Infection / VTE · LIVE

PIRO score for ICU CAP

PIRO-CAP

Sum the Rello 2009 PIRO features for ICU community-acquired pneumonia and return the 0-8 score and published band.

LIVE $0.005 USDC GET /api/calc/piro_cap

Markdown: /docs/piro-cap.md · Canonical: https://magentlab.com/docs/piro-cap

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

What it computes

Sum the Rello 2009 PIRO features for ICU community-acquired pneumonia and return the 0-8 score and published band.

When to use

When an agent has caller-assigned Rello 2009 PIRO inputs obtained within 24 h of ICU admission for community-acquired pneumonia and needs the published total and band, not CURB-65, PSI, or APACHE II.

When not to use

Not a medical device. Not a diagnosis of pneumonia and not a treatment, ICU-admission, or site-of-care order.
Rello 2009 PIRO for ICU CAP only (score obtained within 24 h of ICU admission). Not CURB-65, not PSI/PORT, not APACHE II.
Comorbidities (COPD or immunocompromise) count as one feature: 1 point if either is true, not 1 each.
Age >70 scores 1; age 70 does not. magent does not interpret a chest radiograph; multilobar_opacities is a caller-assigned flag.

Formula

PIRO-CAP (Rello 2009 ICU CAP, within 24 h of ICU admission) = comorbidities (copd or immunocompromise, 1 if either) + age>70 + multilobar_opacities + shock + severe_hypoxemia + acute_renal_failure + bacteremia + ards; each 1; max 8; bands low 0-2, mild 3, high 4, very_high 5-8. Not CURB-65. Not PSI. Not APACHE II

Citation

Title: PIRO score for community-acquired pneumonia: a new prediction rule for assessment of severity in intensive care unit patients with community-acquired pneumonia
Authors: Rello J, Rodriguez A, Lisboa T, Gallego M, Lujan M, Wunderink R
Source: Crit Care Med. 2009;37(2):456-462
DOI: 10.1097/CCM.0b013e318194b021

Worked example

Age 75, multilobar opacities and shock

Given: acute_renal_failure=falseage=75ards=falsebacteremia=falsecopd=falseimmunocompromise=falsemultilobar_opacities=truesevere_hypoxemia=falseshock=true

Age 75 >70 → 1; copd false and immunocompromise false → comorbidities 0
multilobar_opacities true → 1; shock true → 1; remaining flags false
score = 3; band = mild

COPD and immunocompromise both true (one comorbidity point)

Given: acute_renal_failure=falseage=40ards=falsebacteremia=falsecopd=trueimmunocompromise=truemultilobar_opacities=falsesevere_hypoxemia=falseshock=false

copd true or immunocompromise true → comorbidities 1 (not 2)
Age 40 is not >70; remaining flags false
score = 1; band = low

Also searched as

PIRO CAP
PIRO score
Rello PIRO
ICU pneumonia PIRO
community-acquired pneumonia PIRO
PIRO community-acquired pneumonia

Try

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

/api/calc/piro_cap?age=75&copd=false&immunocompromise=false&multilobar_opacities=true&shock=true&severe_hypoxemia=false&acute_renal_failure=false&bacteremia=false&ards=false

Full URL: https://api.magentlab.com/api/calc/piro_cap?age=75&copd=false&immunocompromise=false&multilobar_opacities=true&shock=true&severe_hypoxemia=false&acute_renal_failure=false&bacteremia=false&ards=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/piro_cap?age=75&copd=false&immunocompromise=false&multilobar_opacities=true&shock=true&severe_hypoxemia=false&acute_renal_failure=false&bacteremia=false&ards=false"

Parameters

Name	Type	Required	Description
`age`	integer	required	Age in years (integer 18-120). Age >70 scores 1 (Rello 2009). Age 70 does not score. magent does not compute age from a date of birth.
`copd`	boolean	required	Chronic obstructive pulmonary disease as assigned by the caller (Rello 2009 comorbidity feature with immunocompromise). true or false. COPD or immunocompromise scores 1 together, not 1 each. magent does not diagnose COPD.
`immunocompromise`	boolean	required	Immunocompromise as assigned by the caller (Rello 2009 comorbidity feature with COPD). true or false. COPD or immunocompromise scores 1 together, not 1 each. magent does not assign immune status.
`multilobar_opacities`	boolean	required	Multilobar opacities on chest radiograph as assigned by the caller (Rello 2009). true or false. 1 point if true. magent does not interpret a chest radiograph.
`shock`	boolean	required	Shock as assigned by the caller (Rello 2009). true or false. 1 point if true. magent does not measure blood pressure or diagnose shock.
`severe_hypoxemia`	boolean	required	Severe hypoxemia as assigned by the caller (Rello 2009). true or false. 1 point if true. magent does not measure PaO2 or FiO2.
`acute_renal_failure`	boolean	required	Acute renal failure as assigned by the caller (Rello 2009). true or false. 1 point if true. magent does not assay creatinine.
`bacteremia`	boolean	required	Bacteremia as assigned by the caller (Rello 2009). true or false. 1 point if true. magent does not interpret cultures.
`ards`	boolean	required	Acute respiratory distress syndrome as assigned by the caller (Rello 2009). true or false. 1 point if true. magent does not diagnose ARDS.

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/piro_cap 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": [
    {
      "acute_renal_failure": "false",
      "age": "75",
      "ards": "false",
      "bacteremia": "false",
      "copd": "false",
      "immunocompromise": "false",
      "multilobar_opacities": "true",
      "severe_hypoxemia": "false",
      "shock": "true"
    },
    {
      "acute_renal_failure": "false",
      "age": "75",
      "ards": "false",
      "bacteremia": "false",
      "copd": "false",
      "immunocompromise": "false",
      "multilobar_opacities": "true",
      "severe_hypoxemia": "false",
      "shock": "true"
    }
  ]
}

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/piro_cap",
  "items": [
    {
      "band": "mild",
      "components": [
        {
          "factor": "comorbidities",
          "points": 0,
          "present": false,
          "copd": false,
          "immunocompromise": false
        },
        {
          "value": 75,
          "factor": "age_gt_70",
          "points": 1,
          "present": true
        },
        {
          "factor": "multilobar_opacities",
          "points": 1,
          "present": true
        },
        {
          "factor": "shock",
          "points": 1,
          "present": true
        },
        {
          "factor": "severe_hypoxemia",
          "points": 0,
          "present": false
        },
        {
          "factor": "acute_renal_failure",
          "points": 0,
          "present": false
        },
        {
          "factor": "bacteremia",
          "points": 0,
          "present": false
        },
        {
          "factor": "ards",
          "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": "Rello J, Rodriguez A, Lisboa T, Gallego M, Lujan M, Wunderink R",
        "doi": "10.1097/CCM.0b013e318194b021",
        "id": "rello-2009",
        "pmid": "19114916",
        "source": "Crit Care Med. 2009;37(2):456-462",
        "title": "PIRO score for community-acquired pneumonia: a new prediction rule for assessment of severity in intensive care unit patients with community-acquired pneumonia"
      },
      "formula": "piro_cap",
      "formula_expression": "PIRO-CAP (Rello 2009 ICU CAP, within 24 h of ICU admission) = comorbidities (copd or immunocompromise, 1 if either) + age>70 + multilobar_opacities + shock + severe_hypoxemia + acute_renal_failure + bacteremia + ards; each 1; max 8; bands low 0-2, mild 3, high 4, very_high 5-8. Not CURB-65. Not PSI. Not APACHE II",
      "max_score": 8,
      "score": 3,
      "age_years": 75
    },
    {
      "band": "mild",
      "components": [
        {
          "factor": "comorbidities",
          "points": 0,
          "present": false,
          "copd": false,
          "immunocompromise": false
        },
        {
          "value": 75,
          "factor": "age_gt_70",
          "points": 1,
          "present": true
        },
        {
          "factor": "multilobar_opacities",
          "points": 1,
          "present": true
        },
        {
          "factor": "shock",
          "points": 1,
          "present": true
        },
        {
          "factor": "severe_hypoxemia",
          "points": 0,
          "present": false
        },
        {
          "factor": "acute_renal_failure",
          "points": 0,
          "present": false
        },
        {
          "factor": "bacteremia",
          "points": 0,
          "present": false
        },
        {
          "factor": "ards",
          "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": "Rello J, Rodriguez A, Lisboa T, Gallego M, Lujan M, Wunderink R",
        "doi": "10.1097/CCM.0b013e318194b021",
        "id": "rello-2009",
        "pmid": "19114916",
        "source": "Crit Care Med. 2009;37(2):456-462",
        "title": "PIRO score for community-acquired pneumonia: a new prediction rule for assessment of severity in intensive care unit patients with community-acquired pneumonia"
      },
      "formula": "piro_cap",
      "formula_expression": "PIRO-CAP (Rello 2009 ICU CAP, within 24 h of ICU admission) = comorbidities (copd or immunocompromise, 1 if either) + age>70 + multilobar_opacities + shock + severe_hypoxemia + acute_renal_failure + bacteremia + ards; each 1; max 8; bands low 0-2, mild 3, high 4, very_high 5-8. Not CURB-65. Not PSI. Not APACHE II",
      "max_score": 8,
      "score": 3,
      "age_years": 75
    }
  ]
}

Response

Field	Type	Description
`formula`	string	piro_cap
`formula_expression`	string	Exact expression used
`score`	integer	PIRO-CAP points 0-8
`max_score`	integer	8
`band`	string	Rello 2009 band: low (0-2), mild (3), high (4), or very_high (5-8). A band, not a diagnosis.
`age_years`	integer	Age used for the >70 criterion
`components`	array	Per-feature points. comorbidities is 1 if copd or immunocompromise is true, not 1 each.
`citation`	object	Rello 2009 Crit Care Med citation
`disclaimer`	string	Not-a-device notice

Example JSON

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

{
  "band": "mild",
  "components": [
    {
      "factor": "comorbidities",
      "points": 0,
      "present": false,
      "copd": false,
      "immunocompromise": false
    },
    {
      "value": 75,
      "factor": "age_gt_70",
      "points": 1,
      "present": true
    },
    {
      "factor": "multilobar_opacities",
      "points": 1,
      "present": true
    },
    {
      "factor": "shock",
      "points": 1,
      "present": true
    },
    {
      "factor": "severe_hypoxemia",
      "points": 0,
      "present": false
    },
    {
      "factor": "acute_renal_failure",
      "points": 0,
      "present": false
    },
    {
      "factor": "bacteremia",
      "points": 0,
      "present": false
    },
    {
      "factor": "ards",
      "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": "Rello J, Rodriguez A, Lisboa T, Gallego M, Lujan M, Wunderink R",
    "doi": "10.1097/CCM.0b013e318194b021",
    "id": "rello-2009",
    "pmid": "19114916",
    "source": "Crit Care Med. 2009;37(2):456-462",
    "title": "PIRO score for community-acquired pneumonia: a new prediction rule for assessment of severity in intensive care unit patients with community-acquired pneumonia"
  },
  "formula": "piro_cap",
  "formula_expression": "PIRO-CAP (Rello 2009 ICU CAP, within 24 h of ICU admission) = comorbidities (copd or immunocompromise, 1 if either) + age>70 + multilobar_opacities + shock + severe_hypoxemia + acute_renal_failure + bacteremia + ards; each 1; max 8; bands low 0-2, mild 3, high 4, very_high 5-8. Not CURB-65. Not PSI. Not APACHE II",
  "max_score": 8,
  "score": 3,
  "age_years": 75
}

Client errors (HTTP 400)

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

HTTP	Code	When
400	`invalid_age`	age must be an integer from 18 to 120 Returned before settlement; you are not charged.
400	`invalid_flag`	boolean clinical flags must be true or false 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

CURB-65 — Compute the CURB-65 community-acquired pneumonia severity score from age and discrete flags.
PSI / PORT — Compute the Fine 1997 Pneumonia Severity Index (PORT) two-step risk class and Table 2 point total for community-acquired pneumonia.
SMART-COP — Compute the Charles 2008 SMART-COP point total and IRVS risk band for community-acquired pneumonia.

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.