# mSOFA mSOFA Status: LIVE Price: $0.005 USDC `GET /api/calc/msofa` HTML: https://magentlab.com/docs/msofa Markdown: https://magentlab.com/docs/msofa.md Not a medical device. Not a diagnosis, dose, or listing recommendation. ## What it computes Compute the Grissom 2010 modified SOFA (mSOFA) total from SpO2/FiO2, caller-assigned scleral icterus or jaundice, MAP and adrenergic agents, caller-assigned GCS, and creatinine. ## When to use When an agent needs the published five-organ mSOFA total (max 19) and must not substitute Vincent 1996 SOFA, qSOFA, PaO2/FiO2, platelets, or bilirubin. ## When not to use - Not a medical device, not a Sepsis-3 diagnosis, and not a treatment or triage-exclusion order. - Not Vincent 1996 SOFA (already shipped as sofa) and not qSOFA. Coagulation (platelets) is not scored. Liver is caller-assigned scleral icterus or jaundice (0 or 3), not bilirubin. Respiration is SpO2/FiO2 without a ventilation gate. - Grissom 2010 Table 2 renal row is creatinine only. Adrenergic doses are scored without a ≥1 h duration. GCS and jaundice are caller-assigned. magent does not examine the patient or assay labs. - The paper reported 30-day mortality by day-1 total (0-7, 8-11, >11) in one ICU cohort. magent returns the score only and does not emit those observational bins as a risk class. ## Formula ``` mSOFA = respiration + liver + cardiovascular + cns + renal; respiration SpO2/FiO2 >400 → 0, ≤400 → 1, ≤315 → 2, ≤235 → 3, ≤150 → 4; liver no scleral icterus or jaundice → 0, present → 3; cardiovascular, CNS (GCS), and renal (creatinine) 0-4 as SOFA; coagulation not scored; max 19 ``` ## Citation [A modified sequential organ failure assessment score for critical care triage](https://doi.org/10.1001/dmp.2010.40) Grissom CK, Brown SM, Kuttler KG, Boltax JP, Jones J, Jephson AR, Orme JF Jr Disaster Med Public Health Prep. 2010;4(4):277-284 DOI: [10.1001/dmp.2010.40](https://doi.org/10.1001/dmp.2010.40) ## Worked example ### All organs 0 Given: `creatinine_mg_dl=1.0, fio2=0.21, gcs=15, map_mm_hg=80, scleral_icterus_or_jaundice=false, spo2_percent=96` 1. SpO2/FiO2 96/0.21 >400 → 0; no icterus or jaundice → 0; MAP 80, no pressors → 0; GCS 15 → 0; creatinine 1.0 → 0 2. Score = 0 (max 19) ## Also searched as - mSOFA score - modified SOFA - MSOFA - Grissom mSOFA - modified sequential organ failure assessment - SpO2/FiO2 SOFA ## Parameters - `spo2_percent` (number, required): Pulse-oximeter SpO2 in percent (50-100), not a fraction. Respiration uses SpO2/FiO2: >400 scores 0; ≤400 scores 1; ≤315 scores 2; ≤235 scores 3; ≤150 scores 4 (Grissom 2010 Table 2). magent does not read a probe. - `fio2` (number, required): Inspired oxygen as a fraction (0.21-1.0), not a percent. For nasal cannula, Grissom 2010 estimated FiO2 as 0.21 + 0.03 × L/min; the caller supplies the fraction. - `scleral_icterus_or_jaundice` (boolean, required): Scleral icterus or jaundice as assigned by the caller (Grissom 2010 Table 2). true or false. Absent scores 0; present scores 3. Not serum bilirubin. magent does not examine the patient. - `map_mm_hg` (number, required): Mean arterial pressure in mm Hg (30-180). MAP <70 scores 1 unless a higher cardiovascular band applies. - `dopamine_ug_kg_min` (number, optional): Dopamine in µg/kg·min (0-50) when provided. Absent is 0. 0 < dose ≤5 scores 2; >5 scores 3; >15 scores 4. - `dobutamine` (boolean, optional): Any dobutamine. true or false when provided; absent is false. true scores cardiovascular 2 unless a higher band applies. - `epinephrine_ug_kg_min` (number, optional): Epinephrine in µg/kg·min (0-2) when provided. Absent is 0. 0 < dose ≤0.1 scores 3; >0.1 scores 4. - `norepinephrine_ug_kg_min` (number, optional): Norepinephrine in µg/kg·min (0-2) when provided. Absent is 0. 0 < dose ≤0.1 scores 3; >0.1 scores 4. - `gcs` (integer, required): Glasgow Coma Scale total as assigned by the caller (integer 3-15). 15 scores 0; 13-14 scores 1; 10-12 scores 2; 6-9 scores 3; <6 scores 4. - `creatinine_mg_dl` (number, optional): Creatinine in mg/dL (0.1-20). Provide this or creatinine_umol_l. <1.2 scores 0; 1.2-1.9 scores 1; 2.0-3.4 scores 2; 3.5-4.9 scores 3; ≥5.0 scores 4. Table 2 lists creatinine only (not urine output). - `creatinine_umol_l` (number, optional): Creatinine in µmol/L. Converted as mg/dL = µmol/L / 88.42. ## 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/msofa` 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": [ { "creatinine_mg_dl": "1.0", "fio2": "0.21", "gcs": "15", "map_mm_hg": "80", "scleral_icterus_or_jaundice": "false", "spo2_percent": "96" }, { "creatinine_mg_dl": "1.0", "fio2": "0.21", "gcs": "15", "map_mm_hg": "80", "scleral_icterus_or_jaundice": "false", "spo2_percent": "96" } ] } ``` Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/msofa Example 200: ```json { "count": 2, "path": "/api/calc/msofa", "items": [ { "components": [ { "value": 457.14285714285717, "factor": "respiration", "points": 0, "present": false }, { "value": false, "factor": "liver", "points": 0, "present": false }, { "value": 80.0, "factor": "cardiovascular", "points": 0, "present": false }, { "value": 15, "factor": "cns", "points": 0, "present": false }, { "value": 1.0, "factor": "renal", "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": "Grissom CK, Brown SM, Kuttler KG, Boltax JP, Jones J, Jephson AR, Orme JF Jr", "doi": "10.1001/dmp.2010.40", "id": "grissom-2010", "pmid": "21149228", "source": "Disaster Med Public Health Prep. 2010;4(4):277-284", "title": "A modified sequential organ failure assessment score for critical care triage" }, "formula": "msofa", "formula_expression": "mSOFA = respiration + liver + cardiovascular + cns + renal; respiration SpO2/FiO2 >400 → 0, ≤400 → 1, ≤315 → 2, ≤235 → 3, ≤150 → 4; liver no scleral icterus or jaundice → 0, present → 3; cardiovascular, CNS (GCS), and renal (creatinine) 0-4 as SOFA; coagulation not scored; max 19", "max_score": 19, "score": 0 }, { "components": [ { "value": 457.14285714285717, "factor": "respiration", "points": 0, "present": false }, { "value": false, "factor": "liver", "points": 0, "present": false }, { "value": 80.0, "factor": "cardiovascular", "points": 0, "present": false }, { "value": 15, "factor": "cns", "points": 0, "present": false }, { "value": 1.0, "factor": "renal", "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": "Grissom CK, Brown SM, Kuttler KG, Boltax JP, Jones J, Jephson AR, Orme JF Jr", "doi": "10.1001/dmp.2010.40", "id": "grissom-2010", "pmid": "21149228", "source": "Disaster Med Public Health Prep. 2010;4(4):277-284", "title": "A modified sequential organ failure assessment score for critical care triage" }, "formula": "msofa", "formula_expression": "mSOFA = respiration + liver + cardiovascular + cns + renal; respiration SpO2/FiO2 >400 → 0, ≤400 → 1, ≤315 → 2, ≤235 → 3, ≤150 → 4; liver no scleral icterus or jaundice → 0, present → 3; cardiovascular, CNS (GCS), and renal (creatinine) 0-4 as SOFA; coagulation not scored; max 19", "max_score": 19, "score": 0 } ] } ``` ## Response fields - `formula` (string): msofa - `formula_expression` (string): Exact expression used - `score` (integer): Total points 0-19 - `max_score` (integer): Always 19 - `components` (array): Per-organ points - `citation` (object): Grissom 2010 citation - `disclaimer` (string): Not-a-device notice ## Example JSON Frozen fixture. Not a live lookup. ```json { "components": [ { "value": 457.14285714285717, "factor": "respiration", "points": 0, "present": false }, { "value": false, "factor": "liver", "points": 0, "present": false }, { "value": 80.0, "factor": "cardiovascular", "points": 0, "present": false }, { "value": 15, "factor": "cns", "points": 0, "present": false }, { "value": 1.0, "factor": "renal", "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": "Grissom CK, Brown SM, Kuttler KG, Boltax JP, Jones J, Jephson AR, Orme JF Jr", "doi": "10.1001/dmp.2010.40", "id": "grissom-2010", "pmid": "21149228", "source": "Disaster Med Public Health Prep. 2010;4(4):277-284", "title": "A modified sequential organ failure assessment score for critical care triage" }, "formula": "msofa", "formula_expression": "mSOFA = respiration + liver + cardiovascular + cns + renal; respiration SpO2/FiO2 >400 → 0, ≤400 → 1, ≤315 → 2, ≤235 → 3, ≤150 → 4; liver no scleral icterus or jaundice → 0, present → 3; cardiovascular, CNS (GCS), and renal (creatinine) 0-4 as SOFA; coagulation not scored; max 19", "max_score": 19, "score": 0 } ``` ## Errors - HTTP 400 `invalid_msofa`: mSOFA needs Grissom modified SOFA organ scores in published ranges (SpO2/FiO2 not PaO2/FiO2). 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 - [SOFA](https://magentlab.com/docs/sofa) — Compute the Vincent 1996 SOFA score from PaO2/FiO2, platelets, bilirubin, MAP and adrenergic agents, GCS, and creatinine or urine output. - [qSOFA](https://magentlab.com/docs/qsofa) — Compute the Sepsis-3 qSOFA score from respiratory rate, caller-assigned altered mentation, and systolic blood pressure. ## 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. 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.