-005607	Mon Nov 02, 2026 05:00 AM	sodium	136.0 mmol/L
LAB-005616	Mon Nov 02, 2026 05:00 AM	hemoglobin	10.26 g/dL
LAB-005628	Mon Nov 02, 2026 05:00 AM	wbc	10.52 x10^3/uL
LAB-005629	Mon Nov 02, 2026 05:00 AM	platelets	293.0 x10^3/uL
LAB-005598	Tue Nov 03, 2026 05:00 AM	creatinine	0.82 mg/dL
LAB-005608	Tue Nov 03, 2026 05:00 AM	sodium	136.0 mmol/L
LAB-005617	Tue Nov 03, 2026 05:00 AM	hemoglobin	10.09 g/dL
LAB-005630	Tue Nov 03, 2026 05:00 AM	wbc	8.76 x10^3/uL
LAB-005631	Tue Nov 03, 2026 05:00 AM	platelets	305.0 x10^3/uL
LAB-005599	Wed Nov 04, 2026 05:00 AM	creatinine	0.83 mg/dL
LAB-005609	Wed Nov 04, 2026 05:00 AM	sodium	137.0 mmol/L
LAB-005618	Wed Nov 04, 2026 05:00 AM	hemoglobin	10.1 g/dL
LAB-005632	Wed Nov 04, 2026 05:00 AM	wbc	8.33 x10^3/uL
LAB-005633	Wed Nov 04, 2026 05:00 AM	platelets	199.0 x10^3/uL
LAB-005600	Thu Nov 05, 2026 05:00 AM	creatinine	0.84 mg/dL
LAB-005610	Thu Nov 05, 2026 05:00 AM	sodium	137.0 mmol/L
LAB-005619	Thu Nov 05, 2026 05:00 AM	hemoglobin	10.03 g/dL
LAB-005634	Thu Nov 05, 2026 05:00 AM	wbc	10.56 x10^3/uL
LAB-005635	Thu Nov 05, 2026 05:00 AM	platelets	176.0 x10^3/uL
LAB-005601	Fri Nov 06, 2026 05:00 AM	creatinine	0.84 mg/dL
LAB-005611	Fri Nov 06, 2026 05:00 AM	sodium	141.0 mmol/L
LAB-005620	Fri Nov 06, 2026 05:00 AM	hemoglobin	10.29 g/dL
LAB-005636	Fri Nov 06, 2026 05:00 AM	wbc	9.14 x10^3/uL
LAB-005637	Fri Nov 06, 2026 05:00 AM	platelets	222.0 x10^3/uL
LAB-005602	Sat Nov 07, 2026 05:00 AM	creatinine	0.86 mg/dL
LAB-005612	Sat Nov 07, 2026 05:00 AM	sodium	137.0 mmol/L
LAB-005621	Sat Nov 07, 2026 05:00 AM	hemoglobin	10.1 g/dL
LAB-005638	Sat Nov 07, 2026 05:00 AM	wbc	9.91 x10^3/uL
LAB-005639	Sat Nov 07, 2026 05:00 AM	platelets	199.0 x10^3/uL

Vitals (150)

Vitals
Row	When	Kind	Value	Detail
VIT-016067	Fri Oct 30, 2026 08:23 AM	spo2	98.0	room air
VIT-016068	Fri Oct 30, 2026 08:23 AM	rr	19.0
VIT-016117	Fri Oct 30, 2026 08:23 AM	temp_c	37.4
VIT-016118	Fri Oct 30, 2026 08:23 AM	hr	69.0
VIT-016119	Fri Oct 30, 2026 08:23 AM	map	88.0
VIT-016120	Fri Oct 30, 2026 08:23 AM	gcs	15.0
VIT-016069	Fri Oct 30, 2026 04:23 PM	spo2	96.0	room air
VIT-016070	Fri Oct 30, 2026 04:23 PM	rr	20.0
VIT-016121	Fri Oct 30, 2026 04:23 PM	temp_c	36.6
VIT-016122	Fri Oct 30, 2026 04:23 PM	hr	74.0
VIT-016123	Fri Oct 30, 2026 04:23 PM	map	86.0
VIT-016124	Fri Oct 30, 2026 04:23 PM	gcs	15.0
VIT-016071	Sat Oct 31, 2026 12:23 AM	spo2	95.0	room air
VIT-016072	Sat Oct 31, 2026 12:23 AM	rr	16.0
VIT-016125	Sat Oct 31, 2026 12:23 AM	temp_c	37.3
VIT-016126	Sat Oct 31, 2026 12:23 AM	hr	86.0
VIT-016127	Sat Oct 31, 2026 12:23 AM	map	88.0
VIT-016128	Sat Oct 31, 2026 12:23 AM	gcs	15.0
VIT-016073	Sat Oct 31, 2026 08:23 AM	spo2	94.0	room air
VIT-016074	Sat Oct 31, 2026 08:23 AM	rr	20.0
VIT-016129	Sat Oct 31, 2026 08:23 AM	temp_c	37.4
VIT-016130	Sat Oct 31, 2026 08:23 AM	hr	89.0
VIT-016131	Sat Oct 31, 2026 08:23 AM	map	80.0
VIT-016132	Sat Oct 31, 2026 08:23 AM	gcs	15.0
VIT-016075	Sat Oct 31, 2026 04:23 PM	spo2	99.0	room air
VIT-016076	Sat Oct 31, 2026 04:23 PM	rr	19.0
VIT-016133	Sat Oct 31, 2026 04:23 PM	temp_c	36.7
VIT-016134	Sat Oct 31, 2026 04:23 PM	hr	80.0
VIT-016135	Sat Oct 31, 2026 04:23 PM	map	79.0
VIT-016136	Sat Oct 31, 2026 04:23 PM	gcs	15.0
VIT-016077	Sun Nov 01, 2026 12:23 AM	spo2	95.0	room air
VIT-016078	Sun Nov 01, 2026 12:23 AM	rr	20.0
VIT-016137	Sun Nov 01, 2026 12:23 AM	temp_c	36.8
VIT-016138	Sun Nov 01, 2026 12:23 AM	hr	89.0
VIT-016139	Sun Nov 01, 2026 12:23 AM	map	88.0
VIT-016140	Sun Nov 01, 2026 12:23 AM	gcs	15.0
VIT-016079	Sun Nov 01, 2026 08:23 AM	spo2	97.0	room air
VIT-016080	Sun Nov 01, 2026 08:23 AM	rr	14.0
VIT-016141	Sun Nov 01, 2026 08:23 AM	temp_c	36.5
VIT-016142	Sun Nov 01, 2026 08:23 AM	hr	90.0
VIT-016143	Sun Nov 01, 2026 08:23 AM	map	81.0
VIT-016144	Sun Nov 01, 2026 08:23 AM	gcs	15.0
VIT-016081	Sun Nov 01, 2026 04:23 PM	spo2	99.0	room air
VIT-016082	Sun Nov 01, 2026 04:23 PM	rr	19.0
VIT-016145	Sun Nov 01, 2026 04:23 PM	temp_c	37.5
VIT-016146	Sun Nov 01, 2026 04:23 PM	hr	71.0
VIT-016147	Sun Nov 01, 2026 04:23 PM	map	88.0
VIT-016148	Sun Nov 01, 2026 04:23 PM	gcs	15.0
VIT-016083	Mon Nov 02, 2026 12:23 AM	spo2	95.0	room air
VIT-016084	Mon Nov 02, 2026 12:23 AM	rr	17.0
VIT-016149	Mon Nov 02, 2026 12:23 AM	temp_c	36.8
VIT-016150	Mon Nov 02, 2026 12:23 AM	hr	85.0
VIT-016151	Mon Nov 02, 2026 12:23 AM	map	75.0
VIT-016152	Mon Nov 02, 2026 12:23 AM	gcs	15.0
VIT-016085	Mon Nov 02, 2026 08:23 AM	spo2	96.0	room air
VIT-016086	Mon Nov 02, 2026 08:23 AM	rr	18.0
VIT-016153	Mon Nov 02, 2026 08:23 AM	temp_c	37.3
VIT-016154	Mon Nov 02, 2026 08:23 AM	hr	92.0
VIT-016155	Mon Nov 02, 2026 08:23 AM	map	86.0
VIT-016156	Mon Nov 02, 2026 08:23 AM	gcs	15.0
VIT-016087	Mon Nov 02, 2026 04:23 PM	spo2	94.0	room air
VIT-016088	Mon Nov 02, 2026 04:23 PM	rr	14.0
VIT-016157	Mon Nov 02, 2026 04:23 PM	temp_c	37.3
VIT-016158	Mon Nov 02, 2026 04:23 PM	hr	71.0
VIT-016159	Mon Nov 02, 2026 04:23 PM	map	92.0
VIT-016160	Mon Nov 02, 2026 04:23 PM	gcs	15.0
VIT-016089	Tue Nov 03, 2026 12:23 AM	spo2	97.0	room air
VIT-016090	Tue Nov 03, 2026 12:23 AM	rr	14.0
VIT-016161	Tue Nov 03, 2026 12:23 AM	temp_c	37.4
VIT-016162	Tue Nov 03, 2026 12:23 AM	hr	76.0
VIT-016163	Tue Nov 03, 2026 12:23 AM	map	77.0
VIT-016164	Tue Nov 03, 2026 12:23 AM	gcs	15.0
VIT-016091	Tue Nov 03, 2026 08:23 AM	spo2	94.0	room air
VIT-016092	Tue Nov 03, 2026 08:23 AM	rr	14.0
VIT-016165	Tue Nov 03, 2026 08:23 AM	temp_c	37.2
VIT-016166	Tue Nov 03, 2026 08:23 AM	hr	75.0
VIT-016167	Tue Nov 03, 2026 08:23 AM	map	79.0
VIT-016168	Tue Nov 03, 2026 08:23 AM	gcs	15.0
VIT-016093	Tue Nov 03, 2026 04:23 PM	spo2	99.0	room air
VIT-016094	Tue Nov 03, 2026 04:23 PM	rr	20.0
VIT-016169	Tue Nov 03, 2026 04:23 PM	temp_c	37.6
VIT-016170	Tue Nov 03, 2026 04:23 PM	hr	77.0
VIT-016171	Tue Nov 03, 2026 04:23 PM	map	79.0
VIT-016172	Tue Nov 03, 2026 04:23 PM	gcs	15.0
VIT-016095	Wed Nov 04, 2026 12:23 AM	spo2	99.0	room air
VIT-016096	Wed Nov 04, 2026 12:23 AM	rr	14.0
VIT-016173	Wed Nov 04, 2026 12:23 AM	temp_c	37.3
VIT-016174	Wed Nov 04, 2026 12:23 AM	hr	85.0
VIT-016175	Wed Nov 04, 2026 12:23 AM	map	86.0
VIT-016176	Wed Nov 04, 2026 12:23 AM	gcs	15.0
VIT-016097	Wed Nov 04, 2026 08:23 AM	spo2	96.0	room air
VIT-016098	Wed Nov 04, 2026 08:23 AM	rr	17.0
VIT-016177	Wed Nov 04, 2026 08:23 AM	temp_c	37.2
VIT-016178	Wed Nov 04, 2026 08:23 AM	hr	79.0
VIT-016179	Wed Nov 04, 2026 08:23 AM	map	75.0
VIT-016180	Wed Nov 04, 2026 08:23 AM	gcs	15.0
VIT-016099	Wed Nov 04, 2026 04:23 PM	spo2	94.0	room air
VIT-016100	Wed Nov 04, 2026 04:23 PM	rr	20.0
VIT-016181	Wed Nov 04, 2026 04:23 PM	temp_c	36.7
VIT-016182	Wed Nov 04, 2026 04:23 PM	hr	78.0
VIT-016183	Wed Nov 04, 2026 04:23 PM	map	92.0
VIT-016184	Wed Nov 04, 2026 04:23 PM	gcs	15.0
VIT-016101	Thu Nov 05, 2026 12:23 AM	spo2	94.0	room air
VIT-016102	Thu Nov 05, 2026 12:23 AM	rr	17.0
VIT-016185	Thu Nov 05, 2026 12:23 AM	temp_c	36.8
VIT-016186	Thu Nov 05, 2026 12:23 AM	hr	83.0
VIT-016187	Thu Nov 05, 2026 12:23 AM	map	83.0
VIT-016188	Thu Nov 05, 2026 12:23 AM	gcs	15.0
VIT-016103	Thu Nov 05, 2026 08:23 AM	spo2	96.0	room air
VIT-016104	Thu Nov 05, 2026 08:23 AM	rr	15.0
VIT-016189	Thu Nov 05, 2026 08:23 AM	temp_c	37.2
VIT-016190	Thu Nov 05, 2026 08:23 AM	hr	80.0
VIT-016191	Thu Nov 05, 2026 08:23 AM	map	86.0
VIT-016192	Thu Nov 05, 2026 08:23 AM	gcs	15.0
VIT-016105	Thu Nov 05, 2026 04:23 PM	spo2	97.0	room air
VIT-016106	Thu Nov 05, 2026 04:23 PM	rr	20.0
VIT-016193	Thu Nov 05, 2026 04:23 PM	temp_c	36.7
VIT-016194	Thu Nov 05, 2026 04:23 PM	hr	88.0
VIT-016195	Thu Nov 05, 2026 04:23 PM	map	78.0
VIT-016196	Thu Nov 05, 2026 04:23 PM	gcs	15.0
VIT-016107	Fri Nov 06, 2026 12:23 AM	spo2	95.0	room air
VIT-016108	Fri Nov 06, 2026 12:23 AM	rr	16.0
VIT-016197	Fri Nov 06, 2026 12:23 AM	temp_c	37.5
VIT-016198	Fri Nov 06, 2026 12:23 AM	hr	71.0
VIT-016199	Fri Nov 06, 2026 12:23 AM	map	88.0
VIT-016200	Fri Nov 06, 2026 12:23 AM	gcs	15.0
VIT-016109	Fri Nov 06, 2026 08:23 AM	spo2	95.0	room air
VIT-016110	Fri Nov 06, 2026 08:23 AM	rr	18.0
VIT-016201	Fri Nov 06, 2026 08:23 AM	temp_c	37.1
VIT-016202	Fri Nov 06, 2026 08:23 AM	hr	80.0
VIT-016203	Fri Nov 06, 2026 08:23 AM	map	85.0
VIT-016204	Fri Nov 06, 2026 08:23 AM	gcs	15.0
VIT-016111	Fri Nov 06, 2026 04:23 PM	spo2	97.0	room air
VIT-016112	Fri Nov 06, 2026 04:23 PM	rr	20.0
VIT-016205	Fri Nov 06, 2026 04:23 PM	temp_c	36.6
VIT-016206	Fri Nov 06, 2026 04:23 PM	hr	81.0
VIT-016207	Fri Nov 06, 2026 04:23 PM	map	76.0
VIT-016208	Fri Nov 06, 2026 04:23 PM	gcs	15.0
VIT-016113	Sat Nov 07, 2026 12:23 AM	spo2	99.0	room air
VIT-016114	Sat Nov 07, 2026 12:23 AM	rr	20.0
VIT-016209	Sat Nov 07, 2026 12:23 AM	temp_c	37.1
VIT-016210	Sat Nov 07, 2026 12:23 AM	hr	68.0
VIT-016211	Sat Nov 07, 2026 12:23 AM	map	81.0
VIT-016212	Sat Nov 07, 2026 12:23 AM	gcs	15.0
VIT-016115	Sat Nov 07, 2026 08:23 AM	spo2	97.0	room air
VIT-016116	Sat Nov 07, 2026 08:23 AM	rr	19.0
VIT-016213	Sat Nov 07, 2026 08:23 AM	temp_c	36.7
VIT-016214	Sat Nov 07, 2026 08:23 AM	hr	92.0
VIT-016215	Sat Nov 07, 2026 08:23 AM	map	74.0
VIT-016216	Sat Nov 07, 2026 08:23 AM	gcs	15.0

Medications, orders, echo, history (5)

MED-000663 10-30 09:03 furosemide 40 mg PO
MED-000664 10-31 09:00 furosemide 40 mg PO
MED-000665 11-01 09:00 furosemide 40 mg PO
ECH-000078 2026-10-31 echo LVEF 22.0%
HX-000059 history: heart failure with reduced ejection fraction

Notes

History and physical · DOC-000553 · Dr. Kenji Stavros (attending) · Fri Oct 30, 2026 11:03 AM

Source document DOC-000553: History and physical (synthetic)

HISTORY AND PHYSICAL
Patient: Quinn Northam   MRN: MRN60095932   Admitted: 2026-10-30 08:03
Service: Pulmonology   Attending: Dr. Kenji Stavros

History of present illness: 79-year-old woman admitted with COPD exacerbation. 
Past medical history: heart failure with reduced ejection fraction, type 2 diabetes, hyperlipidemia.
Review of systems otherwise negative.
Exam: Lungs: clear to auscultation bilaterally.
Assessment and plan:
1. COPD exacerbation: bronchodilators and steroids.

Wound care note · DOC-000552 · Elena Jessup, RN, CWOCN (wound_nurse) · Sat Oct 31, 2026 10:03 AM

Cited facts from this note (2)

wound_site: sacral · cited p. 1, line 4 · confidence 0.95

Show source for wound_site

WOUND CARE NOTE Patient: Quinn Northam MRN: MRN60095932 Location: sacrum Stage: unstageable (NPIAP) Description: wound bed obscured by eschar. Size: 4.7 x 1.6 x 0.1 cm. Plan: offloading every 2 hours, foam dressing, nutrition consul …
wound_stage: unstageable · cited p. 1, line 5 · confidence 0.95

Show source for wound_stage

WOUND CARE NOTE Patient: Quinn Northam MRN: MRN60095932 Location: sacrum Stage: unstageable (NPIAP) Description: wound bed obscured by eschar. Size: 4.7 x 1.6 x 0.1 cm. Plan: offloading every 2 hours, foam dressing, nutrition consult.

Source document DOC-000552: Wound care note (synthetic)

WOUND CARE NOTE
Patient: Quinn Northam   MRN: MRN60095932

Location: sacrum
Stage: unstageable (NPIAP)
Description: wound bed obscured by eschar.
Size: 4.7 x 1.6 x 0.1 cm.
Plan: offloading every 2 hours, foam dressing, nutrition consult.

Progress note · DOC-000554 · Dr. Kenji Stavros (attending) · Sun Nov 01, 2026 09:03 AM

Source document DOC-000554: Progress note (synthetic)

PROGRESS NOTE (Attending)
Patient: Quinn Northam   MRN: MRN60095932   Hospital day 3

Subjective: resting, tolerating diet.
Objective: vitals and labs reviewed in the flowsheet.
Assessment and plan:
1. COPD exacerbation: continue current management.
2. Obesity: counsel on weight.
3. HFrEF: diuresis and daily weights; monitor electrolytes.
4. Anemia: trend hemoglobin.
5. Unstageable sacral pressure injury: wound care following, offloading.

Attending: Dr. Kenji Stavros

Discharge summary · DOC-000555 · Dr. Kenji Stavros (attending) · Sat Nov 07, 2026 10:10 AM

Source document DOC-000555: Discharge summary (synthetic)

DISCHARGE SUMMARY
Patient: Quinn Northam   MRN: MRN60095932
Admitted 2026-10-30; discharged 2026-11-07.

Discharge diagnoses:
- COPD exacerbation
- obesity
- HFrEF
- anemia
- unstageable sacral pressure injury
- type 2 diabetes
- hyperlipidemia

Disposition: home with follow-up.