CHIEF COMPLAINT: Subdural hematoma after mechanical fall.

PRESENT ILLNESS: 84-year old man with a history of atrial fibrillation on
Coumadin, CAD, decreased EF, PVD, CKD, and anemia, presented to
[**Hospital3 17921**] Center after mechanical fall. Around 4 AM on
[**2153-10-9**] while at home in [**Hospital3 **], he walked with his
walker into the bathroom. He states walker got caught on a rug
and he fell down, hitting the front of his head on the floor,
denies loss of consciousness. The pt called EMS himself and
taken to an outside hospital. His GCS was 15. His initial head
CT showed bilateral mixed density subdural hemorrhage 12 mm on R
and 11 mm on L with no evidence of midline shift and mild
bilateral uncal herniation with partial effacement of
supracellar cistern. Initial INR was > 7 and he was subsequently
transferred to the [**Hospital1 18**] for further care. In ED he was given
profilnine 2700 units, 2 units FFP and vitamin K 10 mg IV. No
h/o prior falls.

MEDICAL HISTORY: PMH:
Atrial fibrillation
CAD
Decreased EF
PVD
CKD
Anemia
Ostemoyelitis

MEDICATION ON ADMISSION: Carvedilol 3.125 mg [**Hospital1 **]
Niacin 500 mg
Coumadin 5 mg daily
Terazosin 1 mg qhs
Lasix 20 mg daily
Lisinopril 15 mg daily
Alendronate 70 mg q thurs

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: VS; 97.8  147/84  90  16  93% RA
Gen: NAD
Skin: superficial abrasion on forehead, bridge of nose with
ecchymoses as well as above upper lip.  Scant perioral dry
blood.
Superficial abrasion on bilateral knees.
CV: irregularly irregular, no murmurs
Pulm: CTA anteriorly
Abd: soft, NT, ND
Ext: no edema.  Lower left 2nd digit amputated.
Neuro:
Mental status: Awake and alert, cooperative with exam, normal
affect.
Orientation: Oriented to person, place, and date.
Language: Speech fluent with good comprehension and repetition.
Naming intact.
No L/R confusion or neglect.
Cranial Nerves:
I: Not tested
II: Pupils equally round and reactive to light 2.5mm-->2mm
bilaterally. Visual fields are full to confrontation.
III, IV, VI: Extraocular movements intact bilaterally without
nystagmus.
V, VII: Facial strength and sensation intact and symmetric.
VIII: Hearing intact to voice.
IX, X: Palatal elevation symmetrical.
[**Doctor First Name 81**]: Unable to assess [**1-22**] C-collar in place.
XII: Tongue midline without fasciculations.
Motor: Normal bulk and tone bilaterally. No abnormal movements,
tremors. No pronator drift.  Strength full power [**4-24**] in R and L
delt, bicep, tricep, WrE, FE, FF, IP, quad, ham, DF, PF.
Sensation: Intact to light touch throughout.
Reflexes: trace and symmetric throughout.  Downgoing toes.
Coordination: normal on finger-nose-finger bilaterally

FAMILY HISTORY: No family history of early MI, arrhythmia, cardiomyopathy, or
sudden cardiac death; otherwise non-contributory.

SOCIAL HISTORY: Lives in [**Hospital3 **]. Uses walker and fell the day before
admission. Denies current or past tobacco use. Rare alcohol use.
No history of illegal substance use. No recent travel. Lives in
[**Location 5450**] NH.
Subdural hemorrhage following injury without mention of open intracranial wound, with no loss of consciousness,Pneumonia, organism unspecified,Injury to bladder and urethra, without mention of open wound into cavity,Chronic combined systolic and diastolic heart failure,Paroxysmal ventricular tachycardia,Delirium due to conditions classified elsewhere,Urinary tract infection, site not specified,Other and unspecified coagulation defects,Fall from other slipping, tripping, or stumbling,Hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage I through stage IV, or unspecified,Chronic kidney disease, unspecified,Sympatholytics [antiadrenergics] causing adverse effects in therapeutic use,Coronary atherosclerosis of unspecified type of vessel, native or graft,Unspecified accident,Other specified retention of urine,Streptococcus infection in conditions classified elsewhere and of unspecified site, streptococcus, group D [Enterococcus],Peripheral vascular disease, unspecified,Aortocoronary bypass status,Hip joint replacement,Long-term (current) use of anticoagulants,Anemia in chronic kidney disease
Subdural hem w/o coma,Pneumonia, organism NOS,Bladder/urethra inj-clos,Chr syst/diastl hrt fail,Parox ventric tachycard,Delirium d/t other cond,Urin tract infection NOS,Coagulat defect NEC/NOS,Fall from slipping NEC,Hy kid NOS w cr kid I-IV,Chronic kidney dis NOS,Adv eff sympatholytics,Cor ath unsp vsl ntv/gft,Accident NOS,Oth spcf retention urine,Enterococcus group d,Periph vascular dis NOS,Aortocoronary bypass,Joint replaced hip,Long-term use anticoagul,Anemia in chr kidney dis
Admission Date:  [**2153-10-9**]              Discharge Date:   [**2153-10-17**]


Service: MEDICINE

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 1943**]
Chief Complaint:
Subdural hematoma after mechanical fall.

Major Surgical or Invasive Procedure:
None.

History of Present Illness:
84-year old man with a history of atrial fibrillation on
Coumadin, CAD, decreased EF, PVD, CKD, and anemia, presented to
[**Hospital3 17921**] Center after mechanical fall. Around 4 AM on
[**2153-10-9**] while at home in [**Hospital3 **], he walked with his
walker into the bathroom. He states walker got caught on a rug
and he fell down, hitting the front of his head on the floor,
denies loss of consciousness. The pt called EMS himself and
taken to an outside hospital. His GCS was 15. His initial head
CT showed bilateral mixed density subdural hemorrhage 12 mm on R
and 11 mm on L with no evidence of midline shift and mild
bilateral uncal herniation with partial effacement of
supracellar cistern. Initial INR was > 7 and he was subsequently
transferred to the [**Hospital1 18**] for further care. In ED he was given
profilnine 2700 units, 2 units FFP and vitamin K 10 mg IV. No
h/o prior falls.

Past Medical History:
PMH:
Atrial fibrillation
CAD
Decreased EF
PVD
CKD
Anemia
Ostemoyelitis

PSH:
CABG [**58**] years prior
TURP
Bilateral CEA
Bilateral total hip replacements
Bilateral cataracts
L foot 2nd digit amputation [**8-29**]

Social History:
Lives in [**Hospital3 **]. Uses walker and fell the day before
admission. Denies current or past tobacco use. Rare alcohol use.
No history of illegal substance use. No recent travel. Lives in
[**Location 5450**] NH.

Family History:
No family history of early MI, arrhythmia, cardiomyopathy, or
sudden cardiac death; otherwise non-contributory.

Physical Exam:
VS; 97.8  147/84  90  16  93% RA
Gen: NAD
Skin: superficial abrasion on forehead, bridge of nose with
ecchymoses as well as above upper lip.  Scant perioral dry
blood.
Superficial abrasion on bilateral knees.
CV: irregularly irregular, no murmurs
Pulm: CTA anteriorly
Abd: soft, NT, ND
Ext: no edema.  Lower left 2nd digit amputated.
Neuro:
Mental status: Awake and alert, cooperative with exam, normal
affect.
Orientation: Oriented to person, place, and date.
Language: Speech fluent with good comprehension and repetition.
Naming intact.
No L/R confusion or neglect.
Cranial Nerves:
I: Not tested
II: Pupils equally round and reactive to light 2.5mm-->2mm
bilaterally. Visual fields are full to confrontation.
III, IV, VI: Extraocular movements intact bilaterally without
nystagmus.
V, VII: Facial strength and sensation intact and symmetric.
VIII: Hearing intact to voice.
IX, X: Palatal elevation symmetrical.
[**Doctor First Name 81**]: Unable to assess [**1-22**] C-collar in place.
XII: Tongue midline without fasciculations.
Motor: Normal bulk and tone bilaterally. No abnormal movements,
tremors. No pronator drift.  Strength full power [**4-24**] in R and L
delt, bicep, tricep, WrE, FE, FF, IP, quad, ham, DF, PF.
Sensation: Intact to light touch throughout.
Reflexes: trace and symmetric throughout.  Downgoing toes.
Coordination: normal on finger-nose-finger bilaterally

Pertinent Results:
Blood:
[**2153-10-9**] 07:15AM BLOOD WBC-11.0 RBC-3.66* Hgb-11.8* Hct-35.1*
MCV-96 MCH-32.3* MCHC-33.6 RDW-13.8 Plt Ct-272
[**2153-10-9**] Neuts-68.0 Lymphs-24.3 Monos-3.4 Eos-3.9 Baso-0.3
[**2153-10-13**] PT-13.3 PTT-25.7 INR(PT)-1.1
[**2153-10-9**] PT-15.2* PTT-27.9 INR(PT)-1.3*
[**2153-10-9**] PT-58.8* PTT-38.0* INR(PT)-6.6*
[**2153-10-9**] Glucose-150* UreaN-28* Creat-1.5* Na-140 K-4.9 Cl-102
HCO3-29 AnGap-14
[**2153-10-12**] ALT-12 AST-22 LD(LDH)-242 AlkPhos-62 TotBili-0.6
[**2153-10-10**] Calcium-8.4 Phos-2.7 Mg-2.2

Urine:
[**2153-10-12**] URINE Color-Yellow Appear-Hazy Sp [**Last Name (un) **]-1.020
[**2153-10-12**] URINE Blood-LG Nitrite-NEG Protein-100 Glucose-NEG
Ketone-NEG Bilirub-NEG Urobiln-2* pH-5.5 Leuks-SM
[**2153-10-12**] URINE RBC-261* WBC-15* Bacteri-FEW Yeast-FEW Epi-0
[**2153-10-12**] URINE Hours-RANDOM UreaN-1033 Creat-170 Na-57
[**2153-10-12**] URINE Osmolal-648

Microbiology:
MRSA screen [**2153-10-9**]: negative
Urine culture [**2153-10-14**]: Enterococcus (resistant to
Tetracyclines)

Reports:
Echocardiogram, transthoracic [**2153-10-11**]:
IMPRESSION: Mild symmetric left ventricular hypertrophy with
severe systolic and diastolic dysfunction. Moderate aortic
stenosis. Moderate pulmonary artery hypertension.

CT head w/o contrast [**2153-10-9**] 7:38 a.m.: 1. Extensive
bihemispheric subdural hematoma with hypodense and hyperdense
components, the duration/chronicity of the hematoma cannot be
accurately assessed on the CT study. An MRI, if clinically
indicated, can be done to appropirately date the collections.
Findings are stable since the prior study at OSH.
2. A left frontal lenticular shaped hemorrhage with a
fluid-fluid level, could represent an epidural hematoma, albeit
atypical given location, and lack of fracture.
3. No evidence of intraparenchymal/intraventricular hemorrhage.


CT head w/o contrast [**2153-10-12**]: Overall, minimal change with
redemonstration of extensive bilateral subdural blood.

Brief Hospital Course:
1. Subdural hematoma: The patient initially presented to
[**Hospital3 17921**] Center, where he was found to have bilateral
subdural hematoma with no midline shift but with mild uncal
herniation and partial effacement of supracellar cistern. His
INR was >7 at the time. The patient was transferred to [**Hospital1 18**] for
further management. In the emergency department, his
anticoagulation was reversed with profilnine 2700 units, 2 units
FFP and 10 mg IV Vitamin K. Hydralazine was used to maintain
SBP<140, along with the patient's home carvedilol, terazosin,
and lisinopril. Carvedilol was later discontinued and metoprolol
initiated in the setting of bradycardia (see below). The patient
was monitored by serial neurologic examination and repeat head
CTs. The patient should remain off of Coumadin for at least 4
weeks, and may NOT restart Coumadin until he has been
reevaluated by neurosurgery. The patient will be reevaluated by
neurosurgery in 4 weeks, at which time he will have repeat head
CT. Per neurosurgery, he could start aspirin or subcutaneous
heparin in 1 week, but only if absolutely required.

2. Sinus bradycardia: In the intensive care unit, the patient
had an episode of bradycardia to 20 while sleeping. Blood
pressure and other VS remained stable. The patient's bradycardia
could be related to carvedilol (which he was taking at his home
dose), to his known subdural hematoma, or possible to sleep
apnea and urinary retention. The cardiology service was
consulted and recommended changing carvedilol to metoprolol. He
was seen by Dr. [**First Name8 (NamePattern2) **] [**Name (STitle) **] who did not recommend pacemaker.

3. Non-sustained ventricular tachycardia: After discontinuing
carvedilol, the patient had a 20-beat run of NSVT during which
he was asymptomatic. He was evaluated by cardiology, who
recommended metoprolol and repeat echocardiogram. The
echocardiogram showed systolic and diastolic dysfunction, with
LV EF 30%.

4. Paroxysmal atrial fibrillation: The patient was on warfarin
for PAF. His warfarin was held and his anticoagulation reversed
for subdural hematoma, as above. Per neurosurgery, he needs to
remains off of Coumadin for at least 4 weeks and until
reevaluated by neurosurgery (see above).

5. Chronic systolic and diastolic heart failure: The patient's
cardiac function was evaluated by echocardiogram, which showed
systolic and diastolic dysfunction, with LV EF 30%. Initially,
he was treated with his home regimen of Coreg and lisinopril,
with furosemide held. On [**2153-10-10**], carvedilol was discontinued
in the setting of sinus bradycardia and metoprolol was
initiated. On [**2153-10-10**], furosemide was resumed at the patient's
home dose of 20 mg PO daily, and lisinopril was uptitrated to 20
mg daily.

6. Foley catheter trauma: Patient had a Foley placed in the
Neuro-ICU. Then he pulled out his Foley catheter on [**2153-10-12**],
resulting in frank macroscopic hematuria without clots and
urinary retention with bladder scan >500 cc. We placed Foley
catheter and had urology evaluate him. He pulled catheter
multiple times and required restraints (Pt was delirius at the
time just after ICU). Urine is now clear. We started Flomax and
the plan is voiding trial in a week and replace Foley with
urology follow up if still unable to void. To get an appointment
can call: ([**Telephone/Fax (1) 772**].

7. Delirum: Patient had delirium after ICU stay. It was thought
to be secondarely to subdural hematomas, urinary retention and
ICU. Infectious work up showed very tiny pneumonia and
indeterminate UA, but urine culture grew enterococcus ampicillin
sensitive. Therefore, we started a 7-day course of ampicillin.
Remaining infetious work up was unclear. Currently he waxes and
wanes and is slowly improving. We will continue antibiotics and
re-orienting him. Avoiding narcotics and benzodiacepines.

Medications on Admission:
Carvedilol 3.125 mg [**Hospital1 **]
Niacin 500 mg
Coumadin 5 mg daily
Terazosin 1 mg qhs
Lasix 20 mg daily
Lisinopril 15 mg daily
Alendronate 70 mg q thurs

Discharge Medications:
1. Appointment
[**11-22**] at 1:30 for the CT and 2pm for the office
appointment. Provider: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) 8364**], MD Phone:[**Telephone/Fax (1) 1669**]
Date/Time:[**2153-11-22**] 2:00 Please call [**Telephone/Fax (1) 3231**] for any
concerns.
2. Niacin 500 mg Capsule, Sustained Release Sig: One (1)
Capsule, Sustained Release PO BID (2 times a day).
3. Terazosin 1 mg Capsule Sig: One (1) Capsule PO HS (at
bedtime).
4. Alendronate 70 mg Tablet Sig: One (1) Tablet PO QTHUR (every
Thursday).
5. Acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q4H (every
4 hours) as needed for pain or T>100.4.
6. Calcium Carbonate 500 mg Tablet, Chewable Sig: One (1)
Tablet, Chewable PO BID (2 times a day).
7. Lisinopril 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).

8. Furosemide 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).

9. Cholecalciferol (Vitamin D3) 400 unit Tablet Sig: Five (5)
Tablet PO DAILY (Daily).
10. Toprol XL 50 mg Tablet Sustained Release 24 hr Sig: Three
(3) Tablet Sustained Release 24 hr PO once a day.
11. Senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a
day).
12. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID
(2 times a day).
13. Ampicillin 500 mg Capsule Sig: One (1) Capsule PO every six
(6) hours for 5 days.
14. Urine
Voiding trial 1 week from now and re-place Foley if fails.


Discharge Disposition:
Extended Care

Facility:
[**Hospital **] Care

Discharge Diagnosis:
Primary:
1. Subdural hematoma
2. Coagulopathy secondary to warfarin therapy
3. Chronic systolic and diastolic congestive heart failure
4. Sinus bradycardia
5. Non-sustained ventricular tachycardia
6. Paroxysmal atrial fibrillation
7. Genitourinary trauma from Foley catheter

Secondary:
1. Chronic anemia
2. Chronic kidney disease

Discharge Condition:
Stable, unsteady in feet, on atrial fibrillation rate
controlled. Tolerating diet with assistance and eating at 90
degrees.

Discharge Instructions:
You came to the hospital after falling at home and were found to
have a subdural hematoma and a very high level of
anticoagulation. You warfarin was held and your anticoagulation
was reversed. You may NOT resume warfarin for at least 4 weeks,
and you may NOT resume warfarin until told to do so by your
neurosurgeons. You will follow up with Dr. [**First Name (STitle) **] (neurosurgery)
in 4 weeks. At that time, you will need to have another head CT
(see below).

In the intensive care unit, you were observed to have a very low
heart rate. For this reason, your Coreg was discontinued, and
you were started on a new medicine called metoprolol. It was
thought that it was secondary to the bleeding in your head,
urinary retention, sleep and possibly sleep apnea. You will need
outpatient follow up with sleep study.

Return to the hospital for changes in mental status, visual
changes, weakness, tingling, numbness, chest pain, difficulty
breathing, or any other symptom that is concerning to you.

Followup Instructions:
You will need to see Dr. [**First Name (STitle) **] for the diagnosis of subdural
hematoma. You will need a CT of the head without contrast before
this appointment. We have made an appointment for you on
[**11-22**] at 1:30 for the CT and 2pm for the office
appointment. Please call [**Telephone/Fax (1) 3231**] for any concerns. Then you
will see Dr. [**First Name (STitle) **] at 2:00. Provider: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) 8364**], MD
Phone:[**Telephone/Fax (1) 1669**] Date/Time:[**2153-11-22**] 2:00

You should stay off anticoagulation fo at least 4 weeks. In 1
week you could potentially start aspirin or subcutaneous heparin
only if extremely needed and directed to do so by your doctors.


Completed by:[**2153-10-18**]
{'Subdural hemorrhage following injury without mention of open intracranial wound, with no loss of consciousness,Pneumonia, organism unspecified,Injury to bladder and urethra, without mention of open wound into cavity,Chronic combined systolic and diastolic heart failure,Paroxysmal ventricular tachycardia,Delirium due to conditions classified elsewhere,Urinary tract infection, site not specified,Other and unspecified coagulation defects,Fall from other slipping, tripping, or stumbling,Hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage I through stage IV, or unspecified,Chronic kidney disease, unspecified,Sympatholytics [antiadrenergics] causing adverse effects in therapeutic use,Coronary atherosclerosis of unspecified type of vessel, native or graft,Unspecified accident,Other specified retention of urine,Streptococcus infection in conditions classified elsewhere and of unspecified site, streptococcus, group D [Enterococcus],Peripheral vascular disease, unspecified,Aortocoronary bypass status,Hip joint replacement,Long-term (current) use of anticoagulants,Anemia in chronic kidney disease'}


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: Subdural hematoma after mechanical fall.

PRESENT ILLNESS: 84-year old man with a history of atrial fibrillation on
Coumadin, CAD, decreased EF, PVD, CKD, and anemia, presented to
[**Hospital3 17921**] Center after mechanical fall. Around 4 AM on
[**2153-10-9**] while at home in [**Hospital3 **], he walked with his
walker into the bathroom. He states walker got caught on a rug
and he fell down, hitting the front of his head on the floor,
denies loss of consciousness. The pt called EMS himself and
taken to an outside hospital. His GCS was 15. His initial head
CT showed bilateral mixed density subdural hemorrhage 12 mm on R
and 11 mm on L with no evidence of midline shift and mild
bilateral uncal herniation with partial effacement of
supracellar cistern. Initial INR was > 7 and he was subsequently
transferred to the [**Hospital1 18**] for further care. In ED he was given
profilnine 2700 units, 2 units FFP and vitamin K 10 mg IV. No
h/o prior falls.

MEDICAL HISTORY: PMH:
Atrial fibrillation
CAD
Decreased EF
PVD
CKD
Anemia
Ostemoyelitis

MEDICATION ON ADMISSION: Carvedilol 3.125 mg [**Hospital1 **]
Niacin 500 mg
Coumadin 5 mg daily
Terazosin 1 mg qhs
Lasix 20 mg daily
Lisinopril 15 mg daily
Alendronate 70 mg q thurs

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: VS; 97.8  147/84  90  16  93% RA
Gen: NAD
Skin: superficial abrasion on forehead, bridge of nose with
ecchymoses as well as above upper lip.  Scant perioral dry
blood.
Superficial abrasion on bilateral knees.
CV: irregularly irregular, no murmurs
Pulm: CTA anteriorly
Abd: soft, NT, ND
Ext: no edema.  Lower left 2nd digit amputated.
Neuro:
Mental status: Awake and alert, cooperative with exam, normal
affect.
Orientation: Oriented to person, place, and date.
Language: Speech fluent with good comprehension and repetition.
Naming intact.
No L/R confusion or neglect.
Cranial Nerves:
I: Not tested
II: Pupils equally round and reactive to light 2.5mm-->2mm
bilaterally. Visual fields are full to confrontation.
III, IV, VI: Extraocular movements intact bilaterally without
nystagmus.
V, VII: Facial strength and sensation intact and symmetric.
VIII: Hearing intact to voice.
IX, X: Palatal elevation symmetrical.
[**Doctor First Name 81**]: Unable to assess [**1-22**] C-collar in place.
XII: Tongue midline without fasciculations.
Motor: Normal bulk and tone bilaterally. No abnormal movements,
tremors. No pronator drift.  Strength full power [**4-24**] in R and L
delt, bicep, tricep, WrE, FE, FF, IP, quad, ham, DF, PF.
Sensation: Intact to light touch throughout.
Reflexes: trace and symmetric throughout.  Downgoing toes.
Coordination: normal on finger-nose-finger bilaterally

FAMILY HISTORY: No family history of early MI, arrhythmia, cardiomyopathy, or
sudden cardiac death; otherwise non-contributory.

SOCIAL HISTORY: Lives in [**Hospital3 **]. Uses walker and fell the day before
admission. Denies current or past tobacco use. Rare alcohol use.
No history of illegal substance use. No recent travel. Lives in
[**Location 5450**] NH. 

### Response:
{'Subdural hemorrhage following injury without mention of open intracranial wound, with no loss of consciousness,Pneumonia, organism unspecified,Injury to bladder and urethra, without mention of open wound into cavity,Chronic combined systolic and diastolic heart failure,Paroxysmal ventricular tachycardia,Delirium due to conditions classified elsewhere,Urinary tract infection, site not specified,Other and unspecified coagulation defects,Fall from other slipping, tripping, or stumbling,Hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage I through stage IV, or unspecified,Chronic kidney disease, unspecified,Sympatholytics [antiadrenergics] causing adverse effects in therapeutic use,Coronary atherosclerosis of unspecified type of vessel, native or graft,Unspecified accident,Other specified retention of urine,Streptococcus infection in conditions classified elsewhere and of unspecified site, streptococcus, group D [Enterococcus],Peripheral vascular disease, unspecified,Aortocoronary bypass status,Hip joint replacement,Long-term (current) use of anticoagulants,Anemia in chronic kidney disease'}
