Neurology · LIVE

ASTRAL score

ASTRAL

Compute the Ntaios 2012 ASTRAL integer score (Age, Severity NIHSS, Time delay, Range of visual fields, Acute glucose, Level of consciousness) for 3-month mRS >2 after acute ischemic stroke.

LIVE $0.005 USDC GET /api/calc/astral

Markdown: /docs/astral.md · Canonical: https://magentlab.com/docs/astral

Not a medical device. Not a diagnosis, dose, or listing recommendation.

What it computes

Compute the Ntaios 2012 ASTRAL integer score (Age, Severity NIHSS, Time delay, Range of visual fields, Acute glucose, Level of consciousness) for 3-month mRS >2 after acute ischemic stroke.

When to use

When an agent has caller-assigned NIHSS, onset-to-admission delay, visual fields, glucose, and consciousness and needs the published ASTRAL total and the score-31 50% unfavorable grouping, without inventing NIHSS or unofficial outcome percents.

When not to use

• Not a medical device and not a tPA, thrombolysis, or endovascular treatment decision.
• Derived in previously independent acute ischemic stroke (ASTRAL registry, Ntaios 2012). It is not a recommendation for or against reperfusion.
• The caller assigns NIHSS (0-42), visual field defect, impaired consciousness (NIHSS item 1a >0), onset-to-admission >180 min, and glucose. magent does not examine the patient or compute NIHSS.
• Age is 1 point per 5 years (integer division), not age in years. Delay scores 2 only if onset-to-admission is greater than 180 min (180 does not). Glucose scores 1 if <3.7 or >7.3 mmol/L (3.7 and 7.3 do not).
• Score 31 indicates a 50% likelihood of 3-month mRS >2 in Ntaios 2012. magent does not return unofficial per-score percentages.
• This is the stroke ASTRAL score, not an astronomical catalog.

Formula

ASTRAL = age (1 per 5 years) + NIHSS + 2 if onset-to-admission >180 min + 2 if visual field defect + 1 if glucose <3.7 or >7.3 mmol/L + 3 if impaired consciousness; Ntaios 2012; 3-month mRS >2 is 50% at score 31

Citation

Title

An integer-based score to predict functional outcome in acute ischemic stroke: the ASTRAL score

Authors

Ntaios G, Faouzi M, Ferrari J, Lang W, Vemmos K, Michel P

Source

Neurology. 2012;78(24):1916-1922

DOI

10.1212/WNL.0b013e318259e221

Worked example

Also searched as

• ASTRAL score
• Acute Stroke Registry and Analysis of Lausanne
• Ntaios ASTRAL
• ischemic stroke ASTRAL
• ASTRAL NIHSS glucose
• 3-month mRS ASTRAL
• Ntaios 2012 ASTRAL

Try

Opens the live endpoint. Unpaid browser requests show the paywall; agents should send Accept: application/json.

/api/calc/astral?age=40&nihss=0&delay_gt_180=false&visual_field_defect=false&glucose_mmol_l=6.0&loc_impaired=false

Full URL: https://api.magentlab.com/api/calc/astral?age=40&nihss=0&delay_gt_180=false&visual_field_defect=false&glucose_mmol_l=6.0&loc_impaired=false

Call

Expect HTTP 402 until you retry with PAYMENT-SIGNATURE. Incomplete query params return HTTP 400 before any quote or charge.

curl -i -H "Accept: application/json" "https://api.magentlab.com/api/calc/astral?age=40&nihss=0&delay_gt_180=false&visual_field_defect=false&glucose_mmol_l=6.0&loc_impaired=false"

Parameters

Bulk (POST)

POST the same path with a JSON items array. The first item is the GET unit; each additional item is $0.002. Invalid items return HTTP 400 before settlement.

POST /api/calc/astral Max 25 unit_amount + extra_item_amount * (n - 1) extra $0.002 PREVIEW

• 1 to 25 items. Each item uses the same keys as the GET query parameters.
• POST of 1 item costs the same as GET. Lists longer than 25: chunk into multiple POSTs. Extra items still execute; do not pad dummy rows.
• The first invalid item fails the whole request (index in the 400 JSON). You are not charged.
• HTTP 200 is {count, path, items}. Each items[i] is the GET 200 body for that row.
• Catalog misses (empty matches, found=false) stay paid 200s inside that slot.
• x402 resource URL is this path plus n and body_sha256. Browsers that prefer text/html get the same paywall as GET; Pay retries POST with the same items.

Example request (fixture)

{
  "items": [
    {
      "age": "40",
      "delay_gt_180": "false",
      "glucose_mmol_l": "6.0",
      "loc_impaired": "false",
      "nihss": "0",
      "visual_field_defect": "false"
    },
    {
      "age": "40",
      "delay_gt_180": "false",
      "glucose_mmol_l": "6.0",
      "loc_impaired": "false",
      "nihss": "0",
      "visual_field_defect": "false"
    }
  ]
}

Open bulk paywall →

Opens a two-item fixture on the API host. Unpaid browsers get the same MetaMask paywall as GET; Pay retries POST with those items.

Example 200 (fixture)

{
  "count": 2,
  "path": "/api/calc/astral",
  "items": [
    {
      "components": [
        {
          "value": 40,
          "factor": "age",
          "points": 8,
          "present": true
        },
        {
          "value": 0,
          "factor": "nihss",
          "points": 0,
          "present": false
        },
        {
          "factor": "delay_gt_180",
          "points": 0,
          "present": false
        },
        {
          "factor": "visual_field_defect",
          "points": 0,
          "present": false
        },
        {
          "value": 6.0,
          "factor": "glucose",
          "points": 0,
          "present": false
        },
        {
          "factor": "loc_impaired",
          "points": 0,
          "present": false
        }
      ],
      "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
      "citation": {
        "authors": "Ntaios G, Faouzi M, Ferrari J, Lang W, Vemmos K, Michel P",
        "doi": "10.1212/WNL.0b013e318259e221",
        "id": "ntaios-2012",
        "pmid": "22649218",
        "source": "Neurology. 2012;78(24):1916-1922",
        "title": "An integer-based score to predict functional outcome in acute ischemic stroke: the ASTRAL score"
      },
      "formula": "astral",
      "formula_expression": "ASTRAL = age (1 per 5 years) + NIHSS + 2 if onset-to-admission >180 min + 2 if visual field defect + 1 if glucose <3.7 or >7.3 mmol/L + 3 if impaired consciousness; Ntaios 2012; 3-month mRS >2 is 50% at score 31",
      "max_score": 74,
      "score": 8,
      "age_years": 40,
      "delay_gt_180": false,
      "glucose_abnormal": false,
      "glucose_mmol_l": 6.0,
      "loc_impaired": false,
      "nihss": 0,
      "unfavorable_ge_31": false,
      "visual_field_defect": false
    },
    {
      "components": [
        {
          "value": 40,
          "factor": "age",
          "points": 8,
          "present": true
        },
        {
          "value": 0,
          "factor": "nihss",
          "points": 0,
          "present": false
        },
        {
          "factor": "delay_gt_180",
          "points": 0,
          "present": false
        },
        {
          "factor": "visual_field_defect",
          "points": 0,
          "present": false
        },
        {
          "value": 6.0,
          "factor": "glucose",
          "points": 0,
          "present": false
        },
        {
          "factor": "loc_impaired",
          "points": 0,
          "present": false
        }
      ],
      "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
      "citation": {
        "authors": "Ntaios G, Faouzi M, Ferrari J, Lang W, Vemmos K, Michel P",
        "doi": "10.1212/WNL.0b013e318259e221",
        "id": "ntaios-2012",
        "pmid": "22649218",
        "source": "Neurology. 2012;78(24):1916-1922",
        "title": "An integer-based score to predict functional outcome in acute ischemic stroke: the ASTRAL score"
      },
      "formula": "astral",
      "formula_expression": "ASTRAL = age (1 per 5 years) + NIHSS + 2 if onset-to-admission >180 min + 2 if visual field defect + 1 if glucose <3.7 or >7.3 mmol/L + 3 if impaired consciousness; Ntaios 2012; 3-month mRS >2 is 50% at score 31",
      "max_score": 74,
      "score": 8,
      "age_years": 40,
      "delay_gt_180": false,
      "glucose_abnormal": false,
      "glucose_mmol_l": 6.0,
      "loc_impaired": false,
      "nihss": 0,
      "unfavorable_ge_31": false,
      "visual_field_defect": false
    }
  ]
}

Response

Example JSON

Machine form of the same example. Frozen fixture. Not a live lookup.

{
  "components": [
    {
      "value": 40,
      "factor": "age",
      "points": 8,
      "present": true
    },
    {
      "value": 0,
      "factor": "nihss",
      "points": 0,
      "present": false
    },
    {
      "factor": "delay_gt_180",
      "points": 0,
      "present": false
    },
    {
      "factor": "visual_field_defect",
      "points": 0,
      "present": false
    },
    {
      "value": 6.0,
      "factor": "glucose",
      "points": 0,
      "present": false
    },
    {
      "factor": "loc_impaired",
      "points": 0,
      "present": false
    }
  ],
  "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
  "citation": {
    "authors": "Ntaios G, Faouzi M, Ferrari J, Lang W, Vemmos K, Michel P",
    "doi": "10.1212/WNL.0b013e318259e221",
    "id": "ntaios-2012",
    "pmid": "22649218",
    "source": "Neurology. 2012;78(24):1916-1922",
    "title": "An integer-based score to predict functional outcome in acute ischemic stroke: the ASTRAL score"
  },
  "formula": "astral",
  "formula_expression": "ASTRAL = age (1 per 5 years) + NIHSS + 2 if onset-to-admission >180 min + 2 if visual field defect + 1 if glucose <3.7 or >7.3 mmol/L + 3 if impaired consciousness; Ntaios 2012; 3-month mRS >2 is 50% at score 31",
  "max_score": 74,
  "score": 8,
  "age_years": 40,
  "delay_gt_180": false,
  "glucose_abnormal": false,
  "glucose_mmol_l": 6.0,
  "loc_impaired": false,
  "nihss": 0,
  "unfavorable_ge_31": false,
  "visual_field_defect": false
}

Client errors (HTTP 400)

Invalid params return 400 without charge. Shared HTTP 402 and 503 meanings: Payments.

Related tools

• THRIVE — Compute the Flint 2010 THRIVE (Totaled Health Risks in Vascular Events) score from trichotomized age, trichotomized NIHSS, and the chronic disease scale (hypertension, diabetes mellitus, atrial fibrillation).
• PLAN — Compute the O'Donnell 2012 PLAN score (preadmission comorbidities, level of consciousness, age, and neurologic deficit) for death and severe disability after acute ischemic stroke from the published Table 4 items.

Payment

Unpaid requests return HTTP 402 even if query parameters or POST items are missing or invalid, so CDP and agents can index the path. After a PAYMENT-SIGNATURE, invalid params return HTTP 400 JSON before settlement. magent does not charge. Fix the params, then request a new 402 quote for that complete URL. Catalog misses (empty matches, found=false) are valid paid 200s. Unpaid valid requests return HTTP 402 with a base64 PAYMENT-REQUIRED header. HTTP 503 is not a new quote: retry the same PAYMENT-SIGNATURE. Full handshake and shared payment errors: Payments. Stdio MCP: /docs/mcp.

Guarantees

• HTTP 402 is unpaid, including a missing query. After PAYMENT-SIGNATURE, invalid parameters return HTTP 400 before settlement. You are not charged. HTTP 402 never includes the tool JSON.
• exact: settlement finishes before the tool (paymentFlow upfront). batch-settlement: verify/deposit before the tool; chargedCumulativeAmount commits after HTTP 2xx. Uncertain or failed settlement fails closed (HTTP 503). Retry the same PAYMENT-SIGNATURE.
• HTTP 402 is unpaid only. Do not sign a second authorization because of a 503.
• Execution is timeout-bounded and concurrency-capped.
• Calculator inputs are stored encrypted for allowlisted operators (Magent Console). They are not in public logs, SSH lookups, catalog, or rollups. Request logs store path without query.