VYZR Care
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Predictive overview
latest obs 5m ago
Patient intelligence · showcase: possible-bleeding

J. Osei · 69F

Bed 05 · pneumonia · hospital day 8 · Pneumonia complicated by PE; therapeutic anticoagulation started day 4.

Context: Apixaban 10 mg bd (loading) · Aspirin 75 mg — not yet reviewed

VYZR Care RPP Engineconnecting…
Urgent · Rapidly worsening

Haemoglobin 12.1 → 10.9 → 9.6 g/dL over 46h (−2.5 g/dL); heart rate 82 → 95 → 100 → 109 /min over 44h; systolic pressure 126 → 110 → 105 → 104 mmHg over 48h. Falling haemoglobin with a compensatory circulatory response suggests active loss rather than dilution. Patient is anticoagulated (recorded context). If the current slope continues: Hb ≈ 9.2 (8.8–9.5 g/dL) at 6h; HR ≈ 121 (116–127 /min) at 6h, crossing HR 130/min in ~13h; SBP ≈ 97 (93–102 mmHg) at 6h, crossing SBP 100 mmHg in ~4h. 1 related pattern also active (falling perfusion reserve).

Preparing narrative…
01 · Recognized · last 2 d
Urgent · Rapidly worsening

Possible blood loss

Haemoglobin 12.1 → 10.9 → 9.6 g/dL over 46h (−2.5 g/dL); heart rate 82 → 95 → 100 → 109 /min over 44h; systolic pressure 126 → 110 → 105 → 104 mmHg over 48h. Falling haemoglobin with a compensatory circulatory response suggests active loss rather than dilution. Patient is anticoagulated (recorded context).

Pattern strength72/100 · higher evidence

Experimental explainable index, not a probability. 4 of 5 expected signals available 93 measurements across supporting signals

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NOW−72h+24h
Measured · 5 points · last 2h agoProjected · shaded = uncertainty band

9.6 g/dL (−1.3 g/dL since previous), below range, falling · −1.4 g/dL/24h · 4 consecutive falls.

Hemoglobin

9.6 g/dL · falling · −1.4 g/dL/24h · 4 consecutive falls

Heart rate

109 /min · rising · +42 /min/24h · 3 consecutive rises

Systolic blood pressure

104 mmHg · falling · −28 mmHg/24h

Platelets

215 ×10⁹/L · falling · −7 ×10⁹/L/24h · 2 consecutive falls

02 · Predicted
6hhigher evidence confidence

If the current slope continues: Hb ≈ 9.2 (8.8–9.5 g/dL) at 6h; HR ≈ 121 (116–127 /min) at 6h, crossing HR 130/min in ~13h; SBP ≈ 97 (93–102 mmHg) at 6h, crossing SBP 100 mmHg in ~4h.

Next in line if this continues: Further fall toward 8.0 g/dL with haemodynamic compromise if the source is not identified.

Higher evidence quality: several concordant, fresh, repeated measurements. Still a linear extrapolation, not a forecast of outcome.

Projections · 3 made · 0 withheld
Hemoglobinols-recent · fitted on 3 points · slope -0.05 g/dL/h
+6h · Sep 25 21:41
9.2 (8.8–9.5)
+12h · Sep 26 03:41
8.8 (8.5–9.2)
+24h · Sep 26 15:41
8.2 (7.8–8.6)
Heart rateols-recent · fitted on 5 points · slope +1.25 /min/h
+6h · Sep 25 21:41
121 (116–127)
+12h · Sep 26 03:41
129 (123–135)

HR 130/min in ~13h if the current slope continues (at Sep 26 04:41).

Systolic blood pressureols-recent · fitted on 6 points · slope -1.06 mmHg/h
+6h · Sep 25 21:41
97 (93–102)
+12h · Sep 26 03:41
91 (86–96)
+24h · Sep 26 15:41
78 (72–84)

SBP 100 mmHg in ~4h if the current slope continues (at Sep 25 19:41).

Alternative explanations
  • · Haemodilution after intravenous fluids.
  • · Phlebotomy losses over a long admission.
  • · Laboratory variation — a repeat sample confirms a true fall.
  • · Haemolysis or marrow suppression (non-bleeding causes of a fall).
04 · Consider now

Consider gastrointestinal, procedural/surgical-site, retroperitoneal and intramuscular sources; consider haemodilution and haemolysis as alternatives.

The engine judges this pattern strong, fresh and fast enough to justify interrupting a clinician.

Decision support only · no order has been placed · engine rpp-0.4.0 · latest supporting value 8 min ago

03 · Connected

What may be causing what

Mechanistic chain assembled from the recognised features. Each link is a hypothesis for bedside verification, not an established cause.

Falling haemoglobinloss of circulating volumeCompensatory tachycardia, then hypotension
Anticoagulation contextimpaired clot formationOngoing loss from a minor source

Evidence · 12 raw observations

Timestamps are real and irregular · click an observation to focus its trace above
04 · Prevention prompts

Consider, investigate, monitor, escalate

Clinician-support prompts derived from the pattern — not prescriptions. Status is persisted so the team sees what has been planned or judged not appropriate.

Consider causes

Consider gastrointestinal, procedural/surgical-site, retroperitoneal and intramuscular sources; consider haemodilution and haemolysis as alternatives.

Missing information

Stool/vomit description, drain output, and recent procedure detail are not in the structured record.

Investigate

Consider repeat full blood count, coagulation screen repeat, group and save, and imaging directed at the suspected source.

Monitor

Consider increased observation frequency and a repeat haemoglobin within 6 h to establish the slope.

Medication review

Review anticoagulant timing and indication, antiplatelets, NSAIDs and recent heparin exposure.

Level of care

Consider urgent senior review if haemoglobin falls ≥2 g/dL in 24 h, SBP falls below 100 mmHg, or overt bleeding is seen.

Other active patterns · 1

Falling perfusion reserve

Systolic pressure 126 → 110 → 105 → 104 mmHg over 48h; heart rate 82 → 95 → 100 → 109 /min over 44h. Falling pressure with rising rate is a compensation pattern — reserve is being consumed before the numbers look critical.

Concerning · Rapidly worsening
Pattern strength62/100 · moderate evidence

Changed since last review · 5 meaningful

Systolic blood pressure · 122 mmHg → 104 mmHg (−18 mmHg, 8 min ago)falling
Heart rate · 91 /min → 109 /min (+18 /min, 4h ago)rising
Temperature · 36.9 °C → 36.6 °C (−0.3 °C, 35 min ago)falling
Hemoglobin · 10.9 g/dL → 9.6 g/dL (−1.3 g/dL, 2h ago)falling
Platelets · 228 ×10⁹/L → 215 ×10⁹/L (−13 ×10⁹/L, 2h ago)falling
Respiratory rate · 15 /min → 16 /min (+1 /min, 30 min ago)flat
Oxygen saturation · 97 % → 97 % (±0 %, 12 min ago)flat
Consciousness (0 = alert, 1 = new confusion / CVPU) · 0 → 0 (±0, 5 min ago)flat

Reassuring signals · 3

Respiratory rate · 16 /min — in range and steady.
Oxygen saturation · 97 % — in range and steady.
Temperature · 36.6 °C — in range and steady.

Synthetic demonstration · engine output requires clinical correlation and is not a diagnosis