Emergency · LIVE

EHMRG 7-day ED mortality score

EHMRG

Compute the Lee 2012 Emergency Heart Failure Mortality Risk Grade 7-day emergency-department integer score from age, EMS transport, initial systolic BP, heart rate, oxygen saturation, creatinine, potassium, troponin above ULN, active cancer, and home metolazone.

LIVE $0.005 USDC GET /api/calc/ehmrg

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

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

What it computes

Compute the Lee 2012 Emergency Heart Failure Mortality Risk Grade 7-day emergency-department integer score from age, EMS transport, initial systolic BP, heart rate, oxygen saturation, creatinine, potassium, troponin above ULN, active cancer, and home metolazone.

When to use

When an agent has caller-supplied ED presentation values and needs the published Lee 2012 Table 3 7-day ED model total and derivation risk_group 1/2/3/4/5a/5b, not EHMRG30-ST, not ADHERE CART, and not a discharge or admission order.

When not to use

• Not a medical device. magent does not examine the patient and does not measure vitals or laboratories.
• Not a discharge or admission order. This is the Lee 2012 7-day ED integer score only.
• This is not EHMRG30-ST and not ADHERE CART.
• Dialysis-dependent patients are excluded (Lee 2012 Methods and Table 3 footnote). dialysis_dependent must be false to score.
• Unpublished potassium gaps 3.91-3.99 mmol/L pin with the <=3.9 band (+5). Gaps 4.51-4.59 mmol/L pin with the >=4.6 band (+30). magent does not invent extra named potassium classes.
• The caller assigns EMS transport, troponin above ULN, active cancer, home metolazone, and dialysis status. magent does not interpret assays or medication lists.

Formula

ehmrg_score = 2*age_years + 60*(ems_transport) - min(systolic_mm_hg, 160) + clamp(heart_rate_bpm, 80, 120) - 2*min(spo2_percent, 92) + 20*creatinine_mg_dl + K(<=3.9:5, 4.0-4.5:0, >=4.6:30) + 60*(troponin_gt_uln) + 45*(active_cancer) + 60*(metolazone) + 12; Lee 2012 Table 3 7-day ED model; dialysis-dependent excluded; risk_group 1 (score <= -49.1), 2 (-49.0 to -15.9), 3 (-15.8 to 17.9), 4 (18.0 to 56.5), 5a (56.6 to 89.3), 5b (>= 89.4)

Citation

Title

Prediction of heart failure mortality in emergent care: a cohort study

Authors

Lee DS, Stitt A, Austin PC, Stukel TA, Schull MJ, Chong A, Newton GE, Lee JS, Tu JV

Source

Ann Intern Med. 2012;156(11):767-775

DOI

10.7326/0003-4819-156-11-201206050-00003

Worked example

Also searched as

• EHMRG
• Emergency Heart Failure Mortality Risk Grade
• Lee 2012 EHMRG
• 7-day ED heart failure mortality
• EHMRG integer score
• heart failure emergency department score

Try

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

/api/calc/ehmrg?age=70&ems_transport=false&systolic_mm_hg=160&heart_rate_bpm=80&spo2_percent=92&creatinine_mg_dl=1.0&potassium_mmol_l=4.2&troponin_gt_uln=false&active_cancer=false&metolazone=false&dialysis_dependent=false

Full URL: https://api.magentlab.com/api/calc/ehmrg?age=70&ems_transport=false&systolic_mm_hg=160&heart_rate_bpm=80&spo2_percent=92&creatinine_mg_dl=1.0&potassium_mmol_l=4.2&troponin_gt_uln=false&active_cancer=false&metolazone=false&dialysis_dependent=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/ehmrg?age=70&ems_transport=false&systolic_mm_hg=160&heart_rate_bpm=80&spo2_percent=92&creatinine_mg_dl=1.0&potassium_mmol_l=4.2&troponin_gt_uln=false&active_cancer=false&metolazone=false&dialysis_dependent=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/ehmrg 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": [
    {
      "active_cancer": "false",
      "age": "70",
      "creatinine_mg_dl": "1.0",
      "dialysis_dependent": "false",
      "ems_transport": "false",
      "heart_rate_bpm": "80",
      "metolazone": "false",
      "potassium_mmol_l": "4.2",
      "spo2_percent": "92",
      "systolic_mm_hg": "160",
      "troponin_gt_uln": "false"
    },
    {
      "active_cancer": "false",
      "age": "70",
      "creatinine_mg_dl": "1.0",
      "dialysis_dependent": "false",
      "ems_transport": "false",
      "heart_rate_bpm": "80",
      "metolazone": "false",
      "potassium_mmol_l": "4.2",
      "spo2_percent": "92",
      "systolic_mm_hg": "160",
      "troponin_gt_uln": "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/ehmrg",
  "items": [
    {
      "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": "Lee DS, Stitt A, Austin PC, Stukel TA, Schull MJ, Chong A, Newton GE, Lee JS, Tu JV",
        "doi": "10.7326/0003-4819-156-11-201206050-00003",
        "id": "lee-2012",
        "pmid": "22665814",
        "source": "Ann Intern Med. 2012;156(11):767-775",
        "title": "Prediction of heart failure mortality in emergent care: a cohort study"
      },
      "formula": "ehmrg",
      "formula_expression": "ehmrg_score = 2*age_years + 60*(ems_transport) - min(systolic_mm_hg, 160) + clamp(heart_rate_bpm, 80, 120) - 2*min(spo2_percent, 92) + 20*creatinine_mg_dl + K(<=3.9:5, 4.0-4.5:0, >=4.6:30) + 60*(troponin_gt_uln) + 45*(active_cancer) + 60*(metolazone) + 12; Lee 2012 Table 3 7-day ED model; dialysis-dependent excluded; risk_group 1 (score <= -49.1), 2 (-49.0 to -15.9), 3 (-15.8 to 17.9), 4 (18.0 to 56.5), 5a (56.6 to 89.3), 5b (>= 89.4)",
      "systolic_mm_hg": 160,
      "age_years": 70,
      "creatinine_mg_dl": 1.0,
      "potassium_mmol_l": 4.2,
      "heart_rate_bpm": 80,
      "active_cancer": false,
      "dialysis_dependent": false,
      "ehmrg_score": -92.0,
      "ems_transport": false,
      "metolazone": false,
      "risk_group": "1",
      "spo2_percent": 92.0,
      "troponin_gt_uln": 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": "Lee DS, Stitt A, Austin PC, Stukel TA, Schull MJ, Chong A, Newton GE, Lee JS, Tu JV",
        "doi": "10.7326/0003-4819-156-11-201206050-00003",
        "id": "lee-2012",
        "pmid": "22665814",
        "source": "Ann Intern Med. 2012;156(11):767-775",
        "title": "Prediction of heart failure mortality in emergent care: a cohort study"
      },
      "formula": "ehmrg",
      "formula_expression": "ehmrg_score = 2*age_years + 60*(ems_transport) - min(systolic_mm_hg, 160) + clamp(heart_rate_bpm, 80, 120) - 2*min(spo2_percent, 92) + 20*creatinine_mg_dl + K(<=3.9:5, 4.0-4.5:0, >=4.6:30) + 60*(troponin_gt_uln) + 45*(active_cancer) + 60*(metolazone) + 12; Lee 2012 Table 3 7-day ED model; dialysis-dependent excluded; risk_group 1 (score <= -49.1), 2 (-49.0 to -15.9), 3 (-15.8 to 17.9), 4 (18.0 to 56.5), 5a (56.6 to 89.3), 5b (>= 89.4)",
      "systolic_mm_hg": 160,
      "age_years": 70,
      "creatinine_mg_dl": 1.0,
      "potassium_mmol_l": 4.2,
      "heart_rate_bpm": 80,
      "active_cancer": false,
      "dialysis_dependent": false,
      "ehmrg_score": -92.0,
      "ems_transport": false,
      "metolazone": false,
      "risk_group": "1",
      "spo2_percent": 92.0,
      "troponin_gt_uln": false
    }
  ]
}

Response

Example JSON

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

{
  "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": "Lee DS, Stitt A, Austin PC, Stukel TA, Schull MJ, Chong A, Newton GE, Lee JS, Tu JV",
    "doi": "10.7326/0003-4819-156-11-201206050-00003",
    "id": "lee-2012",
    "pmid": "22665814",
    "source": "Ann Intern Med. 2012;156(11):767-775",
    "title": "Prediction of heart failure mortality in emergent care: a cohort study"
  },
  "formula": "ehmrg",
  "formula_expression": "ehmrg_score = 2*age_years + 60*(ems_transport) - min(systolic_mm_hg, 160) + clamp(heart_rate_bpm, 80, 120) - 2*min(spo2_percent, 92) + 20*creatinine_mg_dl + K(<=3.9:5, 4.0-4.5:0, >=4.6:30) + 60*(troponin_gt_uln) + 45*(active_cancer) + 60*(metolazone) + 12; Lee 2012 Table 3 7-day ED model; dialysis-dependent excluded; risk_group 1 (score <= -49.1), 2 (-49.0 to -15.9), 3 (-15.8 to 17.9), 4 (18.0 to 56.5), 5a (56.6 to 89.3), 5b (>= 89.4)",
  "systolic_mm_hg": 160,
  "age_years": 70,
  "creatinine_mg_dl": 1.0,
  "potassium_mmol_l": 4.2,
  "heart_rate_bpm": 80,
  "active_cancer": false,
  "dialysis_dependent": false,
  "ehmrg_score": -92.0,
  "ems_transport": false,
  "metolazone": false,
  "risk_group": "1",
  "spo2_percent": 92.0,
  "troponin_gt_uln": false
}

Client errors (HTTP 400)

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

Related tools

• LACE — Sum van Walraven 2010 Table 3 LACE points from length of stay, acute (emergent) admission, a caller-supplied Charlson integer, and ED visits in the previous 6 months.
• ADHERE — Apply the Fonarow 2005 ADHERE classification and regression tree for in-hospital mortality risk in acutely decompensated heart failure from admission BUN, systolic blood pressure, and serum creatinine.

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.
• 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.