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-00171: Viggo Merriweather

59F · MRN34993785 · Hospital Medicine · admitted Sun Nov 08, 2026 10:50 PM · discharged Thu Nov 12, 2026 12:56 PM · attending Dr. Cyrus Ellingham · resident Dr. Keira Upfield · 163 cm, 58.3 kg

Documented diagnoses (current)

Principal: “community-acquired pneumonia” · J18.9 Pneumonia, unspecified organism
“CKD stage 3” · N18.30 Chronic kidney disease, stage 3 unspecified
“anemia” · D64.9 Anemia, unspecified
“GERD” · K21.9 Gastro-esophageal reflux disease without esophagitis
“hyperlipidemia” · E78.5 Hyperlipidemia, unspecified

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 195.

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=1.006, t.ratio_s1=1.5, creat_rise_48h=0.01, 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=1.006, t.ratio_s3=3.0, creat_peak=1.62, 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=1.006, 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=0.01, 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=10.2, 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=0.3, t.drop_major=2.0, prbc_units=0, t.prbc_major=2	false
outcome: met	`bleeding_documented and anaemic and acute_fall`	bleeding_documented=False, anaemic=True, acute_fall=False	false
outcome: anaemia_only	`anaemic and hgb_drop < t.drop_min and prbc_units == 0`	anaemic=True, hgb_drop=0.3, t.drop_min=1.0, prbc_units=0	true

Chronic kidney disease

Criteria met

Specificity gap

Documented “CKD stage 3” (N18.30); criteria support the more specific 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=372, t.chronic_days=90	true
derived: staging_egfr	`max(egfr_early, egfr_late)`	egfr_early=33.2, egfr_late=36.6	36.6
derived: both_below_60	`egfr_early < t.g2 and egfr_late < t.g2`	egfr_early=33.2, t.g2=60, egfr_late=36.6	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=36.6, 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=33.2, egfr_late=36.6, t.g2=60	false
outcome: g1_g2	`staging_egfr >= t.g2`	staging_egfr=36.6, t.g2=60	false
outcome: g3a	`category == 'G3a'`	category=G3b	false
outcome: g3b	`category == 'G3b'`	category=G3b	true

Heart failure

Insufficient data

No gap

Insufficient data: the criteria could not be applied.

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=False	0
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=0, 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=0	false

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 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=59, t.adult=20	false
outcome: class3	`bmi >= t.c3`	bmi=21.9, t.c3=40	false
outcome: class2	`bmi >= t.c2`	bmi=21.9, t.c2=35	false
outcome: class1	`bmi >= t.c1`	bmi=21.9, t.c1=30	false
outcome: not_met	`bmi < t.c1`	bmi=21.9, t.c1=30	true

Pressure injury

Insufficient data

No gap

Insufficient data: the criteria could not be applied.

Trace

Rule trace (rule pressure_injury v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
Step	Expression	Inputs and thresholds read	Result
derived: sacral	`wound_site == 'sacral'`	wound_site=unknown	unknown
outcome: no_wound_note	`not present(wound_stage)`	wound_stage=unknown	true

Acute respiratory failure

Criteria not met

No gap

Not documented and not supported.

Trace

Rule trace (rule respiratory_failure v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
Step	Expression	Inputs and thresholds read	Result
derived: measured	`present(spo2_min_ra) or present(pao2_min_ra) or present(pf_min)`	spo2_min_ra=94.0, pao2_min_ra=unknown, pf_min=unknown	true
derived: hypoxemia	`coalesce(spo2_min_ra < t.spo2_ra, false) or coalesce(pao2_min_ra < t.pao2, false) or coalesce(pf_min < t.pf, false)`	spo2_min_ra=94.0, t.spo2_ra=88, pao2_min_ra=unknown, t.pao2=60, pf_min=unknown, t.pf=300	false
derived: distress	`coalesce(rr_max >= t.rr_distress, false) or coalesce(wob_increased, false) or adv_resp_support`	rr_max=17.0, 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=37.5, 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=88.0, 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=17.0, t.rr=20, paco2_min_48h=unknown, t.paco2=32	false
derived: sirs_wbc	`coalesce(wbc_max_48h > t.wbc_hi, false) or coalesce(wbc_min_48h < t.wbc_lo, false) or coalesce(bands_max_48h > t.bands, false)`	wbc_max_48h=10.4, t.wbc_hi=12, wbc_min_48h=7.37, 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=186.0	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=0.59	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=1.62	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=1.61	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=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=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 (28)

Labs (pre-admission rows are outpatient values)
Row	When	Test	Value
LAB-005854	Thu Sep 25, 2025 09:15 AM	creatinine	1.75 mg/dL
LAB-005855	Fri Oct 02, 2026 10:05 AM	creatinine	1.61 mg/dL
LAB-005856	Sun Nov 08, 2026 11:50 PM	creatinine	1.62 mg/dL
LAB-005861	Sun Nov 08, 2026 11:50 PM	sodium	140.0 mmol/L
LAB-005866	Sun Nov 08, 2026 11:50 PM	hemoglobin	10.46 g/dL
LAB-005871	Sun Nov 08, 2026 11:50 PM	wbc	10.4 x10^3/uL
LAB-005872	Sun Nov 08, 2026 11:50 PM	platelets	187.0 x10^3/uL
LAB-005881	Sun Nov 08, 2026 11:50 PM	bilirubin	0.59 mg/dL
LAB-005857	Mon Nov 09, 2026 05:00 AM	creatinine	1.59 mg/dL
LAB-005862	Mon Nov 09, 2026 05:00 AM	sodium	136.0 mmol/L
LAB-005867	Mon Nov 09, 2026 05:00 AM	hemoglobin	10.2 g/dL
LAB-005873	Mon Nov 09, 2026 05:00 AM	wbc	9.7 x10^3/uL
LAB-005874	Mon Nov 09, 2026 05:00 AM	platelets	186.0 x10^3/uL
LAB-005858	Tue Nov 10, 2026 05:00 AM	creatinine	1.6 mg/dL
LAB-005863	Tue Nov 10, 2026 05:00 AM	sodium	142.0 mmol/L
LAB-005868	Tue Nov 10, 2026 05:00 AM	hemoglobin	10.28 g/dL
LAB-005875	Tue Nov 10, 2026 05:00 AM	wbc	7.37 x10^3/uL
LAB-005876	Tue Nov 10, 2026 05:00 AM	platelets	202.0 x10^3/uL
LAB-005859	Wed Nov 11, 2026 05:00 AM	creatinine	1.59 mg/dL
LAB-005864	Wed Nov 11, 2026 05:00 AM	sodium	142.0 mmol/L
LAB-005869	Wed Nov 11, 2026 05:00 AM	hemoglobin	10.34 g/dL
LAB-005877	Wed Nov 11, 2026 05:00 AM	wbc	8.18 x10^3/uL
LAB-005878	Wed Nov 11, 2026 05:00 AM	platelets	223.0 x10^3/uL
LAB-005860	Thu Nov 12, 2026 05:00 AM	creatinine	1.6 mg/dL
LAB-005865	Thu Nov 12, 2026 05:00 AM	sodium	138.0 mmol/L
LAB-005870	Thu Nov 12, 2026 05:00 AM	hemoglobin	10.5 g/dL
LAB-005879	Thu Nov 12, 2026 05:00 AM	wbc	9.31 x10^3/uL
LAB-005880	Thu Nov 12, 2026 05:00 AM	platelets	233.0 x10^3/uL

Vitals (66)

Vitals
Row	When	Kind	Value	Detail
VIT-016870	Sun Nov 08, 2026 11:10 PM	spo2	94.0	room air
VIT-016871	Sun Nov 08, 2026 11:10 PM	rr	16.0
VIT-016892	Sun Nov 08, 2026 11:10 PM	temp_c	37.0
VIT-016893	Sun Nov 08, 2026 11:10 PM	hr	76.0
VIT-016894	Sun Nov 08, 2026 11:10 PM	map	79.0
VIT-016895	Sun Nov 08, 2026 11:10 PM	gcs	15.0
VIT-016872	Mon Nov 09, 2026 07:10 AM	spo2	96.0	room air
VIT-016873	Mon Nov 09, 2026 07:10 AM	rr	16.0
VIT-016896	Mon Nov 09, 2026 07:10 AM	temp_c	37.3
VIT-016897	Mon Nov 09, 2026 07:10 AM	hr	88.0
VIT-016898	Mon Nov 09, 2026 07:10 AM	map	85.0
VIT-016899	Mon Nov 09, 2026 07:10 AM	gcs	15.0
VIT-016874	Mon Nov 09, 2026 03:10 PM	spo2	97.0	room air
VIT-016875	Mon Nov 09, 2026 03:10 PM	rr	17.0
VIT-016900	Mon Nov 09, 2026 03:10 PM	temp_c	36.7
VIT-016901	Mon Nov 09, 2026 03:10 PM	hr	74.0
VIT-016902	Mon Nov 09, 2026 03:10 PM	map	77.0
VIT-016903	Mon Nov 09, 2026 03:10 PM	gcs	15.0
VIT-016876	Mon Nov 09, 2026 11:10 PM	spo2	97.0	room air
VIT-016877	Mon Nov 09, 2026 11:10 PM	rr	17.0
VIT-016904	Mon Nov 09, 2026 11:10 PM	temp_c	37.2
VIT-016905	Mon Nov 09, 2026 11:10 PM	hr	68.0
VIT-016906	Mon Nov 09, 2026 11:10 PM	map	92.0
VIT-016907	Mon Nov 09, 2026 11:10 PM	gcs	15.0
VIT-016878	Tue Nov 10, 2026 07:10 AM	spo2	95.0	room air
VIT-016879	Tue Nov 10, 2026 07:10 AM	rr	14.0
VIT-016908	Tue Nov 10, 2026 07:10 AM	temp_c	37.5
VIT-016909	Tue Nov 10, 2026 07:10 AM	hr	81.0
VIT-016910	Tue Nov 10, 2026 07:10 AM	map	74.0
VIT-016911	Tue Nov 10, 2026 07:10 AM	gcs	15.0
VIT-016880	Tue Nov 10, 2026 03:10 PM	spo2	96.0	room air
VIT-016881	Tue Nov 10, 2026 03:10 PM	rr	14.0
VIT-016912	Tue Nov 10, 2026 03:10 PM	temp_c	37.4
VIT-016913	Tue Nov 10, 2026 03:10 PM	hr	83.0
VIT-016914	Tue Nov 10, 2026 03:10 PM	map	80.0
VIT-016915	Tue Nov 10, 2026 03:10 PM	gcs	15.0
VIT-016882	Tue Nov 10, 2026 11:10 PM	spo2	95.0	room air
VIT-016883	Tue Nov 10, 2026 11:10 PM	rr	15.0
VIT-016916	Tue Nov 10, 2026 11:10 PM	temp_c	37.4
VIT-016917	Tue Nov 10, 2026 11:10 PM	hr	90.0
VIT-016918	Tue Nov 10, 2026 11:10 PM	map	90.0
VIT-016919	Tue Nov 10, 2026 11:10 PM	gcs	15.0
VIT-016884	Wed Nov 11, 2026 07:10 AM	spo2	94.0	room air
VIT-016885	Wed Nov 11, 2026 07:10 AM	rr	15.0
VIT-016920	Wed Nov 11, 2026 07:10 AM	temp_c	36.6
VIT-016921	Wed Nov 11, 2026 07:10 AM	hr	89.0
VIT-016922	Wed Nov 11, 2026 07:10 AM	map	76.0
VIT-016923	Wed Nov 11, 2026 07:10 AM	gcs	15.0
VIT-016886	Wed Nov 11, 2026 03:10 PM	spo2	97.0	room air
VIT-016887	Wed Nov 11, 2026 03:10 PM	rr	14.0
VIT-016924	Wed Nov 11, 2026 03:10 PM	temp_c	37.6
VIT-016925	Wed Nov 11, 2026 03:10 PM	hr	83.0
VIT-016926	Wed Nov 11, 2026 03:10 PM	map	89.0
VIT-016927	Wed Nov 11, 2026 03:10 PM	gcs	15.0
VIT-016888	Wed Nov 11, 2026 11:10 PM	spo2	96.0	room air
VIT-016889	Wed Nov 11, 2026 11:10 PM	rr	15.0
VIT-016928	Wed Nov 11, 2026 11:10 PM	temp_c	37.3
VIT-016929	Wed Nov 11, 2026 11:10 PM	hr	83.0
VIT-016930	Wed Nov 11, 2026 11:10 PM	map	84.0
VIT-016931	Wed Nov 11, 2026 11:10 PM	gcs	15.0
VIT-016890	Thu Nov 12, 2026 07:10 AM	spo2	95.0	room air
VIT-016891	Thu Nov 12, 2026 07:10 AM	rr	15.0
VIT-016932	Thu Nov 12, 2026 07:10 AM	temp_c	37.6
VIT-016933	Thu Nov 12, 2026 07:10 AM	hr	80.0
VIT-016934	Thu Nov 12, 2026 07:10 AM	map	84.0
VIT-016935	Thu Nov 12, 2026 07:10 AM	gcs	15.0

Medications, orders, echo, history (4)

MED-000679 11-08 23:50 cefepime per protocol IV
MED-000680 11-09 05:00 piperacillin-tazobactam per protocol IV
MED-000681 11-10 05:00 cefepime per protocol IV
ORD-000150 11-08 23:20 blood_culture: blood cultures x2

Notes

History and physical · DOC-000574 · Dr. Keira Upfield (resident) · Mon Nov 09, 2026 01:50 AM

Cited facts from this note (1)

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

Show source for infection_source

… Hospital Medicine Attending: Dr. Cyrus Ellingham History of present illness: 59-year-old woman admitted with community-acquired pneumonia. Chest x-ray shows left lower lobe pneumonia; blood cultures drawn and ceftriaxone started. Past medical history: GERD, hyperlipidemia. Review of systems otherwise negative. Exam: Lungs: scattered crackle …

Source document DOC-000574: History and physical (synthetic)

HISTORY AND PHYSICAL
Patient: Viggo Merriweather   MRN: MRN34993785   Admitted: 2026-11-08 22:50
Service: Hospital Medicine   Attending: Dr. Cyrus Ellingham

History of present illness: 59-year-old woman admitted with community-acquired pneumonia. Chest x-ray shows left lower lobe pneumonia; blood cultures drawn and ceftriaxone started.
Past medical history: GERD, hyperlipidemia.
Review of systems otherwise negative.
Exam: Lungs: scattered crackles at the bases, no distress.
Assessment and plan:
1. Community-acquired pneumonia: antibiotics.
2. CKD stage 3: renally dose medications.

Progress note · DOC-000575 · Dr. Keira Upfield (resident) · Tue Nov 10, 2026 11:50 PM

Source document DOC-000575: Progress note (synthetic)

PROGRESS NOTE (Resident)
Patient: Viggo Merriweather   MRN: MRN34993785   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. Anemia: trend hemoglobin.

Resident: Dr. Keira Upfield   Attending cosign: completed

Discharge summary · DOC-000576 · Dr. Cyrus Ellingham (attending) · Thu Nov 12, 2026 12:56 PM

Source document DOC-000576: Discharge summary (synthetic)

DISCHARGE SUMMARY
Patient: Viggo Merriweather   MRN: MRN34993785
Admitted 2026-11-08; discharged 2026-11-12.

Discharge diagnoses:
- community-acquired pneumonia
- CKD stage 3
- anemia
- GERD
- hyperlipidemia

Disposition: home with follow-up.