# CRUSADE bleeding score

CRUSADE bleeding score

Status: LIVE
Price: $0.005 USDC
`GET /api/calc/crusade`
HTML: https://magentlab.com/docs/crusade
Markdown: https://magentlab.com/docs/crusade.md

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

## What it computes

Compute the CRUSADE in-hospital major bleeding score from hematocrit, caller-assigned Cockcroft–Gault creatinine clearance, heart rate, sex, signs of CHF, prior vascular disease, diabetes, and systolic BP (Subherwal 2009 Table 4).

## When to use

When an agent needs the published Subherwal 2009 CRUSADE Table 4 total and in-hospital major-bleeding quintile for NSTE-ACS / NSTEMI and must not invent bands or compute Cockcroft–Gault.

## When not to use

- Not a medical device and not a treatment, transfusion, or anticoagulation recommendation.
- Creatinine clearance is Cockcroft–Gault mL/min as assigned by the caller. magent does not compute Cockcroft–Gault.
- Signs of CHF at presentation, prior vascular disease (PAD or prior stroke), and diabetes mellitus are caller-assigned. magent does not examine the patient.
- This is the CRUSADE bleeding score for NSTE-ACS / NSTEMI (Subherwal 2009 Table 4). It is not a STEMI score and not TIMI.
- Quintile percents are the published in-hospital major bleeding rates. max_score is the Table 4 sum of maxima (96). magent does not invent a 100 cap.

## Formula

```
CRUSADE = hematocrit(<31:9, 31-<34:7, 34-<37:3, 37-<40:2, >=40:0) + crcl_ml_min(<=15:39, >15-30:35, >30-60:28, >60-90:17, >90-120:7, >120:0) + heart_rate(<=70:0, 71-80:1, 81-90:3, 91-100:6, 101-110:8, 111-120:10, >=121:11) + female(8) + signs_of_chf(7) + prior_vascular_disease(6) + diabetes(6) + systolic(<=90:10, 91-100:8, 101-120:5, 121-180:1, 181-200:3, >=201:5); Subherwal 2009 Table 4; quintiles <=20 3.1%, 21-30 5.5%, 31-40 8.6%, 41-50 11.9%, >50 19.5%; max 96
```

## Citation

[Baseline risk of major bleeding in non–ST-segment-elevation myocardial infarction: the CRUSADE Bleeding Score](https://doi.org/10.1161/CIRCULATIONAHA.108.828541)
Subherwal S, Bach RG, Chen AY, et al.
Circulation. 2009;119(14):1873-1882
DOI: [10.1161/CIRCULATIONAHA.108.828541](https://doi.org/10.1161/CIRCULATIONAHA.108.828541)

## Worked example

### Low-risk NSTEMI baseline (score 1, very_low)

Given: `crcl_ml_min=130, diabetes=false, heart_rate_bpm=65, hematocrit_percent=42, prior_vascular_disease=false, sex=male, signs_of_chf=false, systolic_mm_hg=140`

1. Hematocrit 42% ≥40 → 0; CrCl 130 mL/min >120 → 0; heart rate 65 ≤70 → 0
2. Male → 0; no CHF → 0; no prior vascular disease → 0; no diabetes → 0; SBP 140 (121–180) → 1
3. Score = 1 (max 96); crusade_band very_low; in-hospital major bleeding 3.1%


## Also searched as

- CRUSADE bleeding score
- CRUSADE score
- Subherwal bleeding score
- NSTEMI bleeding risk
- CRUSADE NSTE-ACS
- in-hospital major bleeding CRUSADE

## Parameters

- `hematocrit_percent` (number, required): Hematocrit percent (10-70). Subherwal 2009 Table 4: <31 → 9; 31–<34 → 7; 34–<37 → 3; 37–<40 → 2; ≥40 → 0.
- `crcl_ml_min` (number, required): Creatinine clearance in mL/min (1-300), Cockcroft–Gault as assigned by the caller. magent does not compute Cockcroft–Gault. Table 4: ≤15 → 39; >15–30 → 35; >30–60 → 28; >60–90 → 17; >90–120 → 7; >120 → 0.
- `heart_rate_bpm` (integer, required): Heart rate in beats per minute (integer 30-220). Table 4: ≤70 → 0; 71–80 → 1; 81–90 → 3; 91–100 → 6; 101–110 → 8; 111–120 → 10; ≥121 → 11.
- `sex` (string, required): Sex (female or male). Female scores 8; male scores 0.
- `signs_of_chf` (boolean, required): Signs of CHF at presentation as assigned by the caller. true or false. 7 points if true. magent does not examine the patient.
- `prior_vascular_disease` (boolean, required): Prior vascular disease (PAD or prior stroke) as assigned by the caller. true or false. 6 points if true.
- `diabetes` (boolean, required): Diabetes mellitus as assigned by the caller. true or false. 6 points if true.
- `systolic_mm_hg` (number, required): Systolic blood pressure in mm Hg (50-250). Table 4 is non-monotonic: ≤90 → 10; 91–100 → 8; 101–120 → 5; 121–180 → 1; 181–200 → 3; ≥201 → 5.

## 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.

Method: `POST /api/calc/crusade`
Max items: 25
Price: unit_amount + extra_item_amount * (n - 1) (unit 5000 atomic, extra 2000 atomic)
Status: 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:

```json
{
  "items": [
    {
      "crcl_ml_min": "130",
      "diabetes": "false",
      "heart_rate_bpm": "65",
      "hematocrit_percent": "42",
      "prior_vascular_disease": "false",
      "sex": "male",
      "signs_of_chf": "false",
      "systolic_mm_hg": "140"
    },
    {
      "crcl_ml_min": "130",
      "diabetes": "false",
      "heart_rate_bpm": "65",
      "hematocrit_percent": "42",
      "prior_vascular_disease": "false",
      "sex": "male",
      "signs_of_chf": "false",
      "systolic_mm_hg": "140"
    }
  ]
}
```

Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/crusade

Example 200:

```json
{
  "count": 2,
  "path": "/api/calc/crusade",
  "items": [
    {
      "components": [
        {
          "value": 42.0,
          "factor": "hematocrit_percent",
          "points": 0,
          "present": false
        },
        {
          "value": 130.0,
          "factor": "crcl_ml_min",
          "points": 0,
          "present": false
        },
        {
          "value": 65,
          "factor": "heart_rate_bpm",
          "points": 0,
          "present": false
        },
        {
          "value": "male",
          "factor": "sex",
          "points": 0,
          "present": false
        },
        {
          "factor": "signs_of_chf",
          "points": 0,
          "present": false
        },
        {
          "factor": "prior_vascular_disease",
          "points": 0,
          "present": false
        },
        {
          "factor": "diabetes",
          "points": 0,
          "present": false
        },
        {
          "value": 140.0,
          "factor": "systolic_mm_hg",
          "points": 1,
          "present": true
        }
      ],
      "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": "Subherwal S, Bach RG, Chen AY, et al.",
        "doi": "10.1161/CIRCULATIONAHA.108.828541",
        "id": "subherwal-2009",
        "pmid": "19332461",
        "source": "Circulation. 2009;119(14):1873-1882",
        "title": "Baseline risk of major bleeding in non–ST-segment-elevation myocardial infarction: the CRUSADE Bleeding Score"
      },
      "formula": "crusade",
      "formula_expression": "CRUSADE = hematocrit(<31:9, 31-<34:7, 34-<37:3, 37-<40:2, >=40:0) + crcl_ml_min(<=15:39, >15-30:35, >30-60:28, >60-90:17, >90-120:7, >120:0) + heart_rate(<=70:0, 71-80:1, 81-90:3, 91-100:6, 101-110:8, 111-120:10, >=121:11) + female(8) + signs_of_chf(7) + prior_vascular_disease(6) + diabetes(6) + systolic(<=90:10, 91-100:8, 101-120:5, 121-180:1, 181-200:3, >=201:5); Subherwal 2009 Table 4; quintiles <=20 3.1%, 21-30 5.5%, 31-40 8.6%, 41-50 11.9%, >50 19.5%; max 96",
      "max_score": 96,
      "score": 1,
      "sex": "male",
      "systolic_mm_hg": 140.0,
      "heart_rate_bpm": 65,
      "crcl_ml_min": 130.0,
      "crusade_band": "very_low",
      "diabetes": false,
      "hematocrit_percent": 42.0,
      "in_hospital_major_bleeding_percent": 3.1,
      "prior_vascular_disease": false,
      "signs_of_chf": false
    },
    {
      "components": [
        {
          "value": 42.0,
          "factor": "hematocrit_percent",
          "points": 0,
          "present": false
        },
        {
          "value": 130.0,
          "factor": "crcl_ml_min",
          "points": 0,
          "present": false
        },
        {
          "value": 65,
          "factor": "heart_rate_bpm",
          "points": 0,
          "present": false
        },
        {
          "value": "male",
          "factor": "sex",
          "points": 0,
          "present": false
        },
        {
          "factor": "signs_of_chf",
          "points": 0,
          "present": false
        },
        {
          "factor": "prior_vascular_disease",
          "points": 0,
          "present": false
        },
        {
          "factor": "diabetes",
          "points": 0,
          "present": false
        },
        {
          "value": 140.0,
          "factor": "systolic_mm_hg",
          "points": 1,
          "present": true
        }
      ],
      "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": "Subherwal S, Bach RG, Chen AY, et al.",
        "doi": "10.1161/CIRCULATIONAHA.108.828541",
        "id": "subherwal-2009",
        "pmid": "19332461",
        "source": "Circulation. 2009;119(14):1873-1882",
        "title": "Baseline risk of major bleeding in non–ST-segment-elevation myocardial infarction: the CRUSADE Bleeding Score"
      },
      "formula": "crusade",
      "formula_expression": "CRUSADE = hematocrit(<31:9, 31-<34:7, 34-<37:3, 37-<40:2, >=40:0) + crcl_ml_min(<=15:39, >15-30:35, >30-60:28, >60-90:17, >90-120:7, >120:0) + heart_rate(<=70:0, 71-80:1, 81-90:3, 91-100:6, 101-110:8, 111-120:10, >=121:11) + female(8) + signs_of_chf(7) + prior_vascular_disease(6) + diabetes(6) + systolic(<=90:10, 91-100:8, 101-120:5, 121-180:1, 181-200:3, >=201:5); Subherwal 2009 Table 4; quintiles <=20 3.1%, 21-30 5.5%, 31-40 8.6%, 41-50 11.9%, >50 19.5%; max 96",
      "max_score": 96,
      "score": 1,
      "sex": "male",
      "systolic_mm_hg": 140.0,
      "heart_rate_bpm": 65,
      "crcl_ml_min": 130.0,
      "crusade_band": "very_low",
      "diabetes": false,
      "hematocrit_percent": 42.0,
      "in_hospital_major_bleeding_percent": 3.1,
      "prior_vascular_disease": false,
      "signs_of_chf": false
    }
  ]
}
```

## Response fields

- `formula` (string): crusade
- `formula_expression` (string): Exact expression used
- `score` (integer): Table 4 point total (integer, max 96)
- `max_score` (integer): Always 96 (sum of Table 4 maxima)
- `crusade_band` (string): very_low (≤20), low (21-30), moderate (31-40), high (41-50), or very_high (>50)
- `in_hospital_major_bleeding_percent` (number): Published in-hospital major bleeding percent for the quintile: 3.1, 5.5, 8.6, 11.9, or 19.5
- `hematocrit_percent` (number): Hematocrit percent used
- `crcl_ml_min` (number): Caller-assigned Cockcroft–Gault creatinine clearance, mL/min
- `heart_rate_bpm` (integer): Heart rate used, beats per minute
- `sex` (string): female or male
- `signs_of_chf` (boolean): Caller-assigned signs of CHF at presentation
- `prior_vascular_disease` (boolean): Caller-assigned prior vascular disease (PAD or prior stroke)
- `diabetes` (boolean): Caller-assigned diabetes mellitus
- `systolic_mm_hg` (number): Systolic BP used, mm Hg
- `components` (array): Per-factor Table 4 points
- `citation` (object): Subherwal 2009 citation
- `disclaimer` (string): Not-a-device notice

## Example JSON

Frozen fixture. Not a live lookup.

```json
{
  "components": [
    {
      "value": 42.0,
      "factor": "hematocrit_percent",
      "points": 0,
      "present": false
    },
    {
      "value": 130.0,
      "factor": "crcl_ml_min",
      "points": 0,
      "present": false
    },
    {
      "value": 65,
      "factor": "heart_rate_bpm",
      "points": 0,
      "present": false
    },
    {
      "value": "male",
      "factor": "sex",
      "points": 0,
      "present": false
    },
    {
      "factor": "signs_of_chf",
      "points": 0,
      "present": false
    },
    {
      "factor": "prior_vascular_disease",
      "points": 0,
      "present": false
    },
    {
      "factor": "diabetes",
      "points": 0,
      "present": false
    },
    {
      "value": 140.0,
      "factor": "systolic_mm_hg",
      "points": 1,
      "present": true
    }
  ],
  "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": "Subherwal S, Bach RG, Chen AY, et al.",
    "doi": "10.1161/CIRCULATIONAHA.108.828541",
    "id": "subherwal-2009",
    "pmid": "19332461",
    "source": "Circulation. 2009;119(14):1873-1882",
    "title": "Baseline risk of major bleeding in non–ST-segment-elevation myocardial infarction: the CRUSADE Bleeding Score"
  },
  "formula": "crusade",
  "formula_expression": "CRUSADE = hematocrit(<31:9, 31-<34:7, 34-<37:3, 37-<40:2, >=40:0) + crcl_ml_min(<=15:39, >15-30:35, >30-60:28, >60-90:17, >90-120:7, >120:0) + heart_rate(<=70:0, 71-80:1, 81-90:3, 91-100:6, 101-110:8, 111-120:10, >=121:11) + female(8) + signs_of_chf(7) + prior_vascular_disease(6) + diabetes(6) + systolic(<=90:10, 91-100:8, 101-120:5, 121-180:1, 181-200:3, >=201:5); Subherwal 2009 Table 4; quintiles <=20 3.1%, 21-30 5.5%, 31-40 8.6%, 41-50 11.9%, >50 19.5%; max 96",
  "max_score": 96,
  "score": 1,
  "sex": "male",
  "systolic_mm_hg": 140.0,
  "heart_rate_bpm": 65,
  "crcl_ml_min": 130.0,
  "crusade_band": "very_low",
  "diabetes": false,
  "hematocrit_percent": 42.0,
  "in_hospital_major_bleeding_percent": 3.1,
  "prior_vascular_disease": false,
  "signs_of_chf": false
}
```

## Errors

- HTTP 400 `invalid_hematocrit`: hematocrit_percent must be a number from 10 to 70. Returned before settlement; you are not charged.
- HTTP 400 `invalid_crcl`: crcl_ml_min must be a number from 1 to 300 (Cockcroft-Gault mL/min as assigned by the caller). Returned before settlement; you are not charged.
- HTTP 400 `invalid_heart_rate`: heart_rate_bpm must be an integer from 30 to 220 Returned before settlement; you are not charged.
- HTTP 400 `invalid_sex`: sex must be female or male Returned before settlement; you are not charged.
- HTTP 400 `invalid_flag`: boolean clinical flags must be true or false Returned before settlement; you are not charged.
- HTTP 400 `invalid_systolic_bp`: systolic_mm_hg or systolic_bp_mm_hg must be a number from 50 to 250. Returned before settlement; you are not charged.
- HTTP 400 `invalid_items`: POST body must be a JSON object with only an items array Returned before settlement; you are not charged.
- HTTP 400 `invalid_item_count`: items must be an array of 1 to 25 objects Returned before settlement; you are not charged.
- HTTP 400 `invalid_item`: each items entry must be a JSON object Returned before settlement; you are not charged.

Shared HTTP 402 and 503: https://magentlab.com/docs/payments

## Related tools

- [TIMI UA/NSTEMI](https://magentlab.com/docs/timi-ua-nstemi) — Compute the TIMI risk score for unstable angina / NSTEMI from age and six caller-assigned flags.
- [HEART score](https://magentlab.com/docs/heart) — Compute the HEART score as age points plus caller-assigned history, ECG, risk factors, and troponin (each 0-2).
- [Killip](https://magentlab.com/docs/killip) — Return the Killip and Kimball 1967 myocardial-infarction heart-failure class 1-4 from a caller-assigned integer, with the published class description and 1967 CCU hospital mortality.

## 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.

- GET the tool with Accept: application/json (do not send Accept: text/html unless you want the human paywall).
- HTTP 402 means you have not paid. Decode the base64 PAYMENT-REQUIRED header. HTTP 503 is not a new quote.
- Sign accepts[0] (exact, EIP-3009) with validBefore = now + maxTimeoutSeconds (600 seconds), or accepts[1] (batch-settlement deposit/voucher) on product GET. Ping and POST {items} stay exact. Magent retries transient facilitator 429/5xx before answering.
- Retry the same URL with PAYMENT-SIGNATURE (base64 JSON of accepted and payload). Magent attaches canonical extensions.bazaar on CDP verify/settle; echoing 402 bazaar is optional.
- Success is HTTP 200 JSON plus PAYMENT-RESPONSE. exact settles before the tool. batch-settlement verifies (and deposit-settles) before the tool and commits the charge after HTTP 2xx. HTTP 503: retry the same PAYMENT-SIGNATURE. Mint a new exact nonce only after a new HTTP 402.

- offered `exact` on eip155:8453: Fixed-price USDC on Base. The buyer authorizes the advertised amount (EIP-3009). magent settles before the tool runs (paymentFlow upfront). extra.assetTransferMethod=eip3009 extra.paymentFlow=upfront.
- offered `batch-settlement` on eip155:8453: Payment-channel vouchers claimed later in batches. Exact stays accepts[0]. Same-path POST {items} is still exact. extra.assetTransferMethod=eip3009 extra.paymentFlow=authorization.

- not offered `upto`: Not offered. Usage-based: buyer authorizes a ceiling, seller settles the actual amount after work. Reserved for a future metered tool. Not for current calculators or code search.

Same-path POST {items} is still scheme exact: one EIP-3009 authorization for GET unit plus $0.002 per extra item. That is not x402 batch-settlement (payment channels / vouchers).

Shared HTTP 402 and 503 table: https://magentlab.com/docs/payments

Stdio MCP (one process per host): https://magentlab.com/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.
- 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.