feature:

Full SOFA Score: Data Layer + Scoring Engine Glasgow Coma Scale: Data Layer + Scoring Engine
2026-06-21 01:09:50 +08:00
parent 78c043e4d3
commit 93ea473d2b
62 changed files with 7133 additions and 72 deletions
@@ -0,0 +1,90 @@
+using Microsoft.EntityFrameworkCore;
+using Microsoft.Extensions.Options;
+using StackExchange.Redis;
+using System.Text.Json;
+
+public class SofaVasopressorResolver
+{
+    private static readonly HashSet<string> VasopressorDrugs = new(StringComparer.OrdinalIgnoreCase)
+    {
+        "DOPAMINE", "DOBUTAMINE", "EPINEPHRINE", "NOREPINEPHRINE",
+        "VASOPRESSIN", "PHENYLEPHRINE"
+    };
+
+    private static readonly JsonSerializerOptions JsonOptions = new()
+    {
+        PropertyNamingPolicy = JsonNamingPolicy.CamelCase,
+        PropertyNameCaseInsensitive = true
+    };
+
+    private readonly AppDbContext _db;
+    private readonly IConnectionMultiplexer _redis;
+    private readonly SofaOptions _options;
+
+    public SofaVasopressorResolver(
+        AppDbContext db,
+        IConnectionMultiplexer redis,
+        IOptions<SofaOptions> options)
+    {
+        _db = db;
+        _redis = redis;
+        _options = options.Value;
+    }
+
+    public static string VasopressorCacheKey(Guid encounterId) =>
+        $"sofa:{encounterId}:vasopressor";
+
+    public async Task CacheFromAdministrationAsync(MedicationAdministration med, CancellationToken ct)
+    {
+        if (!VasopressorDrugs.Contains(med.DrugName)) return;
+
+        var info = new VasopressorInfo(med.DrugName, NormalizeDose(med.DrugName, med.Dose, med.DoseUnit));
+        var json = JsonSerializer.Serialize(new
+        {
+            info.DrugName,
+            info.DoseUgKgMin,
+            med.AdministeredAt
+        }, JsonOptions);
+
+        await _redis.GetDatabase().StringSetAsync(
+            VasopressorCacheKey(med.EncounterId),
+            json,
+            TimeSpan.FromHours(_options.VasopressorWindowHours));
+    }
+
+    public async Task<VasopressorInfo?> GetActiveVasopressorAsync(
+        Guid encounterId, CancellationToken ct)
+    {
+        var cached = await _redis.GetDatabase()
+            .StringGetAsync(VasopressorCacheKey(encounterId));
+        if (cached.HasValue)
+        {
+            using var doc = JsonDocument.Parse((string)cached!);
+            var root = doc.RootElement;
+            return new VasopressorInfo(
+                root.GetProperty("drugName").GetString()!,
+                root.GetProperty("doseUgKgMin").GetDecimal());
+        }
+
+        var since = DateTimeOffset.UtcNow.AddHours(-_options.VasopressorWindowHours);
+        var med = await _db.MedicationAdministrations
+            .AsNoTracking()
+            .Where(m => m.EncounterId == encounterId
+                     && VasopressorDrugs.Contains(m.DrugName)
+                     && m.AdministeredAt >= since)
+            .OrderByDescending(m => m.AdministeredAt)
+            .FirstOrDefaultAsync(ct);
+
+        if (med is null) return null;
+        return new VasopressorInfo(med.DrugName, NormalizeDose(med.DrugName, med.Dose, med.DoseUnit));
+    }
+
+    private static decimal NormalizeDose(string drug, decimal dose, string unit) =>
+        unit.ToLowerInvariant() switch
+        {
+            "mcg/kg/min" or "µg/kg/min" => dose,
+            "mcg/min" or "µg/min"       => dose / 70m,
+            "mg/hr"                      => dose * 1000m / 60m / 70m,
+            _                            => dose
+        };
+}