# PIRO score for ICU CAP PIRO-CAP Status: LIVE Price: $0.005 USDC `GET /api/calc/piro_cap` HTML: https://magentlab.com/docs/piro-cap Markdown: https://magentlab.com/docs/piro-cap.md 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 [PIRO score for community-acquired pneumonia: a new prediction rule for assessment of severity in intensive care unit patients with community-acquired pneumonia](https://doi.org/10.1097/CCM.0b013e318194b021) Rello J, Rodriguez A, Lisboa T, Gallego M, Lujan M, Wunderink R Crit Care Med. 2009;37(2):456-462 DOI: [10.1097/CCM.0b013e318194b021](https://doi.org/10.1097/CCM.0b013e318194b021) ## Worked example ### Age 75, multilobar opacities and shock Given: `acute_renal_failure=false, age=75, ards=false, bacteremia=false, copd=false, immunocompromise=false, multilobar_opacities=true, severe_hypoxemia=false, shock=true` 1. Age 75 >70 → 1; copd false and immunocompromise false → comorbidities 0 2. multilobar_opacities true → 1; shock true → 1; remaining flags false 3. score = 3; band = mild ### COPD and immunocompromise both true (one comorbidity point) Given: `acute_renal_failure=false, age=40, ards=false, bacteremia=false, copd=true, immunocompromise=true, multilobar_opacities=false, severe_hypoxemia=false, shock=false` 1. copd true or immunocompromise true → comorbidities 1 (not 2) 2. Age 40 is not >70; remaining flags false 3. score = 1; band = low ## Also searched as - PIRO CAP - PIRO score - Rello PIRO - ICU pneumonia PIRO - community-acquired pneumonia PIRO - PIRO community-acquired pneumonia ## Parameters - `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. Method: `POST /api/calc/piro_cap` 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": [ { "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" } ] } ``` Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/piro-cap Example 200: ```json { "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", "age_years": 75, "max_score": 8, "score": 3 }, { "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", "age_years": 75, "max_score": 8, "score": 3 } ] } ``` ## Response fields - `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 Frozen fixture. Not a live lookup. ```json { "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", "age_years": 75, "max_score": 8, "score": 3 } ``` ## Errors - HTTP 400 `invalid_age`: age must be an integer from 18 to 120 Returned before settlement; you are not charged. - HTTP 400 `invalid_flag`: boolean clinical flags must be true or false 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 - [CURB-65](https://magentlab.com/docs/curb65) — Compute the CURB-65 community-acquired pneumonia severity score from age and discrete flags. - [PSI / PORT](https://magentlab.com/docs/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](https://magentlab.com/docs/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. - 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.