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Exact Dx synthetic data · demonstration
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.

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ENC-00170: Priya Hartwell

76F · MRN36886123 · Hospital Medicine · admitted Sat Nov 07, 2026 10:10 PM · in hospital · attending Dr. Isaac Abernath · resident Dr. Priya Thorne · 158 cm, 48.6 kg

Documented diagnoses (current)

  • Principal: “urinary tract infection” · N39.0 Urinary tract infection, site not specified
  • “severe protein-calorie malnutrition” · E43 Unspecified severe protein-calorie malnutrition
  • “hypoxia” · R09.02 Hypoxemia

Illustrative grouping now: MS-DRG 689 Kidney and urinary tract infections with MCC. If every open specificity/validation gap were answered as the criteria suggest: MS-DRG 689.

Queries and events

No queries yet.

All rules applied

Every rule's outcome for this encounter (clean results included)
RuleCriteriaFindingOutcome
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)
StepExpressionInputs and thresholds readResult
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=1.053, 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=1.053, t.ratio_s3=3.0, creat_peak=0.79, 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=1.053, 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 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)
StepExpressionInputs and thresholds readResult
derived: anaemic case(sex == 'M', hgb_nadir < t.hb_m, sex == 'F', hgb_nadir < t.hb_f, null) sex=F, hgb_nadir=13.33, 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=True, 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=13.33, anaemic=False true
Chronic kidney disease Clinical judgement required No gap Not documented; egfr 60 or above; ckd g1-g2 requires markers of kidney damage, which are not assessed here.
Trace
Rule trace (rule ckd v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
StepExpressionInputs and thresholds readResult
derived: chronic egfr_n >= 2 and egfr_span_days >= t.chronic_days egfr_n=2, egfr_span_days=313, t.chronic_days=90 true
derived: staging_egfr max(egfr_early, egfr_late) egfr_early=85.2, egfr_late=82.5 85.2
derived: both_below_60 egfr_early < t.g2 and egfr_late < t.g2 egfr_early=85.2, t.g2=60, egfr_late=82.5 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=85.2, 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=85.2, egfr_late=82.5, t.g2=60 false
outcome: g1_g2 staging_egfr >= t.g2 staging_egfr=85.2, t.g2=60 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)
StepExpressionInputs and thresholds readResult
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 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)
StepExpressionInputs and thresholds readResult
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 Criteria met No gap Supported as documented (E43).
Trace
Rule trace (rule malnutrition v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
StepExpressionInputs and thresholds readResult
derived: a_sev_intake intake_pct <= t.a_sev_intake_pct and intake_days >= t.a_sev_intake_days intake_pct=70.0, t.a_sev_intake_pct=50, intake_days=57.0, 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=70.0, t.a_mod_intake_pct=75, intake_days=57.0, t.a_mod_intake_days=7 true
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=180.0, wt_loss_pct=13.8 false
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=180.0, wt_loss_pct=13.8 false
derived: c_sev_intake intake_pct <= t.c_intake_pct and intake_days >= t.c_intake_days intake_pct=70.0, t.c_intake_pct=75, intake_days=57.0, t.c_intake_days=30 true
derived: c_mod_intake intake_pct < t.c_intake_pct and intake_days >= t.c_intake_days intake_pct=70.0, t.c_intake_pct=75, intake_days=57.0, t.c_intake_days=30 true
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=180.0, wt_loss_pct=13.8 true
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=180.0, wt_loss_pct=13.8 true
derived: n_assessed known(intake_pct, wt_loss_pct, fat_loss, muscle_loss, fluid, grip_reduced) intake_pct=70.0, wt_loss_pct=13.8, fat_loss=3, muscle_loss=2, fluid=0, grip_reduced=unknown 5
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=chronic, a_sev_intake=False, a_sev_wt=False, fat_loss=3, muscle_loss=2, fluid=0, grip_reduced=unknown, c_sev_intake=True, c_sev_wt=True 3
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=chronic, a_sev_intake=False, a_mod_intake=True, a_sev_wt=False, a_mod_wt=False, fat_loss=3, muscle_loss=2, fluid=0, grip_reduced=unknown, c_sev_intake=True, c_mod_intake=True, c_sev_wt=True, c_mod_wt=True 4
outcome: severe n_severe >= 2 n_severe=3 true
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)
StepExpressionInputs and thresholds readResult
outcome: not_adult age < t.adult age=76, t.adult=20 false
outcome: class3 bmi >= t.c3 bmi=19.5, t.c3=40 false
outcome: class2 bmi >= t.c2 bmi=19.5, t.c2=35 false
outcome: class1 bmi >= t.c1 bmi=19.5, t.c1=30 false
outcome: not_met bmi < t.c1 bmi=19.5, 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)
StepExpressionInputs and thresholds readResult
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 met Specificity gap Documented “hypoxia” (R09.02); criteria support the more specific Acute respiratory failure with hypoxia (J96.01).
Trace
Rule trace (rule respiratory_failure v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
StepExpressionInputs and thresholds readResult
derived: measured present(spo2_min_ra) or present(pao2_min_ra) or present(pf_min) spo2_min_ra=83.0, pao2_min_ra=50.0, pf_min=238 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=83.0, t.spo2_ra=88, pao2_min_ra=50.0, t.pao2=60, pf_min=238, t.pf=300 true
derived: distress coalesce(rr_max >= t.rr_distress, false) or coalesce(wob_increased, false) or adv_resp_support rr_max=34.0, t.rr_distress=28, wob_increased=True, adv_resp_support=False true
outcome: chronic_baseline home_o2 and hypoxemia home_o2=False, hypoxemia=True false
outcome: met hypoxemia and distress hypoxemia=True, distress=True 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)
StepExpressionInputs and thresholds readResult
derived: sirs_temp coalesce(temp_max_48h > t.t_hi, false) or coalesce(temp_min_48h < t.t_lo, false) temp_max_48h=37.5, t.t_hi=38, temp_min_48h=36.7, 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=34.0, 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=8.51, t.wbc_hi=12, wbc_min_48h=5.51, 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=238, adv_resp_support=False 2
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=215.0 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=0.61 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=74.0 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=0.77 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=0.75 0
derived: sofa_delta sofa_resp + sofa_coag + sofa_liver + sofa_cardio + sofa_cns + sofa_renal - sofa_renal_baseline sofa_resp=2, sofa_coag=0, sofa_liver=0, sofa_cardio=0, sofa_cns=0, sofa_renal=0, sofa_renal_baseline=0 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=1, 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 (40)
Labs (pre-admission rows are outpatient values)
RowWhenTestValue
LAB-005814Sat Oct 25, 2025 09:15 AMcreatinine0.73 mg/dL
LAB-005815Thu Sep 03, 2026 10:05 AMcreatinine0.75 mg/dL
LAB-005823Sat Nov 07, 2026 10:35 PMpao250.0 mmHg
LAB-005824Sat Nov 07, 2026 10:35 PMfio221.0 %
LAB-005816Sat Nov 07, 2026 11:10 PMcreatinine0.76 mg/dL
LAB-005825Sat Nov 07, 2026 11:10 PMsodium140.0 mmol/L
LAB-005832Sat Nov 07, 2026 11:10 PMhemoglobin13.65 g/dL
LAB-005839Sat Nov 07, 2026 11:10 PMwbc8.51 x10^3/uL
LAB-005840Sat Nov 07, 2026 11:10 PMplatelets239.0 x10^3/uL
LAB-005853Sat Nov 07, 2026 11:10 PMbilirubin0.61 mg/dL
LAB-005817Sun Nov 08, 2026 05:00 AMcreatinine0.77 mg/dL
LAB-005826Sun Nov 08, 2026 05:00 AMsodium137.0 mmol/L
LAB-005833Sun Nov 08, 2026 05:00 AMhemoglobin13.71 g/dL
LAB-005841Sun Nov 08, 2026 05:00 AMwbc5.51 x10^3/uL
LAB-005842Sun Nov 08, 2026 05:00 AMplatelets256.0 x10^3/uL
LAB-005818Mon Nov 09, 2026 05:00 AMcreatinine0.75 mg/dL
LAB-005827Mon Nov 09, 2026 05:00 AMsodium136.0 mmol/L
LAB-005834Mon Nov 09, 2026 05:00 AMhemoglobin13.61 g/dL
LAB-005843Mon Nov 09, 2026 05:00 AMwbc5.89 x10^3/uL
LAB-005844Mon Nov 09, 2026 05:00 AMplatelets215.0 x10^3/uL
LAB-005819Tue Nov 10, 2026 05:00 AMcreatinine0.77 mg/dL
LAB-005828Tue Nov 10, 2026 05:00 AMsodium142.0 mmol/L
LAB-005835Tue Nov 10, 2026 05:00 AMhemoglobin13.77 g/dL
LAB-005845Tue Nov 10, 2026 05:00 AMwbc9.49 x10^3/uL
LAB-005846Tue Nov 10, 2026 05:00 AMplatelets271.0 x10^3/uL
LAB-005820Wed Nov 11, 2026 05:00 AMcreatinine0.79 mg/dL
LAB-005829Wed Nov 11, 2026 05:00 AMsodium140.0 mmol/L
LAB-005836Wed Nov 11, 2026 05:00 AMhemoglobin13.34 g/dL
LAB-005847Wed Nov 11, 2026 05:00 AMwbc9.6 x10^3/uL
LAB-005848Wed Nov 11, 2026 05:00 AMplatelets262.0 x10^3/uL
LAB-005821Thu Nov 12, 2026 05:00 AMcreatinine0.79 mg/dL
LAB-005830Thu Nov 12, 2026 05:00 AMsodium136.0 mmol/L
LAB-005837Thu Nov 12, 2026 05:00 AMhemoglobin13.33 g/dL
LAB-005849Thu Nov 12, 2026 05:00 AMwbc10.33 x10^3/uL
LAB-005850Thu Nov 12, 2026 05:00 AMplatelets271.0 x10^3/uL
LAB-005822Fri Nov 13, 2026 05:00 AMcreatinine0.75 mg/dL
LAB-005831Fri Nov 13, 2026 05:00 AMsodium138.0 mmol/L
LAB-005838Fri Nov 13, 2026 05:00 AMhemoglobin13.46 g/dL
LAB-005851Fri Nov 13, 2026 05:00 AMwbc9.04 x10^3/uL
LAB-005852Fri Nov 13, 2026 05:00 AMplatelets242.0 x10^3/uL
Vitals (126)
Vitals
RowWhenKindValueDetail
VIT-016744Sat Nov 07, 2026 10:30 PMspo283.0room air
VIT-016745Sat Nov 07, 2026 10:30 PMrr34.0
VIT-016798Sat Nov 07, 2026 10:30 PMtemp_c37.2
VIT-016799Sat Nov 07, 2026 10:30 PMhr86.0
VIT-016800Sat Nov 07, 2026 10:30 PMmap82.0
VIT-016801Sat Nov 07, 2026 10:30 PMgcs15.0
VIT-016746Sat Nov 07, 2026 10:40 PMo2_lpm4.0nasal cannula
VIT-016747Sun Nov 08, 2026 06:30 AMspo293.0nasal cannula
VIT-016748Sun Nov 08, 2026 06:30 AMrr20.0
VIT-016749Sun Nov 08, 2026 06:30 AMo2_lpm2.0nasal cannula
VIT-016802Sun Nov 08, 2026 06:30 AMtemp_c36.7
VIT-016803Sun Nov 08, 2026 06:30 AMhr71.0
VIT-016804Sun Nov 08, 2026 06:30 AMmap90.0
VIT-016805Sun Nov 08, 2026 06:30 AMgcs15.0
VIT-016750Sun Nov 08, 2026 02:30 PMspo294.0nasal cannula
VIT-016751Sun Nov 08, 2026 02:30 PMrr23.0
VIT-016752Sun Nov 08, 2026 02:30 PMo2_lpm2.0nasal cannula
VIT-016806Sun Nov 08, 2026 02:30 PMtemp_c37.3
VIT-016807Sun Nov 08, 2026 02:30 PMhr87.0
VIT-016808Sun Nov 08, 2026 02:30 PMmap84.0
VIT-016809Sun Nov 08, 2026 02:30 PMgcs15.0
VIT-016753Sun Nov 08, 2026 10:30 PMspo295.0nasal cannula
VIT-016754Sun Nov 08, 2026 10:30 PMrr26.0
VIT-016755Sun Nov 08, 2026 10:30 PMo2_lpm2.0nasal cannula
VIT-016810Sun Nov 08, 2026 10:30 PMtemp_c37.5
VIT-016811Sun Nov 08, 2026 10:30 PMhr74.0
VIT-016812Sun Nov 08, 2026 10:30 PMmap83.0
VIT-016813Sun Nov 08, 2026 10:30 PMgcs15.0
VIT-016756Mon Nov 09, 2026 06:30 AMspo294.0nasal cannula
VIT-016757Mon Nov 09, 2026 06:30 AMrr21.0
VIT-016758Mon Nov 09, 2026 06:30 AMo2_lpm3.0nasal cannula
VIT-016814Mon Nov 09, 2026 06:30 AMtemp_c36.8
VIT-016815Mon Nov 09, 2026 06:30 AMhr89.0
VIT-016816Mon Nov 09, 2026 06:30 AMmap74.0
VIT-016817Mon Nov 09, 2026 06:30 AMgcs15.0
VIT-016759Mon Nov 09, 2026 02:30 PMspo294.0nasal cannula
VIT-016760Mon Nov 09, 2026 02:30 PMrr20.0
VIT-016761Mon Nov 09, 2026 02:30 PMo2_lpm3.0nasal cannula
VIT-016818Mon Nov 09, 2026 02:30 PMtemp_c37.3
VIT-016819Mon Nov 09, 2026 02:30 PMhr79.0
VIT-016820Mon Nov 09, 2026 02:30 PMmap91.0
VIT-016821Mon Nov 09, 2026 02:30 PMgcs15.0
VIT-016762Mon Nov 09, 2026 10:30 PMspo292.0nasal cannula
VIT-016763Mon Nov 09, 2026 10:30 PMrr23.0
VIT-016764Mon Nov 09, 2026 10:30 PMo2_lpm4.0nasal cannula
VIT-016822Mon Nov 09, 2026 10:30 PMtemp_c37.5
VIT-016823Mon Nov 09, 2026 10:30 PMhr78.0
VIT-016824Mon Nov 09, 2026 10:30 PMmap74.0
VIT-016825Mon Nov 09, 2026 10:30 PMgcs15.0
VIT-016765Tue Nov 10, 2026 06:30 AMspo292.0nasal cannula
VIT-016766Tue Nov 10, 2026 06:30 AMrr25.0
VIT-016767Tue Nov 10, 2026 06:30 AMo2_lpm3.0nasal cannula
VIT-016826Tue Nov 10, 2026 06:30 AMtemp_c37.2
VIT-016827Tue Nov 10, 2026 06:30 AMhr74.0
VIT-016828Tue Nov 10, 2026 06:30 AMmap83.0
VIT-016829Tue Nov 10, 2026 06:30 AMgcs15.0
VIT-016768Tue Nov 10, 2026 02:30 PMspo293.0nasal cannula
VIT-016769Tue Nov 10, 2026 02:30 PMrr24.0
VIT-016770Tue Nov 10, 2026 02:30 PMo2_lpm3.0nasal cannula
VIT-016830Tue Nov 10, 2026 02:30 PMtemp_c37.1
VIT-016831Tue Nov 10, 2026 02:30 PMhr89.0
VIT-016832Tue Nov 10, 2026 02:30 PMmap78.0
VIT-016833Tue Nov 10, 2026 02:30 PMgcs15.0
VIT-016771Tue Nov 10, 2026 10:30 PMspo291.0nasal cannula
VIT-016772Tue Nov 10, 2026 10:30 PMrr26.0
VIT-016773Tue Nov 10, 2026 10:30 PMo2_lpm4.0nasal cannula
VIT-016834Tue Nov 10, 2026 10:30 PMtemp_c36.9
VIT-016835Tue Nov 10, 2026 10:30 PMhr85.0
VIT-016836Tue Nov 10, 2026 10:30 PMmap81.0
VIT-016837Tue Nov 10, 2026 10:30 PMgcs15.0
VIT-016774Wed Nov 11, 2026 06:30 AMspo291.0nasal cannula
VIT-016775Wed Nov 11, 2026 06:30 AMrr25.0
VIT-016776Wed Nov 11, 2026 06:30 AMo2_lpm3.0nasal cannula
VIT-016838Wed Nov 11, 2026 06:30 AMtemp_c36.8
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VIT-016841Wed Nov 11, 2026 06:30 AMgcs15.0
VIT-016777Wed Nov 11, 2026 02:30 PMspo293.0nasal cannula
VIT-016778Wed Nov 11, 2026 02:30 PMrr21.0
VIT-016779Wed Nov 11, 2026 02:30 PMo2_lpm4.0nasal cannula
VIT-016842Wed Nov 11, 2026 02:30 PMtemp_c37.0
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VIT-016845Wed Nov 11, 2026 02:30 PMgcs15.0
VIT-016780Wed Nov 11, 2026 10:30 PMspo292.0nasal cannula
VIT-016781Wed Nov 11, 2026 10:30 PMrr25.0
VIT-016782Wed Nov 11, 2026 10:30 PMo2_lpm3.0nasal cannula
VIT-016846Wed Nov 11, 2026 10:30 PMtemp_c37.0
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VIT-016849Wed Nov 11, 2026 10:30 PMgcs15.0
VIT-016783Thu Nov 12, 2026 06:30 AMspo292.0nasal cannula
VIT-016784Thu Nov 12, 2026 06:30 AMrr20.0
VIT-016785Thu Nov 12, 2026 06:30 AMo2_lpm3.0nasal cannula
VIT-016850Thu Nov 12, 2026 06:30 AMtemp_c37.5
VIT-016851Thu Nov 12, 2026 06:30 AMhr70.0
VIT-016852Thu Nov 12, 2026 06:30 AMmap88.0
VIT-016853Thu Nov 12, 2026 06:30 AMgcs15.0
VIT-016786Thu Nov 12, 2026 02:30 PMspo292.0nasal cannula
VIT-016787Thu Nov 12, 2026 02:30 PMrr23.0
VIT-016788Thu Nov 12, 2026 02:30 PMo2_lpm3.0nasal cannula
VIT-016854Thu Nov 12, 2026 02:30 PMtemp_c37.3
VIT-016855Thu Nov 12, 2026 02:30 PMhr84.0
VIT-016856Thu Nov 12, 2026 02:30 PMmap81.0
VIT-016857Thu Nov 12, 2026 02:30 PMgcs15.0
VIT-016789Thu Nov 12, 2026 10:30 PMspo293.0nasal cannula
VIT-016790Thu Nov 12, 2026 10:30 PMrr23.0
VIT-016791Thu Nov 12, 2026 10:30 PMo2_lpm4.0nasal cannula
VIT-016858Thu Nov 12, 2026 10:30 PMtemp_c37.4
VIT-016859Thu Nov 12, 2026 10:30 PMhr76.0
VIT-016860Thu Nov 12, 2026 10:30 PMmap84.0
VIT-016861Thu Nov 12, 2026 10:30 PMgcs15.0
VIT-016792Fri Nov 13, 2026 06:30 AMspo291.0nasal cannula
VIT-016793Fri Nov 13, 2026 06:30 AMrr21.0
VIT-016794Fri Nov 13, 2026 06:30 AMo2_lpm4.0nasal cannula
VIT-016862Fri Nov 13, 2026 06:30 AMtemp_c37.5
VIT-016863Fri Nov 13, 2026 06:30 AMhr79.0
VIT-016864Fri Nov 13, 2026 06:30 AMmap87.0
VIT-016865Fri Nov 13, 2026 06:30 AMgcs15.0
VIT-016795Fri Nov 13, 2026 02:30 PMspo293.0nasal cannula
VIT-016796Fri Nov 13, 2026 02:30 PMrr21.0
VIT-016797Fri Nov 13, 2026 02:30 PMo2_lpm4.0nasal cannula
VIT-016866Fri Nov 13, 2026 02:30 PMtemp_c36.6
VIT-016867Fri Nov 13, 2026 02:30 PMhr92.0
VIT-016868Fri Nov 13, 2026 02:30 PMmap86.0
VIT-016869Fri Nov 13, 2026 02:30 PMgcs15.0
Medications, orders, echo, history (4)

Notes

History and physical · DOC-000572 · Dr. Priya Thorne (resident) · Sun Nov 08, 2026 01:10 AM

Cited facts from this note (3)
bleeding_source
bleeding · cited p. 1, line 7 · confidence 0.50
Show source for bleeding_source
… dmitted with urinary tract infection. Urinalysis with pyuria; treated for urinary tract infection with cefepime. Past medical history: none significant. Denies bleeding, chest pain or fever. Exam: Lungs: increased work of breathing with accessory muscle use. Assessment and plan: 1. Urinary tract infection: antibiotics.
infection_source
urinary tract infection · cited p. 1, line 5 · confidence 0.85
Show source for infection_source
… RN36886123 Admitted: 2026-11-07 22:10 Service: Hospital Medicine Attending: Dr. Isaac Abernath History of present illness: 76-year-old woman admitted with urinary tract infection. Urinalysis with pyuria; treated for urinary tract infection with cefepime. Past medical history: none significant. Denies bleeding, chest pain or fever. Exam: …
work_of_breathing
increased · cited p. 1, line 8 · confidence 0.90
Show source for work_of_breathing
… ysis with pyuria; treated for urinary tract infection with cefepime. Past medical history: none significant. Denies bleeding, chest pain or fever. Exam: Lungs: increased work of breathing with accessory muscle use. Assessment and plan: 1. Urinary tract infection: antibiotics.
Source document DOC-000572: History and physical (synthetic)
HISTORY AND PHYSICAL
Patient: Priya Hartwell   MRN: MRN36886123   Admitted: 2026-11-07 22:10
Service: Hospital Medicine   Attending: Dr. Isaac Abernath

History of present illness: 76-year-old woman admitted with urinary tract infection. Urinalysis with pyuria; treated for urinary tract infection with cefepime.
Past medical history: none significant.
Denies bleeding, chest pain or fever.
Exam: Lungs: increased work of breathing with accessory muscle use.
Assessment and plan:
1. Urinary tract infection: antibiotics.

Nutrition assessment · DOC-000571 · Viggo Ravensworth, RD (dietitian) · Mon Nov 09, 2026 02:10 AM

Cited facts from this note (8)
fat_loss
severe · cited p. 1, line 7 · confidence 0.90
Show source for fat_loss
… xt: chronic illness Intake: estimated energy intake 70% of needs for 57 days. Weight history: 13.8% weight loss over 180 days. Nutrition-focused physical exam: severe loss of subcutaneous fat; moderate muscle wasting; no fluid accumulation. Recommendations: high-protein oral supplement; calorie counts; weekly weights.
fluid_accumulation
none · cited p. 1, line 7 · confidence 0.90
Show source for fluid_accumulation
… needs for 57 days. Weight history: 13.8% weight loss over 180 days. Nutrition-focused physical exam: severe loss of subcutaneous fat; moderate muscle wasting; no fluid accumulation. Recommendations: high-protein oral supplement; calorie counts; weekly weights.
intake_days
57 · cited p. 1, line 5 · confidence 0.95
Show source for intake_days
NUTRITION ASSESSMENT (Registered Dietitian) Patient: Priya Hartwell MRN: MRN36886123 Context: chronic illness Intake: estimated energy intake 70% of needs for 57 days. Weight history: 13.8% weight loss over 180 days. Nutrition-focused physical exam: severe loss of subcutaneous fat; moderate muscle wasting; no fluid accumulat …
intake_pct
70 · cited p. 1, line 5 · confidence 0.95
Show source for intake_pct
NUTRITION ASSESSMENT (Registered Dietitian) Patient: Priya Hartwell MRN: MRN36886123 Context: chronic illness Intake: estimated energy intake 70% of needs for 57 days. Weight history: 13.8% weight loss over 180 days. Nutrition-focused physical exam: severe loss of subcutaneous fat; moderate muscle wasting; no fluid accumulat …
muscle_loss
moderate · cited p. 1, line 7 · confidence 0.90
Show source for muscle_loss
… ated energy intake 70% of needs for 57 days. Weight history: 13.8% weight loss over 180 days. Nutrition-focused physical exam: severe loss of subcutaneous fat; moderate muscle wasting; no fluid accumulation. Recommendations: high-protein oral supplement; calorie counts; weekly weights.
nutrition_context
chronic · cited p. 1, line 4 · confidence 0.95
Show source for nutrition_context
NUTRITION ASSESSMENT (Registered Dietitian) Patient: Priya Hartwell MRN: MRN36886123 Context: chronic illness Intake: estimated energy intake 70% of needs for 57 days. Weight history: 13.8% weight loss over 180 days. Nutrition-focused physical exam: severe loss of subc …
weight_loss_days
180 · cited p. 1, line 6 · confidence 0.95
Show source for weight_loss_days
… tered Dietitian) Patient: Priya Hartwell MRN: MRN36886123 Context: chronic illness Intake: estimated energy intake 70% of needs for 57 days. Weight history: 13.8% weight loss over 180 days. Nutrition-focused physical exam: severe loss of subcutaneous fat; moderate muscle wasting; no fluid accumulation. Recommendations: high-protein oral supplemen …
weight_loss_pct
13.8 · cited p. 1, line 6 · confidence 0.95
Show source for weight_loss_pct
… tered Dietitian) Patient: Priya Hartwell MRN: MRN36886123 Context: chronic illness Intake: estimated energy intake 70% of needs for 57 days. Weight history: 13.8% weight loss over 180 days. Nutrition-focused physical exam: severe loss of subcutaneous fat; moderate muscle wasting; no fluid accumulation. Recommendations: high-protein oral supplemen …
Source document DOC-000571: Nutrition assessment (synthetic)
NUTRITION ASSESSMENT (Registered Dietitian)
Patient: Priya Hartwell   MRN: MRN36886123

Context: chronic illness
Intake: estimated energy intake 70% of needs for 57 days.
Weight history: 13.8% weight loss over 180 days.
Nutrition-focused physical exam: severe loss of subcutaneous fat; moderate muscle wasting; no fluid accumulation.
Recommendations: high-protein oral supplement; calorie counts; weekly weights.

Progress note · DOC-000573 · Dr. Priya Thorne (resident) · Fri Nov 13, 2026 12:55 PM · awaiting cosign

Source document DOC-000573: Progress note (synthetic)
PROGRESS NOTE (Resident)
Patient: Priya Hartwell   MRN: MRN36886123   Hospital day 6

Subjective: resting, tolerating diet.
Objective: vitals and labs reviewed in the flowsheet.
Assessment and plan:
1. Urinary tract infection: continue current management.
2. Severe protein-calorie malnutrition: dietitian following, supplements.
3. Hypoxia: supplemental oxygen, wean as tolerated.

Resident: Dr. Priya Thorne   Attending cosign: pending