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-00165: Lena Foxhall

89M · MRN98685692 · Hospital Medicine · admitted Wed Nov 04, 2026 12:45 PM · discharged Thu Nov 12, 2026 10:04 AM · attending Dr. Jalen Carrow · resident Dr. Camila Oyelaran · 162 cm, 59.3 kg

Documented diagnoses (current)

Principal: “community-acquired pneumonia” · J18.9 Pneumonia, unspecified organism
“chronic kidney disease” · N18.9 Chronic kidney disease, unspecified
“hypoxemia” · R09.02 Hypoxemia

Illustrative grouping now: MS-DRG 195 Simple pneumonia and pleurisy without CC/MCC. If every open specificity/validation gap were answered as the criteria suggest: MS-DRG 194.

Queries and events

No queries yet.

All rules applied

Rule Criteria Finding Outcome

Acute kidney injury

Criteria not met

No gap

Not documented and not supported.

Trace

Rule trace (rule aki v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
Step	Expression	Inputs and thresholds read	Result
derived: meets_definition	`creat_ratio >= t.ratio_s1 or creat_rise_48h >= t.rise_abs or coalesce(uo_hours_lt_0_5 >= t.uo_s1_h, false)`	creat_ratio=1.059, t.ratio_s1=1.5, creat_rise_48h=0.1, 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=1.059, t.ratio_s3=3.0, creat_peak=1.43, 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=1.059, 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=0.1, 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=M, hgb_nadir=13.86, 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=0.5, 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=0.5, t.drop_min=1.0, prbc_units=0	false
outcome: not_anaemic	`present(hgb_nadir) and not anaemic`	hgb_nadir=13.86, anaemic=False	true

Chronic kidney disease

Criteria met

Specificity gap

Documented “chronic kidney disease” (N18.9); criteria support the more specific Chronic kidney disease stage 3a (N18.31).

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=176, t.chronic_days=90	true
derived: staging_egfr	`max(egfr_early, egfr_late)`	egfr_early=56.7, egfr_late=50.2	56.7
derived: both_below_60	`egfr_early < t.g2 and egfr_late < t.g2`	egfr_early=56.7, t.g2=60, egfr_late=50.2	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=56.7, t.g2=60, t.g3a=45, t.g3b=30, t.g4=15	G3a
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=56.7, egfr_late=50.2, t.g2=60	false
outcome: g1_g2	`staging_egfr >= t.g2`	staging_egfr=56.7, t.g2=60	false
outcome: g3a	`category == 'G3a'`	category=G3a	true

Heart failure

Clinical judgement required

No gap

Not documented; 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=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=True	1
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=1, 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=1	true

Hyponatraemia

Criteria met

Specificity gap

Criteria support Hyponatraemia (profound) (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=121.0, t.profound=125, t.moderate=130, t.low=135	profound
outcome: met	`na_min < t.low and na_low_count >= t.repeat and na_treated`	na_min=121.0, t.low=135, na_low_count=6, t.repeat=2, na_treated=True	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=89, t.adult=20	false
outcome: class3	`bmi >= t.c3`	bmi=22.6, t.c3=40	false
outcome: class2	`bmi >= t.c2`	bmi=22.6, t.c2=35	false
outcome: class1	`bmi >= t.c1`	bmi=22.6, t.c1=30	false
outcome: not_met	`bmi < t.c1`	bmi=22.6, 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

Clinical judgement required

Clinical judgement required: Hypoxaemia without a charted sign of respiratory distress.

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=86.0, 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=86.0, t.spo2_ra=88, pao2_min_ra=unknown, t.pao2=60, pf_min=unknown, t.pf=300	true
derived: distress	`coalesce(rr_max >= t.rr_distress, false) or coalesce(wob_increased, false) or adv_resp_support`	rr_max=23.0, t.rr_distress=28, wob_increased=unknown, adv_resp_support=False	false
outcome: chronic_baseline	`home_o2 and hypoxemia`	home_o2=False, hypoxemia=True	false
outcome: met	`hypoxemia and distress`	hypoxemia=True, distress=False	false
outcome: hypoxemia_only	`hypoxemia`	hypoxemia=True	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=37.6, t.t_hi=38, temp_min_48h=36.8, t.t_lo=36	false
derived: sirs_hr	`coalesce(hr_max_48h > t.hr, false)`	hr_max_48h=85.0, 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=22.0, t.rr=20, paco2_min_48h=unknown, t.paco2=32	true
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=10.46, t.wbc_hi=12, wbc_min_48h=7.77, 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=True, sirs_wbc=False	1
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=179.0	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=0.88	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=1.43	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=1.35	1
derived: sofa_delta	`sofa_resp + sofa_coag + sofa_liver + sofa_cardio + sofa_cns + sofa_renal - sofa_renal_baseline`	sofa_resp=0, sofa_coag=0, sofa_liver=0, sofa_cardio=0, sofa_cns=0, sofa_renal=1, sofa_renal_baseline=1	0
derived: sepsis3	`infection_documented and sofa_delta >= t.sofa_delta`	infection_documented=True, sofa_delta=0, t.sofa_delta=2	false
derived: sepsis2	`infection_documented and sirs_count >= t.sirs_min`	infection_documented=True, sirs_count=1, t.sirs_min=2	false
derived: shock	`sepsis3 and norepi_max_48h > 0 and coalesce(lactate_max_48h > t.lactate, false)`	sepsis3=False, norepi_max_48h=0.0, lactate_max_48h=unknown, t.lactate=2	false
outcome: no_infection	`not infection_documented`	infection_documented=True	false
outcome: septic_shock	`shock`	shock=False	false
outcome: both	`sepsis3 and sepsis2`	sepsis3=False, sepsis2=False	false
outcome: sepsis3_only	`sepsis3`	sepsis3=False	false
outcome: definitions_disagree	`sepsis2`	sepsis2=False	false
outcome: neither	`true`	—	true

Structured data

Labs (48)

Labs (pre-admission rows are outpatient values)
Row	When	Test	Value
LAB-005641	Wed Jan 21, 2026 09:15 AM	creatinine	1.22 mg/dL
LAB-005642	Fri Jul 17, 2026 10:05 AM	creatinine	1.35 mg/dL
LAB-005643	Wed Nov 04, 2026 01:45 PM	creatinine	1.33 mg/dL
LAB-005652	Wed Nov 04, 2026 01:45 PM	sodium	123.0 mmol/L
LAB-005661	Wed Nov 04, 2026 01:45 PM	hemoglobin	14.01 g/dL
LAB-005670	Wed Nov 04, 2026 01:45 PM	wbc	10.46 x10^3/uL
LAB-005671	Wed Nov 04, 2026 01:45 PM	platelets	287.0 x10^3/uL
LAB-005688	Wed Nov 04, 2026 01:45 PM	bilirubin	0.88 mg/dL
LAB-005644	Thu Nov 05, 2026 05:00 AM	creatinine	1.41 mg/dL
LAB-005653	Thu Nov 05, 2026 05:00 AM	sodium	121.0 mmol/L
LAB-005662	Thu Nov 05, 2026 05:00 AM	hemoglobin	13.92 g/dL
LAB-005672	Thu Nov 05, 2026 05:00 AM	wbc	7.77 x10^3/uL
LAB-005673	Thu Nov 05, 2026 05:00 AM	platelets	179.0 x10^3/uL
LAB-005645	Fri Nov 06, 2026 05:00 AM	creatinine	1.43 mg/dL
LAB-005654	Fri Nov 06, 2026 05:00 AM	sodium	122.0 mmol/L
LAB-005663	Fri Nov 06, 2026 05:00 AM	hemoglobin	14.05 g/dL
LAB-005674	Fri Nov 06, 2026 05:00 AM	wbc	9.2 x10^3/uL
LAB-005675	Fri Nov 06, 2026 05:00 AM	platelets	253.0 x10^3/uL
LAB-005646	Sat Nov 07, 2026 05:00 AM	creatinine	1.41 mg/dL
LAB-005655	Sat Nov 07, 2026 05:00 AM	sodium	125.0 mmol/L
LAB-005664	Sat Nov 07, 2026 05:00 AM	hemoglobin	14.27 g/dL
LAB-005676	Sat Nov 07, 2026 05:00 AM	wbc	6.09 x10^3/uL
LAB-005677	Sat Nov 07, 2026 05:00 AM	platelets	276.0 x10^3/uL
LAB-005647	Sun Nov 08, 2026 05:00 AM	creatinine	1.41 mg/dL
LAB-005656	Sun Nov 08, 2026 05:00 AM	sodium	127.0 mmol/L
LAB-005665	Sun Nov 08, 2026 05:00 AM	hemoglobin	13.92 g/dL
LAB-005678	Sun Nov 08, 2026 05:00 AM	wbc	9.53 x10^3/uL
LAB-005679	Sun Nov 08, 2026 05:00 AM	platelets	265.0 x10^3/uL
LAB-005648	Mon Nov 09, 2026 05:00 AM	creatinine	1.37 mg/dL
LAB-005657	Mon Nov 09, 2026 05:00 AM	sodium	134.0 mmol/L
LAB-005666	Mon Nov 09, 2026 05:00 AM	hemoglobin	14.26 g/dL
LAB-005680	Mon Nov 09, 2026 05:00 AM	wbc	8.92 x10^3/uL
LAB-005681	Mon Nov 09, 2026 05:00 AM	platelets	203.0 x10^3/uL
LAB-005649	Tue Nov 10, 2026 05:00 AM	creatinine	1.4 mg/dL
LAB-005658	Tue Nov 10, 2026 05:00 AM	sodium	136.0 mmol/L
LAB-005667	Tue Nov 10, 2026 05:00 AM	hemoglobin	14.32 g/dL
LAB-005682	Tue Nov 10, 2026 05:00 AM	wbc	7.79 x10^3/uL
LAB-005683	Tue Nov 10, 2026 05:00 AM	platelets	235.0 x10^3/uL
LAB-005650	Wed Nov 11, 2026 05:00 AM	creatinine	1.35 mg/dL
LAB-005659	Wed Nov 11, 2026 05:00 AM	sodium	137.0 mmol/L
LAB-005668	Wed Nov 11, 2026 05:00 AM	hemoglobin	13.96 g/dL
LAB-005684	Wed Nov 11, 2026 05:00 AM	wbc	6.69 x10^3/uL
LAB-005685	Wed Nov 11, 2026 05:00 AM	platelets	193.0 x10^3/uL
LAB-005651	Thu Nov 12, 2026 05:00 AM	creatinine	1.42 mg/dL
LAB-005660	Thu Nov 12, 2026 05:00 AM	sodium	137.0 mmol/L
LAB-005669	Thu Nov 12, 2026 05:00 AM	hemoglobin	13.86 g/dL
LAB-005686	Thu Nov 12, 2026 05:00 AM	wbc	9.81 x10^3/uL
LAB-005687	Thu Nov 12, 2026 05:00 AM	platelets	192.0 x10^3/uL

Vitals (167)

Vitals
Row	When	Kind	Value	Detail
VIT-016217	Wed Nov 04, 2026 01:05 PM	spo2	86.0	room air
VIT-016218	Wed Nov 04, 2026 01:05 PM	rr	21.0
VIT-016288	Wed Nov 04, 2026 01:05 PM	temp_c	37.5
VIT-016289	Wed Nov 04, 2026 01:05 PM	hr	76.0
VIT-016290	Wed Nov 04, 2026 01:05 PM	map	78.0
VIT-016291	Wed Nov 04, 2026 01:05 PM	gcs	15.0
VIT-016219	Wed Nov 04, 2026 09:05 PM	spo2	92.0	nasal cannula
VIT-016220	Wed Nov 04, 2026 09:05 PM	rr	22.0
VIT-016221	Wed Nov 04, 2026 09:05 PM	o2_lpm	2.0	nasal cannula
VIT-016292	Wed Nov 04, 2026 09:05 PM	temp_c	37.1
VIT-016293	Wed Nov 04, 2026 09:05 PM	hr	85.0
VIT-016294	Wed Nov 04, 2026 09:05 PM	map	91.0
VIT-016295	Wed Nov 04, 2026 09:05 PM	gcs	15.0
VIT-016222	Thu Nov 05, 2026 05:05 AM	spo2	96.0	nasal cannula
VIT-016223	Thu Nov 05, 2026 05:05 AM	rr	22.0
VIT-016224	Thu Nov 05, 2026 05:05 AM	o2_lpm	2.0	nasal cannula
VIT-016296	Thu Nov 05, 2026 05:05 AM	temp_c	36.8
VIT-016297	Thu Nov 05, 2026 05:05 AM	hr	74.0
VIT-016298	Thu Nov 05, 2026 05:05 AM	map	91.0
VIT-016299	Thu Nov 05, 2026 05:05 AM	gcs	15.0
VIT-016225	Thu Nov 05, 2026 01:05 PM	spo2	93.0	nasal cannula
VIT-016226	Thu Nov 05, 2026 01:05 PM	rr	20.0
VIT-016227	Thu Nov 05, 2026 01:05 PM	o2_lpm	2.0	nasal cannula
VIT-016300	Thu Nov 05, 2026 01:05 PM	temp_c	36.8
VIT-016301	Thu Nov 05, 2026 01:05 PM	hr	75.0
VIT-016302	Thu Nov 05, 2026 01:05 PM	map	92.0
VIT-016303	Thu Nov 05, 2026 01:05 PM	gcs	15.0
VIT-016228	Thu Nov 05, 2026 09:05 PM	spo2	94.0	nasal cannula
VIT-016229	Thu Nov 05, 2026 09:05 PM	rr	19.0
VIT-016230	Thu Nov 05, 2026 09:05 PM	o2_lpm	2.0	nasal cannula
VIT-016304	Thu Nov 05, 2026 09:05 PM	temp_c	36.9
VIT-016305	Thu Nov 05, 2026 09:05 PM	hr	72.0
VIT-016306	Thu Nov 05, 2026 09:05 PM	map	77.0
VIT-016307	Thu Nov 05, 2026 09:05 PM	gcs	15.0
VIT-016231	Fri Nov 06, 2026 05:05 AM	spo2	92.0	nasal cannula
VIT-016232	Fri Nov 06, 2026 05:05 AM	rr	18.0
VIT-016233	Fri Nov 06, 2026 05:05 AM	o2_lpm	2.0	nasal cannula
VIT-016308	Fri Nov 06, 2026 05:05 AM	temp_c	37.6
VIT-016309	Fri Nov 06, 2026 05:05 AM	hr	79.0
VIT-016310	Fri Nov 06, 2026 05:05 AM	map	76.0
VIT-016311	Fri Nov 06, 2026 05:05 AM	gcs	15.0
VIT-016234	Fri Nov 06, 2026 01:05 PM	spo2	94.0	nasal cannula
VIT-016235	Fri Nov 06, 2026 01:05 PM	rr	23.0
VIT-016236	Fri Nov 06, 2026 01:05 PM	o2_lpm	2.0	nasal cannula
VIT-016312	Fri Nov 06, 2026 01:05 PM	temp_c	36.9
VIT-016313	Fri Nov 06, 2026 01:05 PM	hr	75.0
VIT-016314	Fri Nov 06, 2026 01:05 PM	map	92.0
VIT-016315	Fri Nov 06, 2026 01:05 PM	gcs	15.0
VIT-016237	Fri Nov 06, 2026 09:05 PM	spo2	95.0	nasal cannula
VIT-016238	Fri Nov 06, 2026 09:05 PM	rr	19.0
VIT-016239	Fri Nov 06, 2026 09:05 PM	o2_lpm	2.0	nasal cannula
VIT-016316	Fri Nov 06, 2026 09:05 PM	temp_c	36.6
VIT-016317	Fri Nov 06, 2026 09:05 PM	hr	86.0
VIT-016318	Fri Nov 06, 2026 09:05 PM	map	77.0
VIT-016319	Fri Nov 06, 2026 09:05 PM	gcs	15.0
VIT-016240	Sat Nov 07, 2026 05:05 AM	spo2	93.0	nasal cannula
VIT-016241	Sat Nov 07, 2026 05:05 AM	rr	18.0
VIT-016242	Sat Nov 07, 2026 05:05 AM	o2_lpm	2.0	nasal cannula
VIT-016320	Sat Nov 07, 2026 05:05 AM	temp_c	37.1
VIT-016321	Sat Nov 07, 2026 05:05 AM	hr	72.0
VIT-016322	Sat Nov 07, 2026 05:05 AM	map	82.0
VIT-016323	Sat Nov 07, 2026 05:05 AM	gcs	15.0
VIT-016243	Sat Nov 07, 2026 01:05 PM	spo2	95.0	nasal cannula
VIT-016244	Sat Nov 07, 2026 01:05 PM	rr	20.0
VIT-016245	Sat Nov 07, 2026 01:05 PM	o2_lpm	2.0	nasal cannula
VIT-016324	Sat Nov 07, 2026 01:05 PM	temp_c	36.7
VIT-016325	Sat Nov 07, 2026 01:05 PM	hr	84.0
VIT-016326	Sat Nov 07, 2026 01:05 PM	map	85.0
VIT-016327	Sat Nov 07, 2026 01:05 PM	gcs	15.0
VIT-016246	Sat Nov 07, 2026 09:05 PM	spo2	95.0	nasal cannula
VIT-016247	Sat Nov 07, 2026 09:05 PM	rr	23.0
VIT-016248	Sat Nov 07, 2026 09:05 PM	o2_lpm	2.0	nasal cannula
VIT-016328	Sat Nov 07, 2026 09:05 PM	temp_c	37.2
VIT-016329	Sat Nov 07, 2026 09:05 PM	hr	69.0
VIT-016330	Sat Nov 07, 2026 09:05 PM	map	86.0
VIT-016331	Sat Nov 07, 2026 09:05 PM	gcs	15.0
VIT-016249	Sun Nov 08, 2026 05:05 AM	spo2	92.0	nasal cannula
VIT-016250	Sun Nov 08, 2026 05:05 AM	rr	21.0
VIT-016251	Sun Nov 08, 2026 05:05 AM	o2_lpm	2.0	nasal cannula
VIT-016332	Sun Nov 08, 2026 05:05 AM	temp_c	36.8
VIT-016333	Sun Nov 08, 2026 05:05 AM	hr	81.0
VIT-016334	Sun Nov 08, 2026 05:05 AM	map	88.0
VIT-016335	Sun Nov 08, 2026 05:05 AM	gcs	15.0
VIT-016252	Sun Nov 08, 2026 01:05 PM	spo2	94.0	nasal cannula
VIT-016253	Sun Nov 08, 2026 01:05 PM	rr	20.0
VIT-016254	Sun Nov 08, 2026 01:05 PM	o2_lpm	2.0	nasal cannula
VIT-016336	Sun Nov 08, 2026 01:05 PM	temp_c	37.0
VIT-016337	Sun Nov 08, 2026 01:05 PM	hr	84.0
VIT-016338	Sun Nov 08, 2026 01:05 PM	map	91.0
VIT-016339	Sun Nov 08, 2026 01:05 PM	gcs	15.0
VIT-016255	Sun Nov 08, 2026 09:05 PM	spo2	96.0	nasal cannula
VIT-016256	Sun Nov 08, 2026 09:05 PM	rr	18.0
VIT-016257	Sun Nov 08, 2026 09:05 PM	o2_lpm	2.0	nasal cannula
VIT-016340	Sun Nov 08, 2026 09:05 PM	temp_c	36.9
VIT-016341	Sun Nov 08, 2026 09:05 PM	hr	72.0
VIT-016342	Sun Nov 08, 2026 09:05 PM	map	86.0
VIT-016343	Sun Nov 08, 2026 09:05 PM	gcs	15.0
VIT-016258	Mon Nov 09, 2026 05:05 AM	spo2	93.0	nasal cannula
VIT-016259	Mon Nov 09, 2026 05:05 AM	rr	18.0
VIT-016260	Mon Nov 09, 2026 05:05 AM	o2_lpm	2.0	nasal cannula
VIT-016344	Mon Nov 09, 2026 05:05 AM	temp_c	37.1
VIT-016345	Mon Nov 09, 2026 05:05 AM	hr	68.0
VIT-016346	Mon Nov 09, 2026 05:05 AM	map	79.0
VIT-016347	Mon Nov 09, 2026 05:05 AM	gcs	15.0
VIT-016261	Mon Nov 09, 2026 01:05 PM	spo2	95.0	nasal cannula
VIT-016262	Mon Nov 09, 2026 01:05 PM	rr	21.0
VIT-016263	Mon Nov 09, 2026 01:05 PM	o2_lpm	2.0	nasal cannula
VIT-016348	Mon Nov 09, 2026 01:05 PM	temp_c	37.3
VIT-016349	Mon Nov 09, 2026 01:05 PM	hr	69.0
VIT-016350	Mon Nov 09, 2026 01:05 PM	map	76.0
VIT-016351	Mon Nov 09, 2026 01:05 PM	gcs	15.0
VIT-016264	Mon Nov 09, 2026 09:05 PM	spo2	95.0	nasal cannula
VIT-016265	Mon Nov 09, 2026 09:05 PM	rr	22.0
VIT-016266	Mon Nov 09, 2026 09:05 PM	o2_lpm	2.0	nasal cannula
VIT-016352	Mon Nov 09, 2026 09:05 PM	temp_c	36.8
VIT-016353	Mon Nov 09, 2026 09:05 PM	hr	91.0
VIT-016354	Mon Nov 09, 2026 09:05 PM	map	84.0
VIT-016355	Mon Nov 09, 2026 09:05 PM	gcs	15.0
VIT-016267	Tue Nov 10, 2026 05:05 AM	spo2	93.0	nasal cannula
VIT-016268	Tue Nov 10, 2026 05:05 AM	rr	19.0
VIT-016269	Tue Nov 10, 2026 05:05 AM	o2_lpm	2.0	nasal cannula
VIT-016356	Tue Nov 10, 2026 05:05 AM	temp_c	36.9
VIT-016357	Tue Nov 10, 2026 05:05 AM	hr	74.0
VIT-016358	Tue Nov 10, 2026 05:05 AM	map	74.0
VIT-016359	Tue Nov 10, 2026 05:05 AM	gcs	15.0
VIT-016270	Tue Nov 10, 2026 01:05 PM	spo2	95.0	nasal cannula
VIT-016271	Tue Nov 10, 2026 01:05 PM	rr	23.0
VIT-016272	Tue Nov 10, 2026 01:05 PM	o2_lpm	2.0	nasal cannula
VIT-016360	Tue Nov 10, 2026 01:05 PM	temp_c	37.4
VIT-016361	Tue Nov 10, 2026 01:05 PM	hr	90.0
VIT-016362	Tue Nov 10, 2026 01:05 PM	map	82.0
VIT-016363	Tue Nov 10, 2026 01:05 PM	gcs	15.0
VIT-016273	Tue Nov 10, 2026 09:05 PM	spo2	92.0	nasal cannula
VIT-016274	Tue Nov 10, 2026 09:05 PM	rr	20.0
VIT-016275	Tue Nov 10, 2026 09:05 PM	o2_lpm	2.0	nasal cannula
VIT-016364	Tue Nov 10, 2026 09:05 PM	temp_c	37.1
VIT-016365	Tue Nov 10, 2026 09:05 PM	hr	72.0
VIT-016366	Tue Nov 10, 2026 09:05 PM	map	87.0
VIT-016367	Tue Nov 10, 2026 09:05 PM	gcs	15.0
VIT-016276	Wed Nov 11, 2026 05:05 AM	spo2	96.0	nasal cannula
VIT-016277	Wed Nov 11, 2026 05:05 AM	rr	23.0
VIT-016278	Wed Nov 11, 2026 05:05 AM	o2_lpm	2.0	nasal cannula
VIT-016368	Wed Nov 11, 2026 05:05 AM	temp_c	36.6
VIT-016369	Wed Nov 11, 2026 05:05 AM	hr	76.0
VIT-016370	Wed Nov 11, 2026 05:05 AM	map	74.0
VIT-016371	Wed Nov 11, 2026 05:05 AM	gcs	15.0
VIT-016279	Wed Nov 11, 2026 01:05 PM	spo2	94.0	nasal cannula
VIT-016280	Wed Nov 11, 2026 01:05 PM	rr	22.0
VIT-016281	Wed Nov 11, 2026 01:05 PM	o2_lpm	2.0	nasal cannula
VIT-016372	Wed Nov 11, 2026 01:05 PM	temp_c	37.3
VIT-016373	Wed Nov 11, 2026 01:05 PM	hr	84.0
VIT-016374	Wed Nov 11, 2026 01:05 PM	map	92.0
VIT-016375	Wed Nov 11, 2026 01:05 PM	gcs	15.0
VIT-016282	Wed Nov 11, 2026 09:05 PM	spo2	93.0	nasal cannula
VIT-016283	Wed Nov 11, 2026 09:05 PM	rr	20.0
VIT-016284	Wed Nov 11, 2026 09:05 PM	o2_lpm	2.0	nasal cannula
VIT-016376	Wed Nov 11, 2026 09:05 PM	temp_c	37.2
VIT-016377	Wed Nov 11, 2026 09:05 PM	hr	89.0
VIT-016378	Wed Nov 11, 2026 09:05 PM	map	84.0
VIT-016379	Wed Nov 11, 2026 09:05 PM	gcs	15.0
VIT-016285	Thu Nov 12, 2026 05:05 AM	spo2	96.0	nasal cannula
VIT-016286	Thu Nov 12, 2026 05:05 AM	rr	19.0
VIT-016287	Thu Nov 12, 2026 05:05 AM	o2_lpm	2.0	nasal cannula
VIT-016380	Thu Nov 12, 2026 05:05 AM	temp_c	36.8
VIT-016381	Thu Nov 12, 2026 05:05 AM	hr	78.0
VIT-016382	Thu Nov 12, 2026 05:05 AM	map	88.0
VIT-016383	Thu Nov 12, 2026 05:05 AM	gcs	15.0

Medications, orders, echo, history (6)

MED-000666 11-04 13:45 ceftriaxone per protocol IV
MED-000667 11-05 05:00 piperacillin-tazobactam per protocol IV
MED-000668 11-06 05:00 piperacillin-tazobactam per protocol IV
MED-000669 11-04 16:45 sodium chloride 3% 100 mL IV
ORD-000144 11-04 13:15 blood_culture: blood cultures x2
ORD-000145 11-04 15:45 fluid_restriction: fluid restriction 1.2 L/day

Notes

History and physical · DOC-000556 · Dr. Camila Oyelaran (resident) · Wed Nov 04, 2026 03:45 PM

Cited facts from this note (1)

infection_source: right lower lobe pneumonia · cited p. 1, line 5 · confidence 0.85

Show source for infection_source

… ice: Hospital Medicine Attending: Dr. Jalen Carrow History of present illness: 89-year-old man admitted with community-acquired pneumonia. Chest x-ray shows right lower lobe pneumonia; blood cultures drawn and ceftriaxone started. Past medical history: none significant. Review of systems otherwise negative. Exam: Lungs: scattered crackles at …

Source document DOC-000556: History and physical (synthetic)

HISTORY AND PHYSICAL
Patient: Lena Foxhall   MRN: MRN98685692   Admitted: 2026-11-04 12:45
Service: Hospital Medicine   Attending: Dr. Jalen Carrow

History of present illness: 89-year-old man admitted with community-acquired pneumonia. Chest x-ray shows right lower lobe pneumonia; blood cultures drawn and ceftriaxone started.
Past medical history: none significant.
Review of systems otherwise negative.
Exam: Lungs: scattered crackles at the bases, no distress.
Assessment and plan:
1. Community-acquired pneumonia: antibiotics.
2. Chronic kidney disease: renally dose medications.

Progress note · DOC-000557 · Dr. Camila Oyelaran (resident) · Fri Nov 06, 2026 04:45 PM

Source document DOC-000557: Progress note (synthetic)

PROGRESS NOTE (Resident)
Patient: Lena Foxhall   MRN: MRN98685692   Hospital day 3

Subjective: resting, tolerating diet.
Objective: vitals and labs reviewed in the flowsheet.
Assessment and plan:
1. Community-acquired pneumonia: continue current management.
2. Hypoxemia: supplemental oxygen, wean as tolerated.

Resident: Dr. Camila Oyelaran   Attending cosign: completed

Discharge summary · DOC-000558 · Dr. Jalen Carrow (attending) · Thu Nov 12, 2026 10:04 AM

Source document DOC-000558: Discharge summary (synthetic)

DISCHARGE SUMMARY
Patient: Lena Foxhall   MRN: MRN98685692
Admitted 2026-11-04; discharged 2026-11-12.

Discharge diagnoses:
- community-acquired pneumonia
- chronic kidney disease
- hypoxemia

Disposition: home with follow-up.