CHIEF COMPLAINT: left hip arthritis

PRESENT ILLNESS: 64 y/o with OA of right hip,presents for surgical management of
pain. His hematology team was consulted for pre and post
operative care.

MEDICAL HISTORY: 1. Superior mesenteric vein thrombosis ([**4-/2095**]) secondary to
ATIII deficiency, on coumadin
2. macrocytosis/thrombocytopenia (thrombocytopenia and
macrocytosis were thought [**3-1**] liver disease from hepatitis B. He
was ruled out for myelodysplastic because his smear lacked
characteristic Pelger [**Last Name (un) 11605**] cells, ovalomacrocytes or microcytic
anemia)
3. Splenomegaly (per U/S in [**2100**])
4. hepatic cirrhosis (grade III/IV)
5. HTN on Naldolol
6. Esopageal varicies (An EGD done in [**2099-7-28**] showed grade 1
and 2 esophageal varicies)
7. Gall bladder polyps
8. Hepatitis B, unknown source of exposure(genotype D, with
precore and BCP mutations (basal core promoter mutation) on
tenofovir
9. Oral HSV on Valcyclovir
10. Hematuria-one episode as a childhood of unclear etiology
11. Colonic Adenoma [**2089**]--> s/p polypectomy. Repeat negative
colonoscopy in [**2094**].

MEDICATION ON ADMISSION: NADOLOL - 20 mg Tablet - one Tablet(s) by mouth daily
TENOFOVIR DISOPROXIL FUMARATE - 300 mg Tablet - 1 Tablet(s) by
mouth daily
VALACYCLOVIR - (Prescribed by Other Provider) - 500 mg Tablet -
1 Tablet(s) by mouth once a day
WARFARIN - 5 mg Tablet - 1-1.5 Tablet(s) by mouth once a day
Patient to take 7.5 mg daily 6 days per week and 5 mg daily 1
day
per week (Sunday).
Medications - OTC
GLUCOSAMINE SULFATE [GLUCOSAMINE] - (Prescribed by Other
Provider) - Dosage uncertain
OMEGA-3 FATTY ACIDS - (OTC) - Dosage uncertain

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: well appearing, well nourished 64 year old male
alert and oriented
no acute distress
LLE:
 -dressing-c/d/i
 -incision-c/d/i -> no erythema or drainage.  DIFFUSE ecchymosis
throughout entire LLE.  mild edema
 -+AT, FHL, [**Last Name (un) 938**]
 -SILT
 -brisk cap refill
 -calf-soft, nontender
 -NVI distally

FAMILY HISTORY: NC

SOCIAL HISTORY: NC
Osteoarthrosis, localized, not specified whether primary or secondary, pelvic region and thigh,Thrombocytopenia, unspecified,Chronic viral hepatitis B without mention of hepatic coma without mention of hepatitis delta,Primary hypercoagulable state,Herpes simplex without mention of complication,Cirrhosis of liver without mention of alcohol,Long-term (current) use of anticoagulants,Unspecified essential hypertension,Anemia, unspecified,Personal history of venous thrombosis and embolism
Loc osteoarth NOS-pelvis,Thrombocytopenia NOS,Hpt B chrn wo cm wo dlta,Prim hypercoagulable st,Herpes simplex NOS,Cirrhosis of liver NOS,Long-term use anticoagul,Hypertension NOS,Anemia NOS,Hx-ven thrombosis/embols
Admission Date:  [**2101-11-10**]              Discharge Date:   [**2101-11-16**]

Date of Birth:  [**2037-3-10**]             Sex:   M

Service: ORTHOPAEDICS

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 64**]
Chief Complaint:
left hip arthritis

Major Surgical or Invasive Procedure:
left tha


History of Present Illness:
64 y/o with OA of right hip,presents for surgical management of
pain. His hematology team was consulted for pre and post
operative care.

infusion, high risk bleeding, high risk thrombosis
.
History of Present Illness: 64 y/o male with chronic hepatitis B
infection with grade [**3-31**] cirrhosis (presently suppressed),
antithrombin III deficiency and superior mesenteric thrombosis
[**2095**](managed by Dr. [**Last Name (STitle) 2805**], on coumadin),
thrombocytopenia/macrocytosis, esophageal varices, and
hypertension who is POD #0 s/p left total hip replacement with
Dr. [**Last Name (STitle) **].
.
From surgical perspective, blood loss estimated to be 750 cc and
procedure was uncomplicated. Patient received 3L LR, 50 mL 25%
albumin, 2 mg versed, 8 mg decadron, 250 mcg fentanyl, total of
6 mg dilaudid, 4 g cefazolin. UOP was 240 cc during procedure.
.
From hematology perspective, patient presented with several days
of abdominal pain and bloating in [**2095-4-28**]. He underwent a CT
can at [**Hospital1 18**] on [**2095-5-19**], which demonstrated a nonocculusive
endoluminal thrombus within the superior mesenteric vein with
extension into more distal branches and extending into the main
portal vein. Work up at the time revealed low Protein C and
antithrombin III levels (Antithrombin III 48%, normal range 80
to 120%; Protein C antigen 31%, protein C functional 46%). On
[**2095-8-3**], the antithrombin III levels were determined was 54%
and the antithrombin antigen was 65%, both below the range of
normal. Further testing revealed he was negative for prothrombin
gene mutation, factor V Leiden, and anticardiolipin. He was
placed on coumadin therapy indefinitely with goal INR of [**3-2**].
.
In anticipation of his upcoming surgery, he was recently seen in
[**Hospital **] clinic on [**2101-9-16**]. At that time he was informed that hip
replacement surgery is associated with a very high risk of
developing thrombotic complications. For this reason, he was
recommended to stop coumadin 5 days prior to surgery and start a
Lovenox bridge (150 mg daily) until the day before his surgery.
He had low antithrombin III levels on [**2101-9-16**] (66%), although
these levels were all checked while he was still on Coumadin.
For this reason, he was recommended to receive ATIII repletion
therapy to correct the deficiency prior to having the procedure.
IVC filter was also considered for DVT prophylaxis, but he had a
relatively contraindication to its use with a prior history of
SMV thrombosis, and it was felt that collateral thrombosis could
further put that vascular tree at risk.
.
With regard to his AT3 deficiency, patient received 1 dose
before surgery to keep level > 100%. Level at baseline is
approximately 55%.
.
Prior to transfer, HR 84 and BP 144/89. Access 2 piv - 16 guage
x 2. Unable to obtain A-line as catheter would not thread.


Past Medical History:
1. Superior mesenteric vein thrombosis ([**4-/2095**]) secondary to
ATIII deficiency, on coumadin
2. macrocytosis/thrombocytopenia (thrombocytopenia and
macrocytosis were thought [**3-1**] liver disease from hepatitis B. He
was ruled out for myelodysplastic because his smear lacked
characteristic Pelger [**Last Name (un) 11605**] cells, ovalomacrocytes or microcytic
anemia)
3. Splenomegaly (per U/S in [**2100**])
4. hepatic cirrhosis (grade III/IV)
5. HTN on Naldolol
6. Esopageal varicies (An EGD done in [**2099-7-28**] showed grade 1
and 2 esophageal varicies)
7. Gall bladder polyps
8. Hepatitis B, unknown source of exposure(genotype D, with
precore and BCP mutations (basal core promoter mutation) on
tenofovir
9. Oral HSV on Valcyclovir
10. Hematuria-one episode as a childhood of unclear etiology
11. Colonic Adenoma [**2089**]--> s/p polypectomy. Repeat negative
colonoscopy in [**2094**].

Social History:
NC

Family History:
NC

Physical Exam:
well appearing, well nourished 64 year old male
alert and oriented
no acute distress
LLE:
 -dressing-c/d/i
 -incision-c/d/i -> no erythema or drainage.  DIFFUSE ecchymosis
throughout entire LLE.  mild edema
 -+AT, FHL, [**Last Name (un) 938**]
 -SILT
 -brisk cap refill
 -calf-soft, nontender
 -NVI distally

Pertinent Results:
[**2101-11-10**] 07:12PM BLOOD WBC-11.2*# RBC-3.94* Hgb-13.7* Hct-39.7*
MCV-101* MCH-34.8* MCHC-34.5 RDW-13.7 Plt Ct-118*
[**2101-11-11**] 04:52AM BLOOD WBC-9.4 RBC-3.53* Hgb-12.6* Hct-35.6*
MCV-101* MCH-35.7* MCHC-35.4* RDW-14.6 Plt Ct-127*
[**2101-11-11**] 03:12PM BLOOD Hct-33.7*
[**2101-11-11**] 08:40PM BLOOD WBC-12.1* RBC-3.13* Hgb-10.6* Hct-31.8*
MCV-102* MCH-34.0* MCHC-33.4 RDW-13.5 Plt Ct-113*
[**2101-11-12**] 08:10AM BLOOD WBC-8.6 RBC-2.75* Hgb-9.8* Hct-28.4*
MCV-103* MCH-35.8* MCHC-34.6 RDW-14.8 Plt Ct-109*
[**2101-11-13**] 06:15AM BLOOD WBC-7.4 RBC-2.41* Hgb-8.4* Hct-24.2*
MCV-100* MCH-34.8* MCHC-34.7 RDW-13.7 Plt Ct-104*
[**2101-11-14**] 05:55AM BLOOD WBC-5.2 RBC-2.16* Hgb-7.8* Hct-22.3*
MCV-103* MCH-36.0* MCHC-34.9 RDW-14.7 Plt Ct-115*
[**2101-11-15**] 01:56AM BLOOD WBC-6.0 RBC-2.65* Hgb-9.3* Hct-26.4*
MCV-100* MCH-35.1* MCHC-35.2* RDW-16.2* Plt Ct-120*
[**2101-11-15**] 06:10AM BLOOD WBC-5.4 RBC-2.58* Hgb-8.9* Hct-25.4*
MCV-98 MCH-34.6* MCHC-35.2* RDW-15.8* Plt Ct-108*
[**2101-11-15**] 07:33PM BLOOD Hct-28.6*
[**2101-11-16**] 06:30AM BLOOD WBC-6.4 RBC-2.75* Hgb-9.6* Hct-27.9*
MCV-101* MCH-34.9* MCHC-34.5 RDW-16.7* Plt Ct-161
[**2101-11-10**] 07:12PM BLOOD Neuts-86.8* Lymphs-9.6* Monos-2.3 Eos-0.9
Baso-0.3
[**2101-11-11**] 04:52AM BLOOD Neuts-78.1* Lymphs-14.4* Monos-7.0
Eos-0.2 Baso-0.3
[**2101-11-15**] 01:40PM BLOOD PT-16.7* PTT-31.7 INR(PT)-1.5*
[**2101-11-16**] 06:30AM BLOOD PT-16.9* PTT-29.2 INR(PT)-1.5*
[**2101-11-14**] 12:21PM BLOOD LMWH-0.28
[**2101-11-10**] 01:59PM BLOOD AT-118
[**2101-11-11**] 04:52AM BLOOD AT-91
[**2101-11-12**] 08:10AM BLOOD AT-72
[**2101-11-13**] 06:15AM BLOOD AT-73
[**2101-11-14**] 05:55AM BLOOD AT-95
[**2101-11-10**] 07:12PM BLOOD Glucose-146* UreaN-16 Creat-0.8 Na-137
K-4.8 Cl-105 HCO3-24 AnGap-13
[**2101-11-11**] 04:52AM BLOOD Glucose-162* UreaN-18 Creat-0.7 Na-135
K-4.2 Cl-104 HCO3-24 AnGap-11
[**2101-11-12**] 08:10AM BLOOD Glucose-130* UreaN-19 Creat-0.8 Na-136
K-3.5 Cl-103 HCO3-28 AnGap-9
[**2101-11-14**] 12:21PM BLOOD Glucose-163* UreaN-17 Creat-0.7 Na-138
K-3.9 Cl-106 HCO3-26 AnGap-10

Brief Hospital Course:
The patient was admitted to the orthopaedic surgery service and
was taken to the operating room for above described procedure.
Please see separately dictated operative report for details. The

surgery was uncomplicated and the patient tolerated the
procedure well. Patient received perioperative IV antibiotics.

Postoperative course was remarkable for the following:

1. please see below

2. heme consulted for antithrombin III deficiency.  follows with
Dr [**Last Name (STitle) 2805**]

Otherwise, pain was initially controlled with a PCA followed by
a transition to oral pain medications on POD#1.  The patient
received lovenox for DVT prophylaxis starting on the morning of
POD#1.  The foley was removed on POD#2 and the patient was
voiding independently thereafter. The surgical dressing was
changed on POD#2 and the surgical incision was found to be clean

and intact without erythema or abnormal drainage. The patient
was seen daily by physical therapy. Labs were checked throughout

the hospital course and repleted accordingly. At the time of
discharge the patient was tolerating a regular diet and feeling
well.  The patient was afebrile with stable vital signs.  The
patient's hematocrit was acceptable and pain was adequately
controlled on an oral regimen. The operative extremity was
neurovascularly intact and the wound was benign.

The patient's weight-bearing status is weight bearing as
tolerated on the operative extremity with posterior hip
precautions.


Mr [**Known lastname 11606**] is discharged to home with services in stable
condition.

Assessment and Plan

Mr. [**Known lastname 11606**] is a 64-year-old male with history of liver
cirrhosis, hepatitis B, SMV/PV thrombosis and antithrombin III
deficiency (on coumadin), who is s/p left total hip replacement
and POD day 0.   Admitted to [**Hospital Unit Name 153**] for administration of AT-3



# s/p left total hip replacement: POD #1. Uncomplicated surgery
per discussion with orthopedics, with estimated blood loss 750
cc. Pain well controlled currently.

- cefazolin per orthopedics recs (total of 3 doses)

- pain control with standing naproxen, tylenol and prn morphine

- written for dilaudid PCA per orthopedics, which can be
consolidated to morphine IV or PO regimen in next 24-48 hours

- monitor [**Hospital1 **] Hct for now and can transition to daily once
stable

- hip plain film per ortho on [**11-10**] and [**2101-11-12**]

- ROM Restictions post surgical hip precautions per ortho

.

# AT III deficiency: hip replacement surgery is associated with
a very high risk of developing thrombotic complications. Given
Mr. [**Known lastname 11607**] ATIII deficiency, underlying liver disease, and
previous history of venous thromboses, he is at high risk for
perioperative thrombosis. Prior to the OR, he received Thrombate
(antithrombin III) at a dose of 3864U IV x1 and his AT level
rose to 118%.

- appreciate hematology/oncology recommendations

- per heme/onc goal is an AT level >75% (ideally 80-120).  This
morning??????s level was 91 so will get dose of 1656 U today

- he should have levels checked daily for at least the next
three days and will be dosed with additional Thrombate prn (at a
dose of 1656U IV daily).

- For DVT prophylaxis, has satarted Lovenox 30mg SC BID 12 hours
after surgery (orthopedics team aware).  Currently not on
treatment dose heparin bridge per heme recs.  Will touch base
about when to formally bridge to coumadin

- Continue coumadin



# Anemia: Hct 39.7--> 35.6 with baseline of 46-47. Unlikely to
be dilutional given lack of dilution of platelets.  Other
possibility includes surgical site bleeding. Less likely B12,
folate, Fe deficiency, or anemia of chronic disease.

- trend with [**Hospital1 **] Hcts

- B12, folate, iron studies all pending

- will guaiac stool



# Hepatitis B: unknown source of exposure(genotype D, with
precore and BCP mutations (basal core promoter mutation) on
tenofovir.

- continue tenofovir per home regimen



# Oral HSV

- continue valacyclovir per home regimen



# HTN: BP currently stable.

- continue nadalol per home regimen



# Thrombocytopenia: stable and at baseline, per review of OMR
and per discussion with hematology.

- trend daily


Medications on Admission:
NADOLOL - 20 mg Tablet - one Tablet(s) by mouth daily
TENOFOVIR DISOPROXIL FUMARATE - 300 mg Tablet - 1 Tablet(s) by
mouth daily
VALACYCLOVIR - (Prescribed by Other Provider) - 500 mg Tablet -
1 Tablet(s) by mouth once a day
WARFARIN - 5 mg Tablet - 1-1.5 Tablet(s) by mouth once a day
Patient to take 7.5 mg daily 6 days per week and 5 mg daily 1
day
per week (Sunday).
Medications - OTC
GLUCOSAMINE SULFATE [GLUCOSAMINE] - (Prescribed by Other
Provider) - Dosage uncertain
OMEGA-3 FATTY ACIDS - (OTC) - Dosage uncertain

Discharge Medications:
1. docusate sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a day).
Disp:*60 Capsule(s)* Refills:*2*
2. Lovenox 30 mg/0.3 mL Syringe Sig: One (1)  Subcutaneous twice
a day: until inr 2.0 -2.5.
Disp:*10 * Refills:*0*
3. oxycodone 5 mg Tablet Sig: 1-2 Tablets PO Q3H (every 3 hours)
as needed for pain.
Disp:*80 Tablet(s)* Refills:*0*
4. Coumadin 7.5 mg Tablet Sig: One (1) Tablet PO once a day:
goal INR [**3-2**].  Follow by [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 9449**].
Disp:*30 Tablet(s)* Refills:*2*
5. multivitamin     Tablet Sig: One (1) Tablet PO DAILY (Daily).

6. acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q6H (every
6 hours).
7. valacyclovir 500 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
8. tenofovir disoproxil fumarate 300 mg Tablet Sig: One (1)
Tablet PO DAILY (Daily).
9. nadolol 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).


Discharge Disposition:
Home With Service

Facility:
[**Hospital 119**] Homecare

Discharge Diagnosis:
left hip osteoarthritis


Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - requires assistance or aid (walker
or cane).


Discharge Instructions:
1. Please return to the emergency department or notify your
physician if you experience any of the following: severe pain
not relieved by medication, increased swelling, decreased
sensation, difficulty with movement, fevers greater than 101.5,
shaking chills, increasing redness or drainage from the incision
site, chest pain, shortness of breath or any other concerns.
2. Please follow up with your primary physician regarding this
admission and any new medications and refills.
3. Resume your home medications unless otherwise instructed.
4. You have been given medications for pain control. Please do
not drive, operate heavy machinery, or drink alcohol while
taking these medications. As your pain decreases, take fewer
tablets and increase the time between doses. This medication can
cause constipation, so you should drink plenty of water daily
and take a stool
softener (such as colace) as needed to prevent this side effect.

5. You may not drive a car until cleared to do so by your
surgeon or your primary physician.
6. Please keep your wounds clean. You may shower starting five
days after surgery, but no tub baths or swimming for at least
four weeks. No dressing is needed if wound continues to be
non-draining. Any stitches or staples that need to be removed
will be taken out by the visiting nurse or rehab facility two
weeks after your surgery.
7. Please call your surgeon's office to schedule or confirm your
follow-up appointment in four weeks.
8. Please DO NOT take any non-steroidal anti-inflammatory
medications (NSAIDs such as celebrex, ibuprofen, advil, aleve,
motrin, etc).
9. ANTICOAGULATION: Please continue your lovenox twice a day and
coumadin 7.5 until your INR is therapeutic to help prevent deep
vein thrombosis (blood clots). After your INR is therapeutic
([**3-2**]) you may stop lovenox injections.  Please follow up with
[**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 9449**] on Friday.
10. WOUND CARE: Please keep your incision clean and dry. It is
okay to shower five days after surgery but no tub baths,
swimming, or submerging your incision until after your four week
checkup. Please place a dry sterile dressing on the wound each
day if there is drainage, otherwise leave it open to air. Check
wound regularly for
signs of infection such as redness or thick yellow drainage.
Staples will be removed by the visiting nurse or rehab facility
in two weeks.
11. VNA (once at home): Home PT/OT, dressing changes as
instructed, wound checks, and staple removal at two weeks after
surgery.
12. ACTIVITY: Weight bearing as tolerated on the operative
extremity. posterior precautions.  mobilize frequently. No
strenuous exercise or heavy lifting until follow up appointment.
Physical Therapy:
post hip precautions
wbat
Treatments Frequency:
daily dressing changes as needed
ice as tolerated
staples out 2 weeks from surgery

Followup Instructions:
Provider: [**First Name11 (Name Pattern1) 177**] [**Initial (NamePattern1) **] [**Last Name (NamePattern4) 3260**], [**MD Number(3) 3261**]:[**Telephone/Fax (1) 1228**]
Date/Time:[**2101-12-9**] 12:40
Provider: [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] Phone:[**Telephone/Fax (1) 2422**] Date/Time:[**2101-12-1**]
10:20
Provider:  [**Name10 (NameIs) **] Phone:[**Telephone/Fax (1) 327**] Date/Time:[**2101-12-1**] 8:30



Completed by:[**2101-11-16**]
{'Osteoarthrosis, localized, not specified whether primary or secondary, pelvic region and thigh,Thrombocytopenia, unspecified,Chronic viral hepatitis B without mention of hepatic coma without mention of hepatitis delta,Primary hypercoagulable state,Herpes simplex without mention of complication,Cirrhosis of liver without mention of alcohol,Long-term (current) use of anticoagulants,Unspecified essential hypertension,Anemia, unspecified,Personal history of venous thrombosis and embolism'}


You are an AI assistant analyzing clinical admission notes from the MIMIC III dataset. Your task is to map symptoms mentioned in the notes to a list of provided ICD-9 LONG_TEXT.



### Clinical text :
CHIEF COMPLAINT: left hip arthritis

PRESENT ILLNESS: 64 y/o with OA of right hip,presents for surgical management of
pain. His hematology team was consulted for pre and post
operative care.

MEDICAL HISTORY: 1. Superior mesenteric vein thrombosis ([**4-/2095**]) secondary to
ATIII deficiency, on coumadin
2. macrocytosis/thrombocytopenia (thrombocytopenia and
macrocytosis were thought [**3-1**] liver disease from hepatitis B. He
was ruled out for myelodysplastic because his smear lacked
characteristic Pelger [**Last Name (un) 11605**] cells, ovalomacrocytes or microcytic
anemia)
3. Splenomegaly (per U/S in [**2100**])
4. hepatic cirrhosis (grade III/IV)
5. HTN on Naldolol
6. Esopageal varicies (An EGD done in [**2099-7-28**] showed grade 1
and 2 esophageal varicies)
7. Gall bladder polyps
8. Hepatitis B, unknown source of exposure(genotype D, with
precore and BCP mutations (basal core promoter mutation) on
tenofovir
9. Oral HSV on Valcyclovir
10. Hematuria-one episode as a childhood of unclear etiology
11. Colonic Adenoma [**2089**]--> s/p polypectomy. Repeat negative
colonoscopy in [**2094**].

MEDICATION ON ADMISSION: NADOLOL - 20 mg Tablet - one Tablet(s) by mouth daily
TENOFOVIR DISOPROXIL FUMARATE - 300 mg Tablet - 1 Tablet(s) by
mouth daily
VALACYCLOVIR - (Prescribed by Other Provider) - 500 mg Tablet -
1 Tablet(s) by mouth once a day
WARFARIN - 5 mg Tablet - 1-1.5 Tablet(s) by mouth once a day
Patient to take 7.5 mg daily 6 days per week and 5 mg daily 1
day
per week (Sunday).
Medications - OTC
GLUCOSAMINE SULFATE [GLUCOSAMINE] - (Prescribed by Other
Provider) - Dosage uncertain
OMEGA-3 FATTY ACIDS - (OTC) - Dosage uncertain

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: well appearing, well nourished 64 year old male
alert and oriented
no acute distress
LLE:
 -dressing-c/d/i
 -incision-c/d/i -> no erythema or drainage.  DIFFUSE ecchymosis
throughout entire LLE.  mild edema
 -+AT, FHL, [**Last Name (un) 938**]
 -SILT
 -brisk cap refill
 -calf-soft, nontender
 -NVI distally

FAMILY HISTORY: NC

SOCIAL HISTORY: NC 

### Response:
{'Osteoarthrosis, localized, not specified whether primary or secondary, pelvic region and thigh,Thrombocytopenia, unspecified,Chronic viral hepatitis B without mention of hepatic coma without mention of hepatitis delta,Primary hypercoagulable state,Herpes simplex without mention of complication,Cirrhosis of liver without mention of alcohol,Long-term (current) use of anticoagulants,Unspecified essential hypertension,Anemia, unspecified,Personal history of venous thrombosis and embolism'}
