@extends('layouts.app') @section('title', 'Inpatient Case Summary | ' . ($admission->patient->full_name ?? '')) @section('styles') @endsection @section('content') @php $patient = $admission->patient; $visit = $admission->visit; $consultation = $visit?->consultation; $triage = $visit?->triage; $labOrders = $visit?->labOrders ?? collect(); $imagingReqs = $visit?->imagingRequests ?? collect(); $prescriptions = $visit?->prescriptions ?? collect(); $invoice = $visit?->invoice; $isDischarged = $admission->status === 'discharged'; // ── Diagnosis: "whichever has been added" ────────────────────── // Structured ICD-10 (if a consultation exists on the linked encounter), // plus the admission's own free-text fields. Preference for the // headline: discharge (final) → admission (provisional) → ICD-10. $structuredDx = $consultation ? trim($consultation->formatted_diagnosis) : ''; $admitDx = trim($admission->diagnosis_on_admission ?? ''); $dischargeDx = trim($admission->discharge_diagnosis ?? ''); if ($dischargeDx !== '') { $primaryDx = $dischargeDx; $primaryDxLabel = 'Discharge (Final) Diagnosis'; } elseif ($admitDx !== '') { $primaryDx = $admitDx; $primaryDxLabel = 'Admission Diagnosis'; } elseif ($structuredDx !== '') { $primaryDx = $structuredDx; $primaryDxLabel = 'Diagnosis (ICD-10)'; } else { $primaryDx = ''; $primaryDxLabel = 'Diagnosis'; } // Vitals (latest triage on the linked encounter), only populated fields. $vitals = []; if ($triage) { if ($triage->blood_pressure_systolic && $triage->blood_pressure_diastolic) { $vitals[] = ['BP', $triage->blood_pressure_systolic . '/' . $triage->blood_pressure_diastolic . ' mmHg']; } if ($triage->pulse) $vitals[] = ['Pulse', $triage->pulse . ' bpm']; if ($triage->temperature) $vitals[] = ['Temp', $triage->temperature . '°C']; if ($triage->respiratory_rate) $vitals[] = ['RR', $triage->respiratory_rate . '/min']; if ($triage->oxygen_saturation) $vitals[] = ['SpO₂', $triage->oxygen_saturation . '%']; if ($triage->weight) $vitals[] = ['Wt', $triage->weight . ' kg']; } $admissionCode = 'IPD-' . str_pad((string) $admission->id, 6, '0', STR_PAD_LEFT); $payerLabel = match($invoice?->payment_mode) { 'insurance' => $invoice?->insuranceCompany?->name ?? 'Insurance', 'corporate' => 'Corporate', 'cash' => 'Cash', 'mpesa' => 'M-Pesa', 'bank_transfer' => 'Bank Transfer', 'waiver' => 'Waiver', default => ucfirst($invoice?->payment_mode ?? '—'), }; @endphp
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Inpatient Case Summary | {{ $patient->full_name ?? '' }}

@include('partials._document-header') {{-- Title --}}

Inpatient Case Summary

{{-- PATIENT IDENTITY --}}
Name:{{ $patient->full_name ?? '' }} MRN:{{ $patient->mrn ?? '' }} Sex:{{ ucfirst($patient->gender ?? '—') }} Age:{{ $patient->age ?? '—' }}
{{-- ADMISSION FACTS --}}
Admission:{{ $admissionCode }} Ward:{{ $admission->ward->name ?? '—' }} Bed:{{ $admission->bed->bed_number ?? '—' }} LOS:{{ $admission->length_of_stay }} day(s)
Admitted:{{ $admission->admission_date?->format('d M Y H:i') ?? '—' }} Discharged:{{ $admission->discharge_date?->format('d M Y H:i') ?? 'Still admitted' }} Clinician:{{ $admission->clinician->name ?? '—' }}
{{-- VITALS --}} @if(count($vitals))
@foreach($vitals as $i => $v) @if($i > 0)·@endif {{ $v[0] }}: {{ $v[1] }} @endforeach
@endif {{-- REASON FOR ADMISSION --}} @if($admission->reason)

Reason for Admission

{{ $admission->reason }}

@endif {{-- DIAGNOSIS — whichever has been recorded --}}

{{ $primaryDxLabel }}

{{ $primaryDx ?: '—' }}

{{-- If both free-text diagnoses exist, show the admission one as context under the final --}} @if($dischargeDx !== '' && $admitDx !== '')
Admission diagnosis: {{ $admitDx }}
@endif {{-- Surface structured ICD-10 codes when the headline came from free text --}} @if($structuredDx !== '' && $primaryDx !== $structuredDx)
ICD-10: {{ $structuredDx }}
@endif
{{-- INVESTIGATIONS — labs + imaging --}} @php $hasInvestigations = $labOrders->count() > 0 || $imagingReqs->count() > 0; @endphp @if($hasInvestigations)

Investigations & Results

@foreach($labOrders as $lab) @endforeach @foreach($imagingReqs as $img) @endforeach
Type Test / Study Result / Findings
Lab {{ $lab->test_name }} {{ $lab->result ? 'Results Attached' : 'Pending' }}
Imaging {{ $img->imaging_type }} @if($img->body_part)
{{ $img->body_part }}
@endif 		{{ $img->report ? 'Report Attached' : 'Pending' }}
@endif {{-- TREATMENT (prescriptions on the encounter) --}} @if($prescriptions->count())

Treatment / Medications

@foreach($prescriptions as $rx) @endforeach
Medication Dose Route Frequency Duration
{{ $rx->drug_name }} {{ $rx->dosage ?? '—' }} {{ $rx->route ?? '—' }} {{ $rx->frequency ?? '—' }} {{ $rx->duration ?? '—' }}
@endif {{-- DAILY WARD ROUND NOTES --}} @php $wardNotes = $admission->nursingNotes->sortBy('created_at'); $notesByDay = $wardNotes->groupBy(fn($n) => $n->created_at->toDateString()); $vitalMap = ['bp'=>'BP','pulse'=>'Pulse','temp'=>'Temp','spo2'=>'SpO₂','rr'=>'RR','weight'=>'Wt','rbs'=>'RBS']; @endphp @if($wardNotes->count())

Daily Ward Round Notes

@foreach($notesByDay as $day => $dayNotes)
{{ \Carbon\Carbon::parse($day)->format('l, d M Y') }} · Day {{ (int) $admission->admission_date->copy()->startOfDay()->diffInDays(\Carbon\Carbon::parse($day)->startOfDay(), true) + 1 }}
@foreach($dayNotes as $note)
{{ ucfirst(str_replace('_', ' ', $note->note_type ?? 'note')) }} · {{ $note->created_at->format('H:i') }} · {{ $note->nurse->name ?? 'Unknown' }}
@php $nv = is_array($note->vitals) ? array_filter($note->vitals) : []; @endphp @if(count($nv))
@foreach($vitalMap as $k => $lbl) @if(!empty($note->vitals[$k])){{ $lbl }}: {{ $note->vitals[$k] }}@endif @endforeach
@endif
{{ $note->content }}
@endforeach
@endforeach
@endif {{-- DISCHARGE DETAILS — only once discharged --}} @if($isDischarged && ($admission->condition_on_discharge || $admission->discharge_instructions || $admission->follow_up_plan || $admission->discharge_summary))

Discharge Details

@php $parts = []; if ($admission->condition_on_discharge) $parts[] = 'Condition on discharge: ' . $admission->condition_on_discharge; if ($admission->discharge_summary) $parts[] = $admission->discharge_summary; if ($admission->discharge_instructions) $parts[] = 'Instructions: ' . $admission->discharge_instructions; if ($admission->follow_up_plan) $parts[] = 'Follow-up: ' . $admission->follow_up_plan; echo e(implode("\n", $parts)); @endphp

@endif {{-- BILLING STRIP --}} @if($invoice)
Bill Total: KES {{ number_format($invoice->total_amount ?? 0) }} Paid: KES {{ number_format($invoice->amount_paid ?? 0) }} Balance: KES {{ number_format($invoice->balance ?? 0) }} Payer: {{ $payerLabel }}
@endif {{-- SIGNATURE + STAMP --}}
Clinician Signature
{{ $admission->clinician->name ?? '—' }}
{{ now()->format('d M Y H:i') }}
Official Stamp
Hospital Stamp
@include('partials._document-footer')
@endsection