Myxedema coma diagnostic score

Myxedema coma score

Sum Popoveniuc 2014 myxedema coma diagnostic points from caller-assigned thermoregulatory, CNS, GI, precipitating-event, cardiovascular, and metabolic bands and return ≥60 potentially diagnostic or 45–59 at risk.

LIVE $0.005 USDC GET /api/calc/myxedema_coma

Markdown: /docs/myxedema-coma.md · Canonical: https://magentlab.com/docs/myxedema-coma

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

What it computes

When to use

When an agent already has the published Popoveniuc 2014 bands assigned and needs the point total and those conclusion cuts. magent does not measure temperature, GCS, or labs and must not invent a myxedema-coma diagnosis or a thyroid-hormone order.

When not to use

Not a medical device.
Not a thyroid hormone order.
Not a myxedema-coma diagnosis. A score ≥60 is potentially diagnostic in Popoveniuc 2014; 45–59 could classify patients at risk. Scores <45 are below that at-risk range; that paper does not name a third band.
magent does not measure temperature, GCS, heart rate, blood pressure, or labs. The caller assigns each published band.
Cardiovascular extras (other EKG changes, effusion, pulmonary edema, cardiomegaly, hypotension) and metabolic flags are additive as in that table. Thermoregulatory, CNS, GI, and bradycardia are mutually exclusive bands.

Formula

Popoveniuc 2014 = thermoregulatory(gt_35→0, 32_to_35→10, lt_32→20) + cns_effects(absent→0, somnolent_lethargic→10, obtunded→15, stupor→20, coma_seizures→30) + gastrointestinal(absent→0, anorexia_pain_constipation→5, decreased_motility→15, paralytic_ileus→20) + 10*precipitating_event + bradycardia(absent→0, 50_to_59→10, 40_to_49→20, lt_40→30) + 10*other_ekg_changes + 10*pericardial_pleural_effusion + 15*pulmonary_edema + 15*cardiomegaly + 20*hypotension + 10*hyponatremia + 10*hypoglycemia + 10*hypoxemia + 10*hypercarbia + 10*decreased_gfr; max 230; ≥60 potentially_diagnostic, 45–59 at_risk

Citation

Title: A diagnostic scoring system for myxedema coma
Authors: Popoveniuc G, Chandra T, Sud A, Sharma M, Blackman MR, Burman KD, Mete M, Desale S, Wartofsky L
Source: Endocr Pract. 2014;20(8):808-817
DOI: 10.4158/EP13460.OR

Worked example

All absent or lowest published bands

Given: bradycardia=absentcardiomegaly=falsecns_effects=absentdecreased_gfr=falsegastrointestinal=absenthypercarbia=falsehypoglycemia=falsehyponatremia=falsehypotension=falsehypoxemia=falseother_ekg_changes=falsepericardial_pleural_effusion=falseprecipitating_event=falsepulmonary_edema=falsethermoregulatory=gt_35

Thermoregulatory gt_35 → 0; CNS absent → 0; GI absent → 0; precipitant false → 0; bradycardia absent → 0; remaining cardiovascular and metabolic flags false → 0
Score = 0 (max 230); myxedema_coma_band = below_at_risk (<45)

Published maxima of hypothermia, coma or seizures, and precipitant

Given: bradycardia=absentcardiomegaly=falsecns_effects=coma_seizuresdecreased_gfr=falsegastrointestinal=absenthypercarbia=falsehypoglycemia=falsehyponatremia=falsehypotension=falsehypoxemia=falseother_ekg_changes=falsepericardial_pleural_effusion=falseprecipitating_event=truepulmonary_edema=falsethermoregulatory=lt_32

lt_32 → 20; coma_seizures → 30; precipitating_event true → 10; remaining factors 0
Score = 60 (max 230); myxedema_coma_band = potentially_diagnostic (≥60). Not a diagnosis or thyroid-hormone order.

Also searched as

myxedema coma score
Popoveniuc 2014
myxedema coma diagnostic score
myxoedema coma score
severe hypothyroidism score
Popoveniuc Wartofsky myxedema
myxedema crisis score
MC diagnostic score

Try

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

/api/calc/myxedema_coma?thermoregulatory=gt_35&cns_effects=absent&gastrointestinal=absent&precipitating_event=false&bradycardia=absent&other_ekg_changes=false&pericardial_pleural_effusion=false&pulmonary_edema=false&cardiomegaly=false&hypotension=false&hyponatremia=false&hypoglycemia=false&hypoxemia=false&hypercarbia=false&decreased_gfr=false

Full URL: https://api.magentlab.com/api/calc/myxedema_coma?thermoregulatory=gt_35&cns_effects=absent&gastrointestinal=absent&precipitating_event=false&bradycardia=absent&other_ekg_changes=false&pericardial_pleural_effusion=false&pulmonary_edema=false&cardiomegaly=false&hypotension=false&hyponatremia=false&hypoglycemia=false&hypoxemia=false&hypercarbia=false&decreased_gfr=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/myxedema_coma?thermoregulatory=gt_35&cns_effects=absent&gastrointestinal=absent&precipitating_event=false&bradycardia=absent&other_ekg_changes=false&pericardial_pleural_effusion=false&pulmonary_edema=false&cardiomegaly=false&hypotension=false&hyponatremia=false&hypoglycemia=false&hypoxemia=false&hypercarbia=false&decreased_gfr=false"

Parameters

Name	Type	Required	Description
`thermoregulatory`	string	required · gt_35, 32_to_35, lt_32	Caller-assigned Popoveniuc 2014 thermoregulatory band. gt_35 (>35 °C) scores 0; 32_to_35 (32–35 °C) scores 10; lt_32 (<32 °C) scores 20. magent does not measure temperature.
`cns_effects`	string	required · absent, somnolent_lethargic, obtunded, stupor, coma_seizures	Caller-assigned Popoveniuc 2014 central-nervous-system band. absent scores 0; somnolent_lethargic 10; obtunded 15; stupor 20; coma_seizures 30. magent does not compute GCS or examine the patient.
`gastrointestinal`	string	required · absent, anorexia_pain_constipation, decreased_motility, paralytic_ileus	Caller-assigned Popoveniuc 2014 gastrointestinal band. absent scores 0; anorexia_pain_constipation (anorexia, abdominal pain, or constipation) scores 5; decreased_motility 15; paralytic_ileus 20. magent does not examine the patient.
`precipitating_event`	boolean	required	Precipitating event as assigned by the caller (true or false). Popoveniuc 2014: true → 10. magent does not take a history.
`bradycardia`	string	required · absent, 50_to_59, 40_to_49, lt_40	Caller-assigned Popoveniuc 2014 bradycardia band. absent scores 0; 50_to_59 (heart rate 50–59) scores 10; 40_to_49 scores 20; lt_40 (<40) scores 30. magent does not measure heart rate.
`other_ekg_changes`	boolean	required	Other electrocardiogram changes as assigned by the caller (true or false): QT prolongation, low voltage, bundle-branch block, nonspecific ST-T changes, or heart block (Popoveniuc 2014). true → 10. magent does not read an ECG.
`pericardial_pleural_effusion`	boolean	required	Pericardial or pleural effusion as assigned by the caller (true or false). Popoveniuc 2014: true → 10. magent does not interpret imaging.
`pulmonary_edema`	boolean	required	Pulmonary edema as assigned by the caller (true or false). Popoveniuc 2014: true → 15. magent does not interpret imaging.
`cardiomegaly`	boolean	required	Cardiomegaly as assigned by the caller (true or false). Popoveniuc 2014: true → 15. magent does not interpret imaging.
`hypotension`	boolean	required	Hypotension or shock as assigned by the caller (true or false). Popoveniuc 2014: true → 20. magent does not measure blood pressure.
`hyponatremia`	boolean	required	Hyponatremia as assigned by the caller (true or false). Popoveniuc 2014: true → 10. magent does not measure sodium.
`hypoglycemia`	boolean	required	Hypoglycemia as assigned by the caller (true or false). Popoveniuc 2014: true → 10. magent does not measure glucose.
`hypoxemia`	boolean	required	Hypoxemia as assigned by the caller (true or false). Popoveniuc 2014: true → 10. magent does not measure oxygen.
`hypercarbia`	boolean	required	Hypercarbia as assigned by the caller (true or false). Popoveniuc 2014: true → 10. magent does not measure carbon dioxide.
`decreased_gfr`	boolean	required	Decrease in glomerular filtration rate as assigned by the caller (true or false). Popoveniuc 2014: true → 10. magent does not compute GFR.

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/myxedema_coma 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": [
    {
      "bradycardia": "absent",
      "cardiomegaly": "false",
      "cns_effects": "absent",
      "decreased_gfr": "false",
      "gastrointestinal": "absent",
      "hypercarbia": "false",
      "hypoglycemia": "false",
      "hyponatremia": "false",
      "hypotension": "false",
      "hypoxemia": "false",
      "other_ekg_changes": "false",
      "pericardial_pleural_effusion": "false",
      "precipitating_event": "false",
      "pulmonary_edema": "false",
      "thermoregulatory": "gt_35"
    },
    {
      "bradycardia": "absent",
      "cardiomegaly": "false",
      "cns_effects": "absent",
      "decreased_gfr": "false",
      "gastrointestinal": "absent",
      "hypercarbia": "false",
      "hypoglycemia": "false",
      "hyponatremia": "false",
      "hypotension": "false",
      "hypoxemia": "false",
      "other_ekg_changes": "false",
      "pericardial_pleural_effusion": "false",
      "precipitating_event": "false",
      "pulmonary_edema": "false",
      "thermoregulatory": "gt_35"
    }
  ]
}

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/myxedema_coma",
  "items": [
    {
      "components": [
        {
          "value": "gt_35",
          "factor": "thermoregulatory",
          "points": 0,
          "present": false
        },
        {
          "value": "absent",
          "factor": "cns_effects",
          "points": 0,
          "present": false
        },
        {
          "value": "absent",
          "factor": "gastrointestinal",
          "points": 0,
          "present": false
        },
        {
          "value": false,
          "factor": "precipitating_event",
          "points": 0,
          "present": false
        },
        {
          "value": "absent",
          "factor": "bradycardia",
          "points": 0,
          "present": false
        },
        {
          "value": false,
          "factor": "other_ekg_changes",
          "points": 0,
          "present": false
        },
        {
          "value": false,
          "factor": "pericardial_pleural_effusion",
          "points": 0,
          "present": false
        },
        {
          "value": false,
          "factor": "pulmonary_edema",
          "points": 0,
          "present": false
        },
        {
          "value": false,
          "factor": "cardiomegaly",
          "points": 0,
          "present": false
        },
        {
          "value": false,
          "factor": "hypotension",
          "points": 0,
          "present": false
        },
        {
          "value": false,
          "factor": "hyponatremia",
          "points": 0,
          "present": false
        },
        {
          "value": false,
          "factor": "hypoglycemia",
          "points": 0,
          "present": false
        },
        {
          "value": false,
          "factor": "hypoxemia",
          "points": 0,
          "present": false
        },
        {
          "value": false,
          "factor": "hypercarbia",
          "points": 0,
          "present": false
        },
        {
          "value": false,
          "factor": "decreased_gfr",
          "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": "Popoveniuc G, Chandra T, Sud A, Sharma M, Blackman MR, Burman KD, Mete M, Desale S, Wartofsky L",
        "doi": "10.4158/EP13460.OR",
        "id": "popoveniuc-2014",
        "pmid": "24518183",
        "source": "Endocr Pract. 2014;20(8):808-817",
        "title": "A diagnostic scoring system for myxedema coma"
      },
      "formula": "myxedema_coma",
      "formula_expression": "Popoveniuc 2014 = thermoregulatory(gt_35→0, 32_to_35→10, lt_32→20) + cns_effects(absent→0, somnolent_lethargic→10, obtunded→15, stupor→20, coma_seizures→30) + gastrointestinal(absent→0, anorexia_pain_constipation→5, decreased_motility→15, paralytic_ileus→20) + 10*precipitating_event + bradycardia(absent→0, 50_to_59→10, 40_to_49→20, lt_40→30) + 10*other_ekg_changes + 10*pericardial_pleural_effusion + 15*pulmonary_edema + 15*cardiomegaly + 20*hypotension + 10*hyponatremia + 10*hypoglycemia + 10*hypoxemia + 10*hypercarbia + 10*decreased_gfr; max 230; ≥60 potentially_diagnostic, 45–59 at_risk",
      "max_score": 230,
      "score": 0,
      "myxedema_coma_band": "below_at_risk"
    },
    {
      "components": [
        {
          "value": "gt_35",
          "factor": "thermoregulatory",
          "points": 0,
          "present": false
        },
        {
          "value": "absent",
          "factor": "cns_effects",
          "points": 0,
          "present": false
        },
        {
          "value": "absent",
          "factor": "gastrointestinal",
          "points": 0,
          "present": false
        },
        {
          "value": false,
          "factor": "precipitating_event",
          "points": 0,
          "present": false
        },
        {
          "value": "absent",
          "factor": "bradycardia",
          "points": 0,
          "present": false
        },
        {
          "value": false,
          "factor": "other_ekg_changes",
          "points": 0,
          "present": false
        },
        {
          "value": false,
          "factor": "pericardial_pleural_effusion",
          "points": 0,
          "present": false
        },
        {
          "value": false,
          "factor": "pulmonary_edema",
          "points": 0,
          "present": false
        },
        {
          "value": false,
          "factor": "cardiomegaly",
          "points": 0,
          "present": false
        },
        {
          "value": false,
          "factor": "hypotension",
          "points": 0,
          "present": false
        },
        {
          "value": false,
          "factor": "hyponatremia",
          "points": 0,
          "present": false
        },
        {
          "value": false,
          "factor": "hypoglycemia",
          "points": 0,
          "present": false
        },
        {
          "value": false,
          "factor": "hypoxemia",
          "points": 0,
          "present": false
        },
        {
          "value": false,
          "factor": "hypercarbia",
          "points": 0,
          "present": false
        },
        {
          "value": false,
          "factor": "decreased_gfr",
          "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": "Popoveniuc G, Chandra T, Sud A, Sharma M, Blackman MR, Burman KD, Mete M, Desale S, Wartofsky L",
        "doi": "10.4158/EP13460.OR",
        "id": "popoveniuc-2014",
        "pmid": "24518183",
        "source": "Endocr Pract. 2014;20(8):808-817",
        "title": "A diagnostic scoring system for myxedema coma"
      },
      "formula": "myxedema_coma",
      "formula_expression": "Popoveniuc 2014 = thermoregulatory(gt_35→0, 32_to_35→10, lt_32→20) + cns_effects(absent→0, somnolent_lethargic→10, obtunded→15, stupor→20, coma_seizures→30) + gastrointestinal(absent→0, anorexia_pain_constipation→5, decreased_motility→15, paralytic_ileus→20) + 10*precipitating_event + bradycardia(absent→0, 50_to_59→10, 40_to_49→20, lt_40→30) + 10*other_ekg_changes + 10*pericardial_pleural_effusion + 15*pulmonary_edema + 15*cardiomegaly + 20*hypotension + 10*hyponatremia + 10*hypoglycemia + 10*hypoxemia + 10*hypercarbia + 10*decreased_gfr; max 230; ≥60 potentially_diagnostic, 45–59 at_risk",
      "max_score": 230,
      "score": 0,
      "myxedema_coma_band": "below_at_risk"
    }
  ]
}

Response

Field	Type	Description
`formula`	string	myxedema_coma
`formula_expression`	string	Exact expression used
`score`	integer	Popoveniuc 2014 myxedema coma diagnostic points 0-230
`max_score`	integer	Always 230
`myxedema_coma_band`	string	potentially_diagnostic when score is ≥60, at_risk when 45-59, below_at_risk when <45 (Popoveniuc 2014 conclusion). Not a myxedema-coma diagnosis or thyroid-hormone order.
`components`	array	Per-factor Popoveniuc 2014 points
`citation`	object	Popoveniuc et al. Endocr Pract 2014 citation
`disclaimer`	string	Not-a-device notice

Example JSON

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

{
  "components": [
    {
      "value": "gt_35",
      "factor": "thermoregulatory",
      "points": 0,
      "present": false
    },
    {
      "value": "absent",
      "factor": "cns_effects",
      "points": 0,
      "present": false
    },
    {
      "value": "absent",
      "factor": "gastrointestinal",
      "points": 0,
      "present": false
    },
    {
      "value": false,
      "factor": "precipitating_event",
      "points": 0,
      "present": false
    },
    {
      "value": "absent",
      "factor": "bradycardia",
      "points": 0,
      "present": false
    },
    {
      "value": false,
      "factor": "other_ekg_changes",
      "points": 0,
      "present": false
    },
    {
      "value": false,
      "factor": "pericardial_pleural_effusion",
      "points": 0,
      "present": false
    },
    {
      "value": false,
      "factor": "pulmonary_edema",
      "points": 0,
      "present": false
    },
    {
      "value": false,
      "factor": "cardiomegaly",
      "points": 0,
      "present": false
    },
    {
      "value": false,
      "factor": "hypotension",
      "points": 0,
      "present": false
    },
    {
      "value": false,
      "factor": "hyponatremia",
      "points": 0,
      "present": false
    },
    {
      "value": false,
      "factor": "hypoglycemia",
      "points": 0,
      "present": false
    },
    {
      "value": false,
      "factor": "hypoxemia",
      "points": 0,
      "present": false
    },
    {
      "value": false,
      "factor": "hypercarbia",
      "points": 0,
      "present": false
    },
    {
      "value": false,
      "factor": "decreased_gfr",
      "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": "Popoveniuc G, Chandra T, Sud A, Sharma M, Blackman MR, Burman KD, Mete M, Desale S, Wartofsky L",
    "doi": "10.4158/EP13460.OR",
    "id": "popoveniuc-2014",
    "pmid": "24518183",
    "source": "Endocr Pract. 2014;20(8):808-817",
    "title": "A diagnostic scoring system for myxedema coma"
  },
  "formula": "myxedema_coma",
  "formula_expression": "Popoveniuc 2014 = thermoregulatory(gt_35→0, 32_to_35→10, lt_32→20) + cns_effects(absent→0, somnolent_lethargic→10, obtunded→15, stupor→20, coma_seizures→30) + gastrointestinal(absent→0, anorexia_pain_constipation→5, decreased_motility→15, paralytic_ileus→20) + 10*precipitating_event + bradycardia(absent→0, 50_to_59→10, 40_to_49→20, lt_40→30) + 10*other_ekg_changes + 10*pericardial_pleural_effusion + 15*pulmonary_edema + 15*cardiomegaly + 20*hypotension + 10*hyponatremia + 10*hypoglycemia + 10*hypoxemia + 10*hypercarbia + 10*decreased_gfr; max 230; ≥60 potentially_diagnostic, 45–59 at_risk",
  "max_score": 230,
  "score": 0,
  "myxedema_coma_band": "below_at_risk"
}

Client errors (HTTP 400)

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

HTTP	Code	When
400	`invalid_myxedema_coma`	Myxedema coma score inputs must match Popoveniuc 2014 thermoregulatory, neurologic, cardiovascular, gastrointestinal, metabolic, and precipitant bands from that paper. Returned before settlement; you are not charged.
400	`invalid_items`	POST body must be a JSON object with only an items array Returned before settlement; you are not charged.
400	`invalid_item_count`	items must be an array of 1 to 25 objects Returned before settlement; you are not charged.
400	`invalid_item`	each items entry must be a JSON object Returned before settlement; you are not charged.

Related tools

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Winters' formula — Compute expected arterial PCO2 in metabolic acidosis from plasma bicarbonate using the Albert–Winters 1967 formula.

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. 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.