# HEMORR2HAGES calculator HEMORR2HAGES Status: LIVE Price: $0.005 USDC `GET /api/calc/hemorr2hages` HTML: https://magentlab.com/docs/hemorr2hages Markdown: https://magentlab.com/docs/hemorr2hages.md Not a medical device. Not a diagnosis, dose, or listing recommendation. ## What it computes Compute the Gage 2006 HEMORR2HAGES bleeding-risk score from age and caller-assigned clinical flags, with published warfarin major-bleed rates per 100 patient-years. ## When to use When an agent needs the published HEMORR2HAGES AF bleeding-risk arithmetic (not HAS-BLED, not ORBIT, not ATRIA) and must not invent the point total from prose. ## When not to use - Not a medical device. Not a diagnosis and not a decision to start or stop anticoagulation. - Not a warfarin prescription. magent does not dose warfarin or interpret INR. - Not HAS-BLED, not ORBIT, and not ATRIA. This tool is the Gage 2006 HEMORR2HAGES score only. - Age >75 scores 1 (76 scores; 75 does not). Prior bleed scores 2. Hepatic or renal disease is one caller flag. magent does not measure platelets, hemoglobin, or CYP2C9. ## Formula ``` HEMORR2HAGES = prior_bleed (2) + hepatic_or_renal (1) + ethanol (1) + malignancy (1) + age_gt_75 (1) + reduced_platelet (1) + uncontrolled_hypertension (1) + anemia (1) + genetic_factors (1) + excessive_fall_risk (1) + stroke (1); max 12; warfarin major bleed per 100 pt-years: 0=1.9, 1=2.5, 2=5.3, 3=8.4, 4=10.4, >=5=12.3 ``` ## Citation [Clinical classification schemes for predicting hemorrhage: results from the National Registry of Atrial Fibrillation (NRAF)](https://doi.org/10.1016/j.ahj.2005.04.017) Gage BF, Yan Y, Milligan PE, et al. Am Heart J. 2006;151(3):713-719 DOI: [10.1016/j.ahj.2005.04.017](https://doi.org/10.1016/j.ahj.2005.04.017) ## Worked example ### Age 60, all flags false Given: `age=60, anemia=false, ethanol=false, excessive_fall_risk=false, genetic_factors=false, hepatic_or_renal=false, malignancy=false, prior_bleed=false, reduced_platelet=false, stroke=false, uncontrolled_hypertension=false` 1. Age 60 is not >75 → 0; all flags false → 0 2. Score = 0 (max 12); bleed_rate_per_100_pt_years 1.9 ## Also searched as - hemorr2hages - hemorrhage - atrial fibrillation - HEMORR2HAGES score - HEMORR₂HAGES - Gage 2006 bleeding score - NRAF hemorrhage score ## Parameters - `age` (integer, required): Age in years (18-120). Age >75 scores 1 (76 scores; 75 does not). - `prior_bleed` (boolean, required): Prior bleed / rebleeding as assigned by the caller. true or false. Scores 2 (the 2 in HEMORR2HAGES). - `hepatic_or_renal` (boolean, required): Hepatic or renal disease as assigned by the caller. true or false. Scores 1 as a single flag. - `ethanol` (boolean, required): Ethanol abuse as assigned by the caller. true or false. Scores 1. - `malignancy` (boolean, required): Malignancy as assigned by the caller. true or false. Scores 1. - `reduced_platelet` (boolean, required): Reduced platelet count or function as assigned by the caller. true or false. Scores 1. magent does not take a platelet count. - `uncontrolled_hypertension` (boolean, required): Uncontrolled hypertension as assigned by the caller. true or false. Scores 1. - `anemia` (boolean, required): Anemia as assigned by the caller. true or false. Scores 1. magent does not take hemoglobin. - `genetic_factors` (boolean, required): Genetic factors as assigned by the caller (paper: CYP2C9). true or false. Scores 1. magent does not genotype. - `excessive_fall_risk` (boolean, required): Excessive fall risk as assigned by the caller. true or false. Scores 1. - `stroke` (boolean, required): Prior stroke as assigned by the caller. true or false. Scores 1. ## 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/hemorr2hages` 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": [ { "age": "60", "anemia": "false", "ethanol": "false", "excessive_fall_risk": "false", "genetic_factors": "false", "hepatic_or_renal": "false", "malignancy": "false", "prior_bleed": "false", "reduced_platelet": "false", "stroke": "false", "uncontrolled_hypertension": "false" }, { "age": "60", "anemia": "false", "ethanol": "false", "excessive_fall_risk": "false", "genetic_factors": "false", "hepatic_or_renal": "false", "malignancy": "false", "prior_bleed": "false", "reduced_platelet": "false", "stroke": "false", "uncontrolled_hypertension": "false" } ] } ``` Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/hemorr2hages Example 200: ```json { "count": 2, "path": "/api/calc/hemorr2hages", "items": [ { "components": [ { "factor": "prior_bleed", "points": 0, "present": false }, { "factor": "hepatic_or_renal", "points": 0, "present": false }, { "factor": "ethanol", "points": 0, "present": false }, { "factor": "malignancy", "points": 0, "present": false }, { "value": 60, "factor": "age_gt_75", "points": 0, "present": false }, { "factor": "reduced_platelet", "points": 0, "present": false }, { "factor": "uncontrolled_hypertension", "points": 0, "present": false }, { "factor": "anemia", "points": 0, "present": false }, { "factor": "genetic_factors", "points": 0, "present": false }, { "factor": "excessive_fall_risk", "points": 0, "present": false }, { "factor": "stroke", "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": "Gage BF, Yan Y, Milligan PE, et al.", "doi": "10.1016/j.ahj.2005.04.017", "id": "gage-2006", "pmid": "16504638", "source": "Am Heart J. 2006;151(3):713-719", "title": "Clinical classification schemes for predicting hemorrhage: results from the National Registry of Atrial Fibrillation (NRAF)" }, "formula": "hemorr2hages", "formula_expression": "HEMORR2HAGES = prior_bleed (2) + hepatic_or_renal (1) + ethanol (1) + malignancy (1) + age_gt_75 (1) + reduced_platelet (1) + uncontrolled_hypertension (1) + anemia (1) + genetic_factors (1) + excessive_fall_risk (1) + stroke (1); max 12; warfarin major bleed per 100 pt-years: 0=1.9, 1=2.5, 2=5.3, 3=8.4, 4=10.4, >=5=12.3", "age_years": 60, "max_score": 12, "score": 0, "bleed_rate_per_100_pt_years": 1.9 }, { "components": [ { "factor": "prior_bleed", "points": 0, "present": false }, { "factor": "hepatic_or_renal", "points": 0, "present": false }, { "factor": "ethanol", "points": 0, "present": false }, { "factor": "malignancy", "points": 0, "present": false }, { "value": 60, "factor": "age_gt_75", "points": 0, "present": false }, { "factor": "reduced_platelet", "points": 0, "present": false }, { "factor": "uncontrolled_hypertension", "points": 0, "present": false }, { "factor": "anemia", "points": 0, "present": false }, { "factor": "genetic_factors", "points": 0, "present": false }, { "factor": "excessive_fall_risk", "points": 0, "present": false }, { "factor": "stroke", "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": "Gage BF, Yan Y, Milligan PE, et al.", "doi": "10.1016/j.ahj.2005.04.017", "id": "gage-2006", "pmid": "16504638", "source": "Am Heart J. 2006;151(3):713-719", "title": "Clinical classification schemes for predicting hemorrhage: results from the National Registry of Atrial Fibrillation (NRAF)" }, "formula": "hemorr2hages", "formula_expression": "HEMORR2HAGES = prior_bleed (2) + hepatic_or_renal (1) + ethanol (1) + malignancy (1) + age_gt_75 (1) + reduced_platelet (1) + uncontrolled_hypertension (1) + anemia (1) + genetic_factors (1) + excessive_fall_risk (1) + stroke (1); max 12; warfarin major bleed per 100 pt-years: 0=1.9, 1=2.5, 2=5.3, 3=8.4, 4=10.4, >=5=12.3", "age_years": 60, "max_score": 12, "score": 0, "bleed_rate_per_100_pt_years": 1.9 } ] } ``` ## Response fields - `formula` (string): hemorr2hages - `formula_expression` (string): Exact expression used - `score` (integer): Total points 0-12 - `max_score` (integer): Always 12 - `bleed_rate_per_100_pt_years` (number): Gage 2006 warfarin major bleed rate per 100 patient-years: 1.9 (0), 2.5 (1), 5.3 (2), 8.4 (3), 10.4 (4), 12.3 (≥5). Not a diagnosis. - `age_years` (integer): Age used for the >75 criterion - `components` (array): Per-factor points - `citation` (object): Gage 2006 Am Heart J citation - `disclaimer` (string): Not-a-device notice ## Example JSON Frozen fixture. Not a live lookup. ```json { "components": [ { "factor": "prior_bleed", "points": 0, "present": false }, { "factor": "hepatic_or_renal", "points": 0, "present": false }, { "factor": "ethanol", "points": 0, "present": false }, { "factor": "malignancy", "points": 0, "present": false }, { "value": 60, "factor": "age_gt_75", "points": 0, "present": false }, { "factor": "reduced_platelet", "points": 0, "present": false }, { "factor": "uncontrolled_hypertension", "points": 0, "present": false }, { "factor": "anemia", "points": 0, "present": false }, { "factor": "genetic_factors", "points": 0, "present": false }, { "factor": "excessive_fall_risk", "points": 0, "present": false }, { "factor": "stroke", "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": "Gage BF, Yan Y, Milligan PE, et al.", "doi": "10.1016/j.ahj.2005.04.017", "id": "gage-2006", "pmid": "16504638", "source": "Am Heart J. 2006;151(3):713-719", "title": "Clinical classification schemes for predicting hemorrhage: results from the National Registry of Atrial Fibrillation (NRAF)" }, "formula": "hemorr2hages", "formula_expression": "HEMORR2HAGES = prior_bleed (2) + hepatic_or_renal (1) + ethanol (1) + malignancy (1) + age_gt_75 (1) + reduced_platelet (1) + uncontrolled_hypertension (1) + anemia (1) + genetic_factors (1) + excessive_fall_risk (1) + stroke (1); max 12; warfarin major bleed per 100 pt-years: 0=1.9, 1=2.5, 2=5.3, 3=8.4, 4=10.4, >=5=12.3", "age_years": 60, "max_score": 12, "score": 0, "bleed_rate_per_100_pt_years": 1.9 } ``` ## Errors - HTTP 400 `invalid_age`: age must be an integer from 18 to 120 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_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 - [HAS-BLED](https://magentlab.com/docs/has-bled) — Compute the HAS-BLED bleeding-risk score from discrete clinical flags. - [ORBIT bleeding score](https://magentlab.com/docs/orbit) — Compute the O'Brien 2015 ORBIT bleeding score from age and caller-assigned anemia, bleeding history, insufficient kidney, and antiplatelet flags. - [ATRIA hemorrhage score](https://magentlab.com/docs/atria) — Compute the Fang 2011 ATRIA hemorrhage score from caller-assigned anemia, severe renal disease, age, prior hemorrhage, and hypertension flags. ## 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 echoing accepted, payload, and extensions when present). - 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.