# NUTRIC (Nutrition Risk in the Critically Ill) NUTRIC Status: LIVE Price: $0.005 USDC `GET /api/calc/nutric` HTML: https://magentlab.com/docs/nutric Markdown: https://magentlab.com/docs/nutric.md Not a medical device. Not a diagnosis, dose, or listing recommendation. ## What it computes Sum Heyland 2011 original 6-variable NUTRIC (Nutrition Risk in the Critically Ill) Table 4 overall points, including IL-6, and return whether the total is high nutrition risk (score ≥6). ## When to use When an agent has caller-supplied age, APACHE II, SOFA, comorbidity count, hospital days to ICU, and IL-6 and needs the published original NUTRIC total and high-risk flag, not a feeding order, and not Rahman 2015 mNUTRIC. ## When not to use - Not a medical device. - Not a feeding order or nutrition-therapy prescription. - Heyland 2011 original 6-variable NUTRIC including IL-6 (Table 4 overall). high_risk is true iff score ≥ 6. This is not Rahman 2015 mNUTRIC (IL-6 omitted; do not use the 5–9 cutoff). - magent does not compute APACHE II or SOFA; the caller supplies those integers. APACHE II 28 scores 2 (the 20–28 row, not the overlapping ≥28 row). ## Formula ``` NUTRIC = age (0–2) + apache_ii (0–3) + sofa (0–2) + comorbidities (0–1) + hospital_days_to_icu (0–1) + il6_pg_ml (0–1); Heyland 2011 Table 4 overall including IL-6; max 10; high_risk if score ≥ 6 ``` ## Citation [Identifying critically ill patients who benefit the most from nutrition therapy: the development and initial validation of a novel risk assessment tool](https://doi.org/10.1186/cc10546) Heyland DK, Dhaliwal R, Jiang X, Day AG Crit Care. 2011;15(6):R268 DOI: [10.1186/cc10546](https://doi.org/10.1186/cc10546) ## Worked example ### All zero bands, age 40 Given: `age=40, apache_ii=10, comorbidities=0, hospital_days_to_icu=0, il6_pg_ml=100, sofa=4` 1. age 40 <50 → 0; apache_ii 10 <15 → 0; sofa 4 <6 → 0 2. comorbidities 0 → 0; hospital_days_to_icu 0 → 0; il6_pg_ml 100 <400 → 0 3. Score = 0 (max 10); high_risk false ### Age 75, APACHE II 20, SOFA 10 at the high-risk cutoff Given: `age=75, apache_ii=20, comorbidities=0, hospital_days_to_icu=0, il6_pg_ml=100, sofa=10` 1. age ≥75 → 2; apache_ii 20–28 → 2; sofa ≥10 → 2 2. comorbidities, hospital days, and IL-6 stay 0 3. Score = 6 (max 10); high_risk true ## Also searched as - NUTRIC - Nutrition Risk in the Critically Ill - Heyland NUTRIC - NUTRIC score - nutrition risk critically ill - NUTRIC IL-6 ## Parameters - `age` (integer, required): Age in years (18-120). Heyland 2011 Table 4 overall: <50 → 0; 50–<75 → 1; ≥75 → 2. Age 50 scores 1. Age 74 scores 1. Age 75 scores 2. - `apache_ii` (integer, required): Caller-supplied APACHE II total (integer 0-71). Heyland 2011 Table 4 overall: <15 → 0; 15–<20 → 1; 20–28 inclusive → 2; ≥29 → 3. APACHE II 28 scores 2 (the 20–28 row, not the overlapping ≥28 row). magent does not compute APACHE II. - `sofa` (integer, required): Caller-supplied SOFA total (integer 0-24). Heyland 2011 Table 4 overall: <6 → 0; 6–<10 → 1; ≥10 → 2. magent does not compute SOFA. - `comorbidities` (integer, required): Number of comorbidities (integer 0-20). Heyland 2011 Table 4 overall: 0–1 → 0; ≥2 → 1. - `hospital_days_to_icu` (number, required): Days from hospital admission to ICU admission (0-365). Heyland 2011 Table 4 overall: 0–<1 → 0; ≥1 → 1. 0.9 scores 0. 1.0 scores 1. - `il6_pg_ml` (number, required): Serum IL-6 in pg/mL (0-100000). Heyland 2011 Table 4 overall original 6-variable NUTRIC: 0–<400 → 0; ≥400 → 1. 399.9 scores 0. 400 scores 1. This is not Rahman 2015 mNUTRIC (IL-6 omitted). ## 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/nutric` 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": "40", "apache_ii": "10", "comorbidities": "0", "hospital_days_to_icu": "0", "il6_pg_ml": "100", "sofa": "4" }, { "age": "40", "apache_ii": "10", "comorbidities": "0", "hospital_days_to_icu": "0", "il6_pg_ml": "100", "sofa": "4" } ] } ``` Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/nutric Example 200: ```json { "count": 2, "path": "/api/calc/nutric", "items": [ { "components": [ { "value": 40, "factor": "age", "points": 0, "present": false }, { "value": 10, "factor": "apache_ii", "points": 0, "present": false }, { "value": 4, "factor": "sofa", "points": 0, "present": false }, { "value": 0, "factor": "comorbidities", "points": 0, "present": false }, { "value": 0.0, "factor": "hospital_days_to_icu", "points": 0, "present": false }, { "value": 100.0, "factor": "il6_pg_ml", "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": "Heyland DK, Dhaliwal R, Jiang X, Day AG", "doi": "10.1186/cc10546", "id": "heyland-2011", "pmid": "22085762", "source": "Crit Care. 2011;15(6):R268", "title": "Identifying critically ill patients who benefit the most from nutrition therapy: the development and initial validation of a novel risk assessment tool" }, "formula": "nutric", "formula_expression": "NUTRIC = age (0–2) + apache_ii (0–3) + sofa (0–2) + comorbidities (0–1) + hospital_days_to_icu (0–1) + il6_pg_ml (0–1); Heyland 2011 Table 4 overall including IL-6; max 10; high_risk if score ≥ 6", "age_years": 40, "max_score": 10, "score": 0, "high_risk": false, "apache_ii": 10, "comorbidities": 0, "hospital_days_to_icu": 0.0, "il6_pg_ml": 100.0, "sofa": 4 }, { "components": [ { "value": 40, "factor": "age", "points": 0, "present": false }, { "value": 10, "factor": "apache_ii", "points": 0, "present": false }, { "value": 4, "factor": "sofa", "points": 0, "present": false }, { "value": 0, "factor": "comorbidities", "points": 0, "present": false }, { "value": 0.0, "factor": "hospital_days_to_icu", "points": 0, "present": false }, { "value": 100.0, "factor": "il6_pg_ml", "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": "Heyland DK, Dhaliwal R, Jiang X, Day AG", "doi": "10.1186/cc10546", "id": "heyland-2011", "pmid": "22085762", "source": "Crit Care. 2011;15(6):R268", "title": "Identifying critically ill patients who benefit the most from nutrition therapy: the development and initial validation of a novel risk assessment tool" }, "formula": "nutric", "formula_expression": "NUTRIC = age (0–2) + apache_ii (0–3) + sofa (0–2) + comorbidities (0–1) + hospital_days_to_icu (0–1) + il6_pg_ml (0–1); Heyland 2011 Table 4 overall including IL-6; max 10; high_risk if score ≥ 6", "age_years": 40, "max_score": 10, "score": 0, "high_risk": false, "apache_ii": 10, "comorbidities": 0, "hospital_days_to_icu": 0.0, "il6_pg_ml": 100.0, "sofa": 4 } ] } ``` ## Response fields - `formula` (string): nutric - `formula_expression` (string): Exact expression used - `score` (integer): NUTRIC points 0-10 - `max_score` (integer): 10 - `high_risk` (boolean): true iff score ≥ 6 (Heyland 2011 original 6-variable NUTRIC with IL-6). Not a feeding order. Not the Rahman 2015 mNUTRIC 5–9 cutoff. - `age_years` (integer): Age used for the 0–2 age points - `apache_ii` (integer): Caller-supplied APACHE II total used for the 0–3 points - `sofa` (integer): Caller-supplied SOFA total used for the 0–2 points - `comorbidities` (integer): Comorbidity count used for the 0–1 points - `hospital_days_to_icu` (number): Hospital days to ICU used for the 0–1 points - `il6_pg_ml` (number): IL-6 pg/mL used for the 0–1 points - `components` (array): Per-item Heyland 2011 Table 4 overall points - `citation` (object): Heyland et al. Crit Care 2011 citation - `disclaimer` (string): Not-a-device notice ## Example JSON Frozen fixture. Not a live lookup. ```json { "components": [ { "value": 40, "factor": "age", "points": 0, "present": false }, { "value": 10, "factor": "apache_ii", "points": 0, "present": false }, { "value": 4, "factor": "sofa", "points": 0, "present": false }, { "value": 0, "factor": "comorbidities", "points": 0, "present": false }, { "value": 0.0, "factor": "hospital_days_to_icu", "points": 0, "present": false }, { "value": 100.0, "factor": "il6_pg_ml", "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": "Heyland DK, Dhaliwal R, Jiang X, Day AG", "doi": "10.1186/cc10546", "id": "heyland-2011", "pmid": "22085762", "source": "Crit Care. 2011;15(6):R268", "title": "Identifying critically ill patients who benefit the most from nutrition therapy: the development and initial validation of a novel risk assessment tool" }, "formula": "nutric", "formula_expression": "NUTRIC = age (0–2) + apache_ii (0–3) + sofa (0–2) + comorbidities (0–1) + hospital_days_to_icu (0–1) + il6_pg_ml (0–1); Heyland 2011 Table 4 overall including IL-6; max 10; high_risk if score ≥ 6", "age_years": 40, "max_score": 10, "score": 0, "high_risk": false, "apache_ii": 10, "comorbidities": 0, "hospital_days_to_icu": 0.0, "il6_pg_ml": 100.0, "sofa": 4 } ``` ## Errors - HTTP 400 `invalid_age`: age must be an integer from 18 to 120 Returned before settlement; you are not charged. - HTTP 400 `invalid_apache_ii`: apache_ii must be an integer from 0 to 71 (Heyland 2011 NUTRIC). Returned before settlement; you are not charged. - HTTP 400 `invalid_sofa_total`: sofa must be an integer from 0 to 24 (Heyland 2011 NUTRIC). Returned before settlement; you are not charged. - HTTP 400 `invalid_comorbidity_count`: comorbidities must be an integer from 0 to 20 (Heyland 2011 NUTRIC). Returned before settlement; you are not charged. - HTTP 400 `invalid_hospital_days`: hospital_days_to_icu must be a number from 0 to 365 (Heyland 2011 NUTRIC). Returned before settlement; you are not charged. - HTTP 400 `invalid_il6`: il6_pg_ml must be a number from 0 to 100000 (Heyland 2011 NUTRIC). 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 - [NRS-2002](https://magentlab.com/docs/nrs-2002) — Sum Kondrup 2003 NRS-2002 impaired nutritional status (0–3), disease severity (0–3), and 1 if age ≥70, and return whether the total is at nutritional risk (score ≥3). ## 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.