Datasets:
metaboulie
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c2n2_2018_processed

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303 values
49,400
# Acute Renal Failure : Baseline Cr difficult to assess from labs but appeared to be around 0.6 - 0.7 .
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198406.txt
49,401
Patient's creatinine was 0.9 on admission , likely prerenal in the context of appearing dry .
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198406.txt
49,402
No recent antibiotics or other nephrotoxins , and no symptoms of UTI with benign UA .
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198406.txt
49,403
Patient was hypotensive during her hospital stay .
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198406.txt
49,404
As a result , her kidney function deteriorated rapidly .
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198406.txt
49,405
Her creatinine bumped to 2.9 on day 3 .
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198406.txt
49,406
Patient declined hemodialysis , so she was made comfort measures only after all medical options to keep her alive failed .
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198406.txt
49,407
On the morning of her expiration , her K was 5.4 , and she was not producing urine .
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198406.txt
49,408
She passed at 1900 that day .
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198406.txt
49,409
It is therefore very likely that she died of hyperkalemia .
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198406.txt
49,410
On telemetry , she went into brief VT followed by asystole minutes before her demise .
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198406.txt
49,411
.
[ 0 ]
[ "." ]
198406.txt
49,412
# Fall : Etiology of fall was unclear .
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198406.txt
49,413
The most concerning possibility was that patient's AS led to syncope due to hypoperfusion .
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198406.txt
49,414
Unfortunately , as the fall was unwitnessed and the patient did not remember what happened this was impossible to prove .
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198406.txt
49,415
Patient underwent a repeat TTE which showed critical aortic valve stenosis ( valve area <0.8cm2 ) .
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198406.txt
49,416
Therefore , it was certainly very likely that AS played a role in the fall .
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198406.txt
49,417
.
[ 0 ]
[ "." ]
198406.txt
49,418
# Humeral Fracture : Patient was seen by Orthopedics in the ED .
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198406.txt
49,419
Ortho decided to manage conservatively with sling and analgesia .
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198406.txt
49,420
Pain control was achieved with tylenol around the clock , lidocaine patch , and low dose dilaudid with a goal to minimize effect on blood pressure .
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198406.txt
49,421
Patient's pain was well - controlled on the above regimen .
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198406.txt
49,422
.
[ 0 ]
[ "." ]
198406.txt
49,423
# Rhythm : Patient was in atrial fibrillation , and not anticoagulated .
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198406.txt
49,424
She was not on aspirin or coumadin because of a previous GI bleed .
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198406.txt
49,425
Metoprolol was held given her hypotension .
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198406.txt
49,426
Patient was observed on telemetry during her hospital stay in CCU .
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198406.txt
49,427
She went into VT followed by asystole minutes before she expired , likely secondary to hyperkalemia in the setting of acute renal failure .
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198406.txt
49,428
.
[ 0 ]
[ "." ]
198406.txt
49,429
# Leukocytosis : Unclear etiology , though rapid increase and lack of fevers , chills , or other acute changes suggested possibly leukemoid reaction in the context of fracture and injury .
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198406.txt
49,430
Cultures were negative , including blood cx , urine cx and c.diff .
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198406.txt
49,431
Patient was not started on antibiotics since she had no sign of infection .
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198406.txt
49,432
.
[ 0 ]
[ "." ]
198406.txt
49,433
# Anemia : Patient had history of normocytic anemia , baseline around 29 - 20 .
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198406.txt
49,434
Her hct was 43.6 on admission , likely hemoconcentrated .
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198406.txt
49,435
Hct decreased to her baseline of 29 during the next two days .
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198406.txt
49,436
She had no signs of active bleeding .
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198406.txt
49,437
.
[ 0 ]
[ "." ]
198406.txt
49,438
# CAD : Patient reported history of CAD , but with minimal details and there are no caths in our system .
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198406.txt
49,439
Patient was not on ASA or statin ( lipids normal ) .
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198406.txt
49,440
Patient had some cardiac enzyme leaks during her hospital stay , likely in the setting of hypotension and decreased blood supply to coronaries .
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198406.txt
49,441
.
[ 0 ]
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198406.txt
49,442
# PPx : Patient was given subcutaneous heparin for DVT prophylaxis .
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198406.txt
49,443
.
[ 0 ]
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198406.txt
49,444
# FEN : Patient was given cardiac healthy diet during this hospital stay .
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198406.txt
49,445
.
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198406.txt
49,446
# CODE : DNR/DNI ( discussed with patient and son - HCP ) .
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198406.txt
49,447
# Contact : [ * * Name ( NI ) * * ] [ * * Telephone/Fax ( 1 ) 92787 * * ] ( H ) , [ * * Telephone/Fax ( 1 ) 92788 * * ] ( C )
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198406.txt
49,448
Medications on Admission : 1 .
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198406.txt
49,449
Metoprolol Tartrate 25 mg PO TID 2 .
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198406.txt
49,450
Levothyroxine 100 mcg PO once a day .
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198406.txt
49,451
3 .
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[ "3", "." ]
198406.txt
49,452
Calcium Carbonate 500 mg PO TID 4 .
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198406.txt
49,453
Ergocalciferol 50 , 000 unit weekly 5 .
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198406.txt
49,454
Risedronate 35 mg PO once a week .
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198406.txt
49,455
6 .
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198406.txt
49,456
Cyanocobalamin 1 , 000 mcg/mL Injection once a month 7 .
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198406.txt
49,457
Lorazepam 0.25 QAM , O.25 QPM , 0.5 mg QHS 8 Capsaicin 0.025 % Cream Topical TID 9 .
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198406.txt
49,458
Acetaminophen 1000 mg PO Q6H 10 .
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198406.txt
49,459
Mirtazapine 15 mg PO QHS
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198406.txt
49,460
Discharge Medications : Deceased
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198406.txt
49,461
Discharge Disposition : Expired
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[ "Discharge", "Disposition", ":", "Expired" ]
198406.txt
49,462
Discharge Diagnosis : Chief cause of death : critical AS Immediate cause of death : acute renal failure
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198406.txt
49,463
Discharge Condition : Deceased
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198406.txt
49,464
Discharge Instructions : Deceased
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198406.txt
49,465
Followup Instructions : Deceased
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[ "Followup", "Instructions", ":", "Deceased" ]
198406.txt