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ORBI STEMI cardiogenic shock score

ORBI

Sum the Auffret 2018 ORBI predictors after STEMI primary PCI and return the integer score (0-36), class I-IV, and derivation-cohort in-hospital cardiogenic-shock percent.

LIVE $0.005 USDC GET /api/calc/orbi

Markdown: /docs/orbi.md · Canonical: https://magentlab.com/docs/orbi

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

What it computes

Sum the Auffret 2018 ORBI predictors after STEMI primary PCI and return the integer score (0-36), class I-IV, and derivation-cohort in-hospital cardiogenic-shock percent.

When to use

When an agent needs the published ORBI point total after STEMI treated by primary PCI and must not invent a shock-treatment order, a cath-lab protocol, or the ORBIT bleeding score.

When not to use

Not a medical device and not a cath-lab, reperfusion, or shock-treatment order. magent does not examine the patient, read the ECG, or assign TIMI flow.
Killip class is i, ii, or iii as assigned by the caller. Killip IV (cardiogenic shock on admission) is rejected because the derivation excluded those patients.
SBP <125 mm Hg and pulse pressure <45 mm Hg is a single caller-assigned boolean (sbp_lt_125_and_pp_lt_45). magent does not take separate SBP or pulse-pressure numbers.
Class percents are the Auffret 2018 derivation-cohort observed in-hospital cardiogenic-shock rates (I 1.3%, II 6.6%, III 11.7%, IV 31.8%). Validation-cohort rates differ and are not returned.
Not the O'Brien 2015 ORBIT bleeding score. Integer weights round the multivariable adjusted odds ratios; theoretical maximum 36.

Formula

ORBI = age_years>70 (2) + prior_stroke_tia (2) + cardiac_arrest_on_admission (3) + anterior_stemi (1) + fmc_to_ppci_gt_90_min (2) + killip_class (i:0, ii:2, iii:6; iv rejected) + heart_rate>90 (3) + sbp_lt_125_and_pp_lt_45 (4) + glucose_gt_10_mmol_l (3) + left_main_culprit (5) + post_ppci_timi_lt_3 (5); Auffret 2018 rounded adjusted ORs; max 36; derivation in-hospital CS class I 0-7 1.3%, II 8-10 6.6%, III 11-12 11.7%, IV >=13 31.8%

Citation

Title: Predicting the development of in-hospital cardiogenic shock in patients with ST-segment elevation myocardial infarction treated by primary percutaneous coronary intervention: the ORBI risk score
Authors: Auffret V, Cottin Y, Leurent G, et al.
Source: Eur Heart J. 2018;39(22):2090-2102
DOI: 10.1093/eurheartj/ehy127

Worked example

No risk flags, age 60, Killip I, heart rate 70

Given: age_years=60anterior_stemi=falsecardiac_arrest_on_admission=falsefmc_to_ppci_gt_90_min=falseglucose_gt_10_mmol_l=falseheart_rate=70killip_class=ileft_main_culprit=falsepost_ppci_timi_lt_3=falseprior_stroke_tia=falsesbp_lt_125_and_pp_lt_45=false

age_years 60 is not >70 → 0; all boolean flags false → 0; killip i → 0; heart_rate 70 is not >90 → 0
score = 0 (max 36); class I; derivation in-hospital CS 1.3%

All predictors present (theoretical max 36)

Given: age_years=71anterior_stemi=truecardiac_arrest_on_admission=truefmc_to_ppci_gt_90_min=trueglucose_gt_10_mmol_l=trueheart_rate=91killip_class=iiileft_main_culprit=truepost_ppci_timi_lt_3=trueprior_stroke_tia=truesbp_lt_125_and_pp_lt_45=true

age_years 71 → 2; stroke/TIA 2; arrest 3; anterior 1; FMC>90 2; killip iii 6; HR>90 3; SBP/PP 4; glucose 3; left main 5; TIMI<3 5
score = 36 (max 36); class IV; derivation in-hospital CS 31.8%

Also searched as

ORBI risk score
Auffret STEMI shock score
STEMI in-hospital cardiogenic shock
ORBI class
primary PCI shock score
FMC to PPCI ORBI
ORBI STEMI PPCI
Auffret 2018 ORBI

Try

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

/api/calc/orbi?age_years=60&prior_stroke_tia=false&cardiac_arrest_on_admission=false&anterior_stemi=false&fmc_to_ppci_gt_90_min=false&killip_class=i&heart_rate=70&sbp_lt_125_and_pp_lt_45=false&glucose_gt_10_mmol_l=false&left_main_culprit=false&post_ppci_timi_lt_3=false

Full URL: https://api.magentlab.com/api/calc/orbi?age_years=60&prior_stroke_tia=false&cardiac_arrest_on_admission=false&anterior_stemi=false&fmc_to_ppci_gt_90_min=false&killip_class=i&heart_rate=70&sbp_lt_125_and_pp_lt_45=false&glucose_gt_10_mmol_l=false&left_main_culprit=false&post_ppci_timi_lt_3=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/orbi?age_years=60&prior_stroke_tia=false&cardiac_arrest_on_admission=false&anterior_stemi=false&fmc_to_ppci_gt_90_min=false&killip_class=i&heart_rate=70&sbp_lt_125_and_pp_lt_45=false&glucose_gt_10_mmol_l=false&left_main_culprit=false&post_ppci_timi_lt_3=false"

Parameters

Name	Type	Required	Description
`age_years`	integer	required	Age in years (18-120). Auffret 2018: older than 70 scores 2; 70 or younger scores 0.
`prior_stroke_tia`	boolean	required	Prior stroke or TIA (Auffret 2018: 2 points). true or false.
`cardiac_arrest_on_admission`	boolean	required	Cardiac arrest on admission (Auffret 2018: 3 points). true or false.
`anterior_stemi`	boolean	required	Anterior ST-elevation myocardial infarction (Auffret 2018: 1 point). Caller-assigned. magent does not read the ECG.
`fmc_to_ppci_gt_90_min`	boolean	required	First medical contact to primary PCI greater than 90 minutes (Auffret 2018: 2 points). true or false. magent does not compute timestamps.
`killip_class`	string	required · i, ii, iii	Caller-assigned Killip class after STEMI (Auffret 2018): i (0), ii (2), or iii (6). Killip IV is rejected because the derivation excluded cardiogenic shock on admission. magent does not examine the patient.
`heart_rate`	integer	required	Heart rate in beats per minute (integer 30-220). Auffret 2018: greater than 90 scores 3.
`sbp_lt_125_and_pp_lt_45`	boolean	required	Whether systolic BP is <125 mm Hg and pulse pressure is <45 mm Hg together (Auffret 2018: 4 points). Single caller-assigned boolean; magent does not take separate SBP or pulse-pressure numbers.
`glucose_gt_10_mmol_l`	boolean	required	Admission glucose >10 mmol/L (Auffret 2018: 3 points). true or false. magent does not convert units.
`left_main_culprit`	boolean	required	Whether the culprit lesion is the left main coronary artery (Auffret 2018: 5 points). Caller-assigned. magent does not read the angiogram.
`post_ppci_timi_lt_3`	boolean	required	Whether post-primary-PCI TIMI flow is <3 (Auffret 2018: 5 points). Caller-assigned. magent does not assign TIMI flow.

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/orbi 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": [
    {
      "age_years": "60",
      "anterior_stemi": "false",
      "cardiac_arrest_on_admission": "false",
      "fmc_to_ppci_gt_90_min": "false",
      "glucose_gt_10_mmol_l": "false",
      "heart_rate": "70",
      "killip_class": "i",
      "left_main_culprit": "false",
      "post_ppci_timi_lt_3": "false",
      "prior_stroke_tia": "false",
      "sbp_lt_125_and_pp_lt_45": "false"
    },
    {
      "age_years": "60",
      "anterior_stemi": "false",
      "cardiac_arrest_on_admission": "false",
      "fmc_to_ppci_gt_90_min": "false",
      "glucose_gt_10_mmol_l": "false",
      "heart_rate": "70",
      "killip_class": "i",
      "left_main_culprit": "false",
      "post_ppci_timi_lt_3": "false",
      "prior_stroke_tia": "false",
      "sbp_lt_125_and_pp_lt_45": "false"
    }
  ]
}

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/orbi",
  "items": [
    {
      "components": [
        {
          "value": 60,
          "factor": "age_years",
          "points": 0,
          "present": false
        },
        {
          "value": "i",
          "factor": "killip_class",
          "points": 0,
          "present": false
        },
        {
          "value": 70,
          "factor": "heart_rate",
          "points": 0,
          "present": false
        },
        {
          "factor": "prior_stroke_tia",
          "points": 0,
          "present": false
        },
        {
          "factor": "cardiac_arrest_on_admission",
          "points": 0,
          "present": false
        },
        {
          "factor": "anterior_stemi",
          "points": 0,
          "present": false
        },
        {
          "factor": "fmc_to_ppci_gt_90_min",
          "points": 0,
          "present": false
        },
        {
          "factor": "sbp_lt_125_and_pp_lt_45",
          "points": 0,
          "present": false
        },
        {
          "factor": "glucose_gt_10_mmol_l",
          "points": 0,
          "present": false
        },
        {
          "factor": "left_main_culprit",
          "points": 0,
          "present": false
        },
        {
          "factor": "post_ppci_timi_lt_3",
          "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": "Auffret V, Cottin Y, Leurent G, et al.",
        "doi": "10.1093/eurheartj/ehy127",
        "id": "auffret-2018",
        "pmid": "29554243",
        "source": "Eur Heart J. 2018;39(22):2090-2102",
        "title": "Predicting the development of in-hospital cardiogenic shock in patients with ST-segment elevation myocardial infarction treated by primary percutaneous coronary intervention: the ORBI risk score"
      },
      "formula": "orbi",
      "formula_expression": "ORBI = age_years>70 (2) + prior_stroke_tia (2) + cardiac_arrest_on_admission (3) + anterior_stemi (1) + fmc_to_ppci_gt_90_min (2) + killip_class (i:0, ii:2, iii:6; iv rejected) + heart_rate>90 (3) + sbp_lt_125_and_pp_lt_45 (4) + glucose_gt_10_mmol_l (3) + left_main_culprit (5) + post_ppci_timi_lt_3 (5); Auffret 2018 rounded adjusted ORs; max 36; derivation in-hospital CS class I 0-7 1.3%, II 8-10 6.6%, III 11-12 11.7%, IV >=13 31.8%",
      "age_years": 60,
      "max_score": 36,
      "score": 0,
      "killip_class": "i",
      "heart_rate": 70,
      "in_hospital_cs_percent": 1.3,
      "orbi_class": "I"
    },
    {
      "components": [
        {
          "value": 60,
          "factor": "age_years",
          "points": 0,
          "present": false
        },
        {
          "value": "i",
          "factor": "killip_class",
          "points": 0,
          "present": false
        },
        {
          "value": 70,
          "factor": "heart_rate",
          "points": 0,
          "present": false
        },
        {
          "factor": "prior_stroke_tia",
          "points": 0,
          "present": false
        },
        {
          "factor": "cardiac_arrest_on_admission",
          "points": 0,
          "present": false
        },
        {
          "factor": "anterior_stemi",
          "points": 0,
          "present": false
        },
        {
          "factor": "fmc_to_ppci_gt_90_min",
          "points": 0,
          "present": false
        },
        {
          "factor": "sbp_lt_125_and_pp_lt_45",
          "points": 0,
          "present": false
        },
        {
          "factor": "glucose_gt_10_mmol_l",
          "points": 0,
          "present": false
        },
        {
          "factor": "left_main_culprit",
          "points": 0,
          "present": false
        },
        {
          "factor": "post_ppci_timi_lt_3",
          "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": "Auffret V, Cottin Y, Leurent G, et al.",
        "doi": "10.1093/eurheartj/ehy127",
        "id": "auffret-2018",
        "pmid": "29554243",
        "source": "Eur Heart J. 2018;39(22):2090-2102",
        "title": "Predicting the development of in-hospital cardiogenic shock in patients with ST-segment elevation myocardial infarction treated by primary percutaneous coronary intervention: the ORBI risk score"
      },
      "formula": "orbi",
      "formula_expression": "ORBI = age_years>70 (2) + prior_stroke_tia (2) + cardiac_arrest_on_admission (3) + anterior_stemi (1) + fmc_to_ppci_gt_90_min (2) + killip_class (i:0, ii:2, iii:6; iv rejected) + heart_rate>90 (3) + sbp_lt_125_and_pp_lt_45 (4) + glucose_gt_10_mmol_l (3) + left_main_culprit (5) + post_ppci_timi_lt_3 (5); Auffret 2018 rounded adjusted ORs; max 36; derivation in-hospital CS class I 0-7 1.3%, II 8-10 6.6%, III 11-12 11.7%, IV >=13 31.8%",
      "age_years": 60,
      "max_score": 36,
      "score": 0,
      "killip_class": "i",
      "heart_rate": 70,
      "in_hospital_cs_percent": 1.3,
      "orbi_class": "I"
    }
  ]
}

Response

Field	Type	Description
`formula`	string	orbi
`formula_expression`	string	Exact expression used
`score`	integer	ORBI points 0-36
`max_score`	integer	36
`orbi_class`	string	Auffret 2018 class I (0-7), II (8-10), III (11-12), or IV (>=13)
`in_hospital_cs_percent`	number	Derivation-cohort observed in-hospital cardiogenic-shock percent: 1.3, 6.6, 11.7, or 31.8
`age_years`	integer	Age in years used
`killip_class`	string	Caller-assigned Killip i, ii, or iii
`heart_rate`	integer	Heart rate used, beats per minute
`components`	array	Per-factor points
`citation`	object	Auffret et al. Eur Heart J 2018 citation
`disclaimer`	string	Not-a-device notice

Example JSON

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

{
  "components": [
    {
      "value": 60,
      "factor": "age_years",
      "points": 0,
      "present": false
    },
    {
      "value": "i",
      "factor": "killip_class",
      "points": 0,
      "present": false
    },
    {
      "value": 70,
      "factor": "heart_rate",
      "points": 0,
      "present": false
    },
    {
      "factor": "prior_stroke_tia",
      "points": 0,
      "present": false
    },
    {
      "factor": "cardiac_arrest_on_admission",
      "points": 0,
      "present": false
    },
    {
      "factor": "anterior_stemi",
      "points": 0,
      "present": false
    },
    {
      "factor": "fmc_to_ppci_gt_90_min",
      "points": 0,
      "present": false
    },
    {
      "factor": "sbp_lt_125_and_pp_lt_45",
      "points": 0,
      "present": false
    },
    {
      "factor": "glucose_gt_10_mmol_l",
      "points": 0,
      "present": false
    },
    {
      "factor": "left_main_culprit",
      "points": 0,
      "present": false
    },
    {
      "factor": "post_ppci_timi_lt_3",
      "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": "Auffret V, Cottin Y, Leurent G, et al.",
    "doi": "10.1093/eurheartj/ehy127",
    "id": "auffret-2018",
    "pmid": "29554243",
    "source": "Eur Heart J. 2018;39(22):2090-2102",
    "title": "Predicting the development of in-hospital cardiogenic shock in patients with ST-segment elevation myocardial infarction treated by primary percutaneous coronary intervention: the ORBI risk score"
  },
  "formula": "orbi",
  "formula_expression": "ORBI = age_years>70 (2) + prior_stroke_tia (2) + cardiac_arrest_on_admission (3) + anterior_stemi (1) + fmc_to_ppci_gt_90_min (2) + killip_class (i:0, ii:2, iii:6; iv rejected) + heart_rate>90 (3) + sbp_lt_125_and_pp_lt_45 (4) + glucose_gt_10_mmol_l (3) + left_main_culprit (5) + post_ppci_timi_lt_3 (5); Auffret 2018 rounded adjusted ORs; max 36; derivation in-hospital CS class I 0-7 1.3%, II 8-10 6.6%, III 11-12 11.7%, IV >=13 31.8%",
  "age_years": 60,
  "max_score": 36,
  "score": 0,
  "killip_class": "i",
  "heart_rate": 70,
  "in_hospital_cs_percent": 1.3,
  "orbi_class": "I"
}

Client errors (HTTP 400)

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

HTTP	Code	When
400	`invalid_orbi`	ORBI needs Auffret 2018 STEMI shock predictors (Killip I–III, hemodynamics, lesion, TIMI) in published ranges. 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

Killip — Return the Killip and Kimball 1967 myocardial-infarction heart-failure class 1-4 from a caller-assigned integer, with the published class description and 1967 CCU hospital mortality.
Shock index — Compute the Allgöwer–Burri shock index as heart rate in bpm divided by cuff systolic pressure in mm Hg.

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.