feature: qSOFA Scoring & Sepsis Bundle Compliance

2026-06-18 22:52:43 +08:00
parent 3c54feb38a
commit 4b46c09f90
34 changed files with 2351 additions and 18 deletions
@@ -47,10 +47,12 @@ public class EsIndexerService : BackgroundService
        {
            _kafkaOptions.Topics.ObservationRecorded,
            _kafkaOptions.Topics.AlertGenerated,
-            _kafkaOptions.Topics.EncounterStatusChanged
+            _kafkaOptions.Topics.EncounterStatusChanged,
+            _kafkaOptions.Topics.SepsisBundleCreated,
+            _kafkaOptions.Topics.SepsisBundleUpdated
        });

-        _logger.LogInformation("EsIndexerService started. Subscribed to 3 topics.");
+        _logger.LogInformation("EsIndexerService started. Subscribed to 5 topics.");

        try
        {
@@ -91,6 +93,10 @@ public class EsIndexerService : BackgroundService
            HandleObservationRecordedAsync(payload, ct),
        var t when t == _kafkaOptions.Topics.AlertGenerated =>
            HandleAlertGeneratedAsync(payload, ct),
+        var t when t == _kafkaOptions.Topics.SepsisBundleCreated =>
+            HandleSepsisBundleEventAsync(payload, ct),
+        var t when t == _kafkaOptions.Topics.SepsisBundleUpdated =>
+            HandleSepsisBundleEventAsync(payload, ct),
        _ => Task.CompletedTask
    };

@@ -260,4 +266,63 @@ public class EsIndexerService : BackgroundService
            _logger.LogWarning(
                "Could not update patient_encounters for alert on encounter {Id}", evt.EncounterId);
    }
+
+    // --- sepsis.bundle.created / sepsis.bundle.updated ---
+    // Denormalizes bundle status onto the patient_encounters document so department
+    // acuity dashboards can filter/sort by sepsis bundle compliance state.
+    private async Task HandleSepsisBundleEventAsync(string payload, CancellationToken ct)
+    {
+        using var doc = JsonDocument.Parse(payload);
+        var root = doc.RootElement;
+
+        var encounterId = root.GetProperty("encounterId").GetString()!;
+        var complianceStatus = root.TryGetProperty("complianceStatus", out var cs)
+            ? cs.GetString() ?? "IN_PROGRESS"
+            : "IN_PROGRESS";
+        var deadlineAt = root.TryGetProperty("deadlineAt", out var dl) ? dl.GetString() : null;
+
+        var scriptLines = new List<string>
+        {
+            "ctx._source.sepsisBundleStatus = params.status",
+            "ctx._source.sepsisBundleDeadlineAt = params.deadlineAt"
+        };
+
+        var scriptParams = new Dictionary<string, object?>
+        {
+            ["status"] = complianceStatus,
+            ["deadlineAt"] = deadlineAt
+        };
+
+        if (root.TryGetProperty("elementStatus", out _))
+        {
+            scriptLines.Add("ctx._source.sepsisBundleElementsCompleted = params.elementsCompleted");
+            scriptParams["elementsCompleted"] = root.TryGetProperty("elementsCompleted", out var ec)
+                ? ec.GetInt32()
+                : (complianceStatus is "COMPLIANT" or "NON_COMPLIANT" ? 4 : 0);
+        }
+        else
+        {
+            scriptLines.Add("ctx._source.sepsisBundleElementsCompleted = 0");
+        }
+
+        var updateResp = await _elastic.UpdateAsync<PatientEncounterDocument, object>(
+            _esOptions.Indices.PatientEncounters,
+            encounterId,
+            u => u
+                .Script(new Script(new InlineScript
+                {
+                    Source = string.Join(";\n", scriptLines),
+                    Language = ScriptLanguage.Painless,
+                    Params = scriptParams!
+                }))
+                .RetryOnConflict(3),
+            ct);
+
+        if (!updateResp.IsValidResponse && updateResp.Result != Result.NotFound)
+            _logger.LogWarning(
+                "Could not update patient_encounters bundle status for encounter {Id}", encounterId);
+
+        _logger.LogDebug("Updated patient_encounters bundle status for encounter {Id} → {Status}",
+            encounterId, complianceStatus);
+    }
 }