# HACOR score (Duan) HACOR Status: LIVE Price: $0.005 USDC `GET /api/calc/hacor` HTML: https://magentlab.com/docs/hacor Markdown: https://magentlab.com/docs/hacor.md Not a medical device. Not a diagnosis, dose, or listing recommendation. ## What it computes Sum Duan 2017 HACOR (ESM Table 2) points from heart rate, pH, GCS, PaO2/FiO2, and respiratory rate and return low (≤5) or high (>5). ## When to use When an agent needs the published HACOR total and ≤5 vs >5 band at 1 hour of NIV and must not invent an intubation or NIV-failure order or use GCS 10–12 / ≤9 tables. ## When not to use - Not a medical device and not an intubation or NIV-failure order. magent does not read an ABG, GCS the patient, or a ventilator. - Weights follow Duan 2017 ESM Table 2 only (max 25). GCS 15 → 0, 13–14 → 2, 11–12 → 5, ≤10 → 10. Do not use secondary tables that fold 10 into the 11–12 band. - The paper compared ≤5 vs >5 at 1 hour of NIV in hypoxemic patients. The band is not an intubation order. - Heart rate, pH, GCS, PaO2/FiO2, and respiratory rate are caller-supplied. magent does not measure them. ## Formula ``` HACOR = HR(≤120→0, ≥121→1) + pH(≥7.35→0, 7.30–7.34→2, 7.25–7.29→3, <7.25→4) + GCS(15→0, 13–14→2, 11–12→5, ≤10→10) + P/F(≥201→0, 176–200→2, 151–175→3, 126–150→4, 101–125→5, ≤100→6) + RR(≤30→0, 31–35→1, 36–40→2, 41–45→3, ≥46→4); Duan 2017 ESM Table 2; max 25; low ≤5, high >5 ``` ## Citation [Assessment of heart rate, acidosis, consciousness, oxygenation, and respiratory rate to predict noninvasive ventilation failure in hypoxemic patients](https://doi.org/10.1007/s00134-016-4601-3) Duan J, Han X, Bai L, Zhou L, Huang S Intensive Care Med. 2017;43(2):192-199 DOI: [10.1007/s00134-016-4601-3](https://doi.org/10.1007/s00134-016-4601-3) ## Worked example ### All zero-point bands Given: `gcs=15, heart_rate_bpm=80, pf_ratio=300, ph=7.40, respiratory_rate=18` 1. HR 80 → 0; pH 7.40 → 0; GCS 15 → 0; P/F 300 → 0; RR 18 → 0 2. Score = 0 (max 25); hacor_band = low (≤5) ### GCS 10 on an otherwise zero baseline Given: `gcs=10, heart_rate_bpm=80, pf_ratio=300, ph=7.40, respiratory_rate=18` 1. GCS 10 → 10 (ESM Table 2 ≤10); remaining factors 0 2. Score = 10 (max 25); hacor_band = high (>5). Not an intubation order. ## Also searched as - HACOR - HACOR score - Duan HACOR - NIV failure score - heart rate acidosis consciousness oxygenation respiratory rate - HACOR NIV - Duan 2017 HACOR - hypoxemic NIV failure ## Parameters - `heart_rate_bpm` (integer, required): Heart rate in beats/min (integer 30-220). Duan 2017 ESM Table 2: ≤120 → 0, ≥121 → 1. - `ph` (number, required): Arterial pH (6.80-7.80). Duan 2017 ESM Table 2: ≥7.35 → 0, 7.30-7.34 → 2, 7.25-7.29 → 3, <7.25 → 4. magent does not read an ABG. - `gcs` (integer, required): Total Glasgow Coma Scale 3-15 as assigned by the caller. Duan 2017 ESM Table 2: 15 → 0, 13-14 → 2, 11-12 → 5, ≤10 → 10. Not a GCS 10-12 / ≤9 table. magent does not GCS the patient. - `pf_ratio` (number, required): PaO2/FiO2 ratio (20-800). Duan 2017 ESM Table 2: ≥201 → 0, 176-200 → 2, 151-175 → 3, 126-150 → 4, 101-125 → 5, ≤100 → 6. magent does not read an ABG or a ventilator. - `respiratory_rate` (integer, required): Respiratory rate in breaths/min (integer 4-80). Duan 2017 ESM Table 2: ≤30 → 0, 31-35 → 1, 36-40 → 2, 41-45 → 3, ≥46 → 4. ## 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/hacor` 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": [ { "gcs": "15", "heart_rate_bpm": "80", "pf_ratio": "300", "ph": "7.40", "respiratory_rate": "18" }, { "gcs": "15", "heart_rate_bpm": "80", "pf_ratio": "300", "ph": "7.40", "respiratory_rate": "18" } ] } ``` Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/hacor Example 200: ```json { "count": 2, "path": "/api/calc/hacor", "items": [ { "components": [ { "value": 80, "factor": "heart_rate_bpm", "points": 0, "present": false }, { "value": 7.4, "factor": "ph", "points": 0, "present": false }, { "value": 15, "factor": "gcs", "points": 0, "present": false }, { "value": 300.0, "factor": "pf_ratio", "points": 0, "present": false }, { "value": 18, "factor": "respiratory_rate", "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": "Duan J, Han X, Bai L, Zhou L, Huang S", "doi": "10.1007/s00134-016-4601-3", "id": "duan-2017", "pmid": "27812731", "source": "Intensive Care Med. 2017;43(2):192-199", "title": "Assessment of heart rate, acidosis, consciousness, oxygenation, and respiratory rate to predict noninvasive ventilation failure in hypoxemic patients" }, "formula": "hacor", "formula_expression": "HACOR = HR(≤120→0, ≥121→1) + pH(≥7.35→0, 7.30–7.34→2, 7.25–7.29→3, <7.25→4) + GCS(15→0, 13–14→2, 11–12→5, ≤10→10) + P/F(≥201→0, 176–200→2, 151–175→3, 126–150→4, 101–125→5, ≤100→6) + RR(≤30→0, 31–35→1, 36–40→2, 41–45→3, ≥46→4); Duan 2017 ESM Table 2; max 25; low ≤5, high >5", "max_score": 25, "score": 0, "heart_rate_bpm": 80, "gcs": 15, "hacor_band": "low", "pf_ratio": 300.0, "ph": 7.4, "respiratory_rate": 18 }, { "components": [ { "value": 80, "factor": "heart_rate_bpm", "points": 0, "present": false }, { "value": 7.4, "factor": "ph", "points": 0, "present": false }, { "value": 15, "factor": "gcs", "points": 0, "present": false }, { "value": 300.0, "factor": "pf_ratio", "points": 0, "present": false }, { "value": 18, "factor": "respiratory_rate", "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": "Duan J, Han X, Bai L, Zhou L, Huang S", "doi": "10.1007/s00134-016-4601-3", "id": "duan-2017", "pmid": "27812731", "source": "Intensive Care Med. 2017;43(2):192-199", "title": "Assessment of heart rate, acidosis, consciousness, oxygenation, and respiratory rate to predict noninvasive ventilation failure in hypoxemic patients" }, "formula": "hacor", "formula_expression": "HACOR = HR(≤120→0, ≥121→1) + pH(≥7.35→0, 7.30–7.34→2, 7.25–7.29→3, <7.25→4) + GCS(15→0, 13–14→2, 11–12→5, ≤10→10) + P/F(≥201→0, 176–200→2, 151–175→3, 126–150→4, 101–125→5, ≤100→6) + RR(≤30→0, 31–35→1, 36–40→2, 41–45→3, ≥46→4); Duan 2017 ESM Table 2; max 25; low ≤5, high >5", "max_score": 25, "score": 0, "heart_rate_bpm": 80, "gcs": 15, "hacor_band": "low", "pf_ratio": 300.0, "ph": 7.4, "respiratory_rate": 18 } ] } ``` ## Response fields - `formula` (string): hacor - `formula_expression` (string): Exact expression used - `score` (integer): HACOR points 0-25 - `max_score` (integer): Always 25 - `hacor_band` (string): low when score is ≤5, high when score is >5 (Duan 2017 comparison at 1 h of NIV). Not an intubation or NIV-failure order. - `heart_rate_bpm` (integer): Heart rate used, bpm - `ph` (number): Arterial pH used - `gcs` (integer): Caller-assigned total GCS used - `pf_ratio` (number): PaO2/FiO2 used - `respiratory_rate` (integer): Respiratory rate used, breaths/min - `components` (array): Per-factor points - `citation` (object): Duan 2017 Intensive Care Med citation - `disclaimer` (string): Not-a-device notice ## Example JSON Frozen fixture. Not a live lookup. ```json { "components": [ { "value": 80, "factor": "heart_rate_bpm", "points": 0, "present": false }, { "value": 7.4, "factor": "ph", "points": 0, "present": false }, { "value": 15, "factor": "gcs", "points": 0, "present": false }, { "value": 300.0, "factor": "pf_ratio", "points": 0, "present": false }, { "value": 18, "factor": "respiratory_rate", "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": "Duan J, Han X, Bai L, Zhou L, Huang S", "doi": "10.1007/s00134-016-4601-3", "id": "duan-2017", "pmid": "27812731", "source": "Intensive Care Med. 2017;43(2):192-199", "title": "Assessment of heart rate, acidosis, consciousness, oxygenation, and respiratory rate to predict noninvasive ventilation failure in hypoxemic patients" }, "formula": "hacor", "formula_expression": "HACOR = HR(≤120→0, ≥121→1) + pH(≥7.35→0, 7.30–7.34→2, 7.25–7.29→3, <7.25→4) + GCS(15→0, 13–14→2, 11–12→5, ≤10→10) + P/F(≥201→0, 176–200→2, 151–175→3, 126–150→4, 101–125→5, ≤100→6) + RR(≤30→0, 31–35→1, 36–40→2, 41–45→3, ≥46→4); Duan 2017 ESM Table 2; max 25; low ≤5, high >5", "max_score": 25, "score": 0, "heart_rate_bpm": 80, "gcs": 15, "hacor_band": "low", "pf_ratio": 300.0, "ph": 7.4, "respiratory_rate": 18 } ``` ## Errors - 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_ph`: ph must be a number from 6.80 to 7.80 (Duan 2017 HACOR). Returned before settlement; you are not charged. - HTTP 400 `invalid_gcs_total`: gcs must be an integer from 3 to 15. Returned before settlement; you are not charged. - HTTP 400 `invalid_pf_ratio`: pf_ratio must be a number from 20 to 800. Returned before settlement; you are not charged. - HTTP 400 `invalid_respiratory_rate`: respiratory_rate must be an integer from 4 to 80. 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 - [ROX index](https://magentlab.com/docs/rox) — Compute the ROX index as pulse-oximetry SpO2 percent divided by inspired oxygen fraction, then divided by respiratory rate. - [PaO2/FiO2 ratio](https://magentlab.com/docs/pf-ratio) — Compute the PaO2/FiO2 ratio as arterial PO2 in mm Hg divided by inspired oxygen fraction. - [Rapid shallow breathing index](https://magentlab.com/docs/rsbi) — Compute the Yang and Tobin rapid shallow breathing index as respiratory rate in breaths/min divided by tidal volume in liters. ## 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.