# AMI READMITS 30-day readmission score READMITS Status: LIVE Price: $0.005 USDC `GET /api/calc/readmits` HTML: https://magentlab.com/docs/readmits Markdown: https://magentlab.com/docs/readmits.md Not a medical device. Not a diagnosis, dose, or listing recommendation. ## What it computes Sum the Nguyen 2018 first-day AMI READMITS predictors and return the integer score, Table 4 quintile, and mean predicted 30-day readmission percent. ## When to use When an agent needs the published first-day AMI READMITS point total within 24 hours of AMI admission and must not invent a PCI, reperfusion, or discharge order, or the full-stay model. ## When not to use - Not a medical device and not a PCI, reperfusion, or discharge order. magent does not assay creatinine or natriuretic peptides, take blood pressure, or examine the patient. - First-day AMI READMITS only (Nguyen 2018 Table 2). Does not include the full-stay model's intravenous diuretics, discharge anemia, or post-acute care. - Sex is the published nonmale/female item (female scores 2). Not race. - Quintile percents are Table 4 mean predicted 30-day readmission risk (3/7/11/16/35%), not an individual measured rate. - Creatinine >2 mg/dL, elevated BNP or NT-proBNP, PCI within 24 hours, and SBP <100 mm Hg are caller-assigned booleans. magent does not convert units or read timestamps. ## Formula ``` READMITS = creatinine_gt_2 (6) + elevated_bnp (8) + floor((age_years-18)/10) (1 per decade >18) + diabetes (4) + female (2) + no_pci_within_24h (1) + sbp_lt_100 (3); Nguyen 2018 first-day AMI READMITS Table 2; max 32 at age 100; Table 4 quintiles <=13 extremely_low 3%, 14-15 low 7%, 16-17 moderate 11%, 18-19 high 16%, >=20 extremely_high 35% ``` ## Citation [Predicting 30-Day Hospital Readmissions in Acute Myocardial Infarction: The AMI "READMITS" (Renal Function, Elevated Brain Natriuretic Peptide, Age, Diabetes Mellitus, Nonmale Sex, Intervention with Timely Percutaneous Coronary Intervention, and Low Systolic Blood Pressure) Score](https://doi.org/10.1161/JAHA.118.008882) Nguyen OK, Makam AN, Clark C, et al. J Am Heart Assoc. 2018;7(8):e008882 DOI: [10.1161/JAHA.118.008882](https://doi.org/10.1161/JAHA.118.008882) ## Worked example ### Age 58 male, no first-day flags, PCI within 24 hours Given: `age_years=58, creatinine_gt_2=false, diabetes=false, elevated_bnp=false, pci_within_24h=true, sbp_lt_100=false, sex=male` 1. age_years 58 -> floor((58-18)/10) = 4; male -> 0; creatinine_gt_2 false -> 0; elevated_bnp false -> 0; diabetes false -> 0; pci_within_24h true -> 0; sbp_lt_100 false -> 0 2. score = 4 (max 32); quintile extremely_low; Table 4 mean predicted 3% ### Age 58 male, creatinine, elevated BNP, and diabetes (score 20 or more) Given: `age_years=58, creatinine_gt_2=true, diabetes=true, elevated_bnp=true, pci_within_24h=true, sbp_lt_100=false, sex=male` 1. age decades 4 + creatinine_gt_2 6 + elevated_bnp 8 + diabetes 4 2. score = 22 (max 32); quintile extremely_high; Table 4 mean predicted 35% ## Also searched as - AMI READMITS - Nguyen 2018 READMITS - 30-day AMI readmission score - first-day READMITS - AMI creatinine BNP readmission - READMITS quintile - Nguyen AMI readmission - timely PCI READMITS ## Parameters - `age_years` (integer, required): Age in years (18-100). Nguyen 2018: 1 point per decade over 18, floor((age_years-18)/10). - `sex` (string, required): female or male (Nguyen 2018 nonmale sex). Female scores 2. Male scores 0. A published sex item, not race. - `creatinine_gt_2` (boolean, required): Whether serum creatinine was >2 mg/dL within the first 24 hours (Nguyen 2018: 6 points). Caller-assigned. magent does not assay creatinine. - `elevated_bnp` (boolean, required): Whether BNP was >=50 pg/mL or NT-proBNP was >=125 pg/mL within the first 24 hours (Nguyen 2018: 8 points). Caller-assigned. magent does not assay natriuretic peptides. - `diabetes` (boolean, required): Diabetes mellitus history (Nguyen 2018: 4 points). true or false. - `pci_within_24h` (boolean, required): Whether PCI occurred within the first 24 hours (Nguyen 2018: false scores 1; true scores 0). Caller-assigned. magent does not read timestamps or the angiogram. - `sbp_lt_100` (boolean, required): Whether systolic blood pressure was <100 mm Hg within the first 24 hours (Nguyen 2018: 3 points). Caller-assigned boolean; magent does not take an SBP number. ## 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/readmits` 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_years": "58", "creatinine_gt_2": "false", "diabetes": "false", "elevated_bnp": "false", "pci_within_24h": "true", "sbp_lt_100": "false", "sex": "male" }, { "age_years": "58", "creatinine_gt_2": "false", "diabetes": "false", "elevated_bnp": "false", "pci_within_24h": "true", "sbp_lt_100": "false", "sex": "male" } ] } ``` Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/readmits Example 200: ```json { "count": 2, "path": "/api/calc/readmits", "items": [ { "components": [ { "factor": "creatinine_gt_2", "points": 0, "present": false }, { "factor": "elevated_bnp", "points": 0, "present": false }, { "value": 58, "factor": "age_years", "points": 4, "present": true }, { "factor": "diabetes", "points": 0, "present": false }, { "value": "male", "factor": "sex", "points": 0, "present": false }, { "factor": "no_pci_within_24h", "points": 0, "present": false }, { "factor": "sbp_lt_100", "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.", "age_years": 58, "citation": { "authors": "Nguyen OK, Makam AN, Clark C, et al.", "doi": "10.1161/JAHA.118.008882", "id": "nguyen-2018", "pmid": "29666144", "source": "J Am Heart Assoc. 2018;7(8):e008882", "title": "Predicting 30-Day Hospital Readmissions in Acute Myocardial Infarction: The AMI \"READMITS\" (Renal Function, Elevated Brain Natriuretic Peptide, Age, Diabetes Mellitus, Nonmale Sex, Intervention with Timely Percutaneous Coronary Intervention, and Low Systolic Blood Pressure) Score" }, "formula": "readmits", "formula_expression": "READMITS = creatinine_gt_2 (6) + elevated_bnp (8) + floor((age_years-18)/10) (1 per decade >18) + diabetes (4) + female (2) + no_pci_within_24h (1) + sbp_lt_100 (3); Nguyen 2018 first-day AMI READMITS Table 2; max 32 at age 100; Table 4 quintiles <=13 extremely_low 3%, 14-15 low 7%, 16-17 moderate 11%, 18-19 high 16%, >=20 extremely_high 35%", "max_score": 32, "score": 4, "sex": "male", "diabetes": false, "age_decades": 4, "creatinine_gt_2": false, "elevated_bnp": false, "pci_within_24h": true, "predicted_readmission_percent": 3, "quintile": "extremely_low", "sbp_lt_100": false }, { "components": [ { "factor": "creatinine_gt_2", "points": 0, "present": false }, { "factor": "elevated_bnp", "points": 0, "present": false }, { "value": 58, "factor": "age_years", "points": 4, "present": true }, { "factor": "diabetes", "points": 0, "present": false }, { "value": "male", "factor": "sex", "points": 0, "present": false }, { "factor": "no_pci_within_24h", "points": 0, "present": false }, { "factor": "sbp_lt_100", "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.", "age_years": 58, "citation": { "authors": "Nguyen OK, Makam AN, Clark C, et al.", "doi": "10.1161/JAHA.118.008882", "id": "nguyen-2018", "pmid": "29666144", "source": "J Am Heart Assoc. 2018;7(8):e008882", "title": "Predicting 30-Day Hospital Readmissions in Acute Myocardial Infarction: The AMI \"READMITS\" (Renal Function, Elevated Brain Natriuretic Peptide, Age, Diabetes Mellitus, Nonmale Sex, Intervention with Timely Percutaneous Coronary Intervention, and Low Systolic Blood Pressure) Score" }, "formula": "readmits", "formula_expression": "READMITS = creatinine_gt_2 (6) + elevated_bnp (8) + floor((age_years-18)/10) (1 per decade >18) + diabetes (4) + female (2) + no_pci_within_24h (1) + sbp_lt_100 (3); Nguyen 2018 first-day AMI READMITS Table 2; max 32 at age 100; Table 4 quintiles <=13 extremely_low 3%, 14-15 low 7%, 16-17 moderate 11%, 18-19 high 16%, >=20 extremely_high 35%", "max_score": 32, "score": 4, "sex": "male", "diabetes": false, "age_decades": 4, "creatinine_gt_2": false, "elevated_bnp": false, "pci_within_24h": true, "predicted_readmission_percent": 3, "quintile": "extremely_low", "sbp_lt_100": false } ] } ``` ## Response fields - `formula` (string): readmits - `formula_expression` (string): Exact expression used - `score` (integer): First-day READMITS points; 0-32 at the age 18-100 clamp - `max_score` (integer): 32 (age 100 plus all other items) - `quintile` (string): Nguyen 2018 Table 4: extremely_low (<=13), low (14-15), moderate (16-17), high (18-19), or extremely_high (>=20) - `predicted_readmission_percent` (integer): Table 4 mean predicted 30-day readmission percent: 3, 7, 11, 16, or 35 - `age_years` (integer): Age in years used - `age_decades` (integer): floor((age_years-18)/10) points from age - `sex` (string): female or male used - `creatinine_gt_2` (boolean): Caller-assigned creatinine >2 mg/dL flag - `elevated_bnp` (boolean): Caller-assigned elevated BNP or NT-proBNP flag - `diabetes` (boolean): Caller-assigned diabetes history flag - `pci_within_24h` (boolean): Caller-assigned PCI within 24 hours flag - `sbp_lt_100` (boolean): Caller-assigned SBP <100 mm Hg flag - `components` (array): Per-factor points - `citation` (object): Nguyen et al. J Am Heart Assoc 2018 citation - `disclaimer` (string): Not-a-device notice ## Example JSON Frozen fixture. Not a live lookup. ```json { "components": [ { "factor": "creatinine_gt_2", "points": 0, "present": false }, { "factor": "elevated_bnp", "points": 0, "present": false }, { "value": 58, "factor": "age_years", "points": 4, "present": true }, { "factor": "diabetes", "points": 0, "present": false }, { "value": "male", "factor": "sex", "points": 0, "present": false }, { "factor": "no_pci_within_24h", "points": 0, "present": false }, { "factor": "sbp_lt_100", "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.", "age_years": 58, "citation": { "authors": "Nguyen OK, Makam AN, Clark C, et al.", "doi": "10.1161/JAHA.118.008882", "id": "nguyen-2018", "pmid": "29666144", "source": "J Am Heart Assoc. 2018;7(8):e008882", "title": "Predicting 30-Day Hospital Readmissions in Acute Myocardial Infarction: The AMI \"READMITS\" (Renal Function, Elevated Brain Natriuretic Peptide, Age, Diabetes Mellitus, Nonmale Sex, Intervention with Timely Percutaneous Coronary Intervention, and Low Systolic Blood Pressure) Score" }, "formula": "readmits", "formula_expression": "READMITS = creatinine_gt_2 (6) + elevated_bnp (8) + floor((age_years-18)/10) (1 per decade >18) + diabetes (4) + female (2) + no_pci_within_24h (1) + sbp_lt_100 (3); Nguyen 2018 first-day AMI READMITS Table 2; max 32 at age 100; Table 4 quintiles <=13 extremely_low 3%, 14-15 low 7%, 16-17 moderate 11%, 18-19 high 16%, >=20 extremely_high 35%", "max_score": 32, "score": 4, "sex": "male", "diabetes": false, "age_decades": 4, "creatinine_gt_2": false, "elevated_bnp": false, "pci_within_24h": true, "predicted_readmission_percent": 3, "quintile": "extremely_low", "sbp_lt_100": false } ``` ## Errors - HTTP 400 `invalid_readmits`: READMITS needs Nguyen 2018 first-day creatinine, natriuretic peptide, age, diabetes, sex, PCI, and systolic BP in published ranges. 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 - [Killip](https://magentlab.com/docs/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. - [ORBI](https://magentlab.com/docs/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. ## 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.