# Complete Rockall

Rockall

Status: WEDGE
Price: $0.005 USDC
`GET /api/calc/rockall`
HTML: https://magentlab.com/docs/rockall
Markdown: https://magentlab.com/docs/rockall.md

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

## What it computes

Compute the Rockall 1996 complete (post-endoscopy) score from age, heart rate, systolic blood pressure, caller-assigned comorbidity, diagnosis, and stigmata of recent haemorrhage after acute upper gastrointestinal haemorrhage.

## When to use

When an agent needs the published complete/post-endoscopy Rockall score (age + shock + comorbidity + diagnosis + stigmata) and must not apply pre-endoscopy-only Rockall, AIMS65, or Glasgow-Blatchford.

## When not to use

- Not a medical device and not a diagnosis of the cause or severity of bleeding.
- This is complete (post-endoscopy) Rockall 1996, which includes diagnosis and stigmata of recent haemorrhage. It is not the pre-endoscopy-only (admission) score.
- Not AIMS65 and not the Glasgow-Blatchford score.
- magent does not assign comorbidity, diagnosis, or stigmata. The caller maps cardiac failure, IHD, or any major comorbidity to cardiac; renal failure, liver failure, or disseminated malignancy to renal_liver_metastatic; no lesion and no SRH to diagnosis none; Mallory-Weiss to mallory_weiss; all other diagnoses to other; upper GI malignancy to malignancy; none or dark spot only to stigmata none_or_spot; blood in the upper GI tract, adherent clot, or visible or spurting vessel to blood_clot_vessel.

## Formula

```
Rockall = age (<60: 0, 60-79: 1, >=80: 2) + shock (SBP<100: 2; else HR>=100: 1; else 0) + comorbidity (none: 0, cardiac: 2, renal_liver_metastatic: 3) + diagnosis (none: 0, mallory_weiss: 0, other: 1, malignancy: 2) + stigmata (none_or_spot: 0, blood_clot_vessel: 2); max 11
```

## Citation

[Risk assessment after acute upper gastrointestinal haemorrhage](https://doi.org/10.1136/gut.38.3.316)
Rockall TA, Logan RF, Devlin HB, Northfield TC
Gut. 1996;38(3):316-321
DOI: [10.1136/gut.38.3.316](https://doi.org/10.1136/gut.38.3.316)

## Worked example

### Age 50, no shock, no comorbidity, diagnosis none, stigmata none_or_spot

Given: `age=50, comorbidity=none, diagnosis=none, heart_rate_bpm=80, stigmata=none_or_spot, systolic_mm_hg=120`

1. Age 50 is <60 → 0; HR 80 with SBP 120 is not tachycardia or hypotension → 0; comorbidity none → 0; diagnosis none → 0; stigmata none_or_spot → 0
2. Score = 0 (max 11)


### Age 80, hypotension, renal/liver/metastatic, malignancy, blood/clot/vessel (max 11)

Given: `age=80, comorbidity=renal_liver_metastatic, diagnosis=malignancy, heart_rate_bpm=60, stigmata=blood_clot_vessel, systolic_mm_hg=99`

1. Age 80 ≥ 80 → 2; SBP 99 < 100 → 2 (hypotension; tachycardia not added); renal_liver_metastatic → 3; malignancy → 2; blood_clot_vessel → 2
2. Score = 11 (max 11)


## Also searched as

- complete Rockall
- post-endoscopy Rockall
- Rockall 1996
- full Rockall score
- post endoscopy Rockall
- Rockall GI bleed score
- complete Rockall score

## Parameters

- `age` (integer, required): Age in years (18-120). <60 scores 0; 60-79 scores 1; ≥80 scores 2. 59 does not score; 60 scores 1; 79 scores 1; 80 scores 2.
- `heart_rate_bpm` (integer, required): Heart rate in beats per minute (integer 30-220). With SBP ≥100, HR ≥100 scores 1 (tachycardia); 99 does not. Not added when SBP <100.
- `systolic_mm_hg` (number, required): Systolic blood pressure in mm Hg (50-250). SBP <100 scores 2 (hypotension) and tachycardia is not added; 100 does not score hypotension.
- `comorbidity` (string, required): Caller-assigned comorbidity: none (0), cardiac (2; cardiac failure, IHD, or any major comorbidity), or renal_liver_metastatic (3; renal failure, liver failure, or disseminated malignancy). magent does not assign comorbidity.
- `diagnosis` (string, required): Caller-assigned diagnosis: none (0; no lesion identified and no stigmata of recent haemorrhage), mallory_weiss (0), other (1; all other diagnoses), or malignancy (2; malignancy of the upper GI tract). magent does not assign diagnosis.
- `stigmata` (string, required): Caller-assigned stigmata of recent haemorrhage: none_or_spot (0; none or dark spot only) or blood_clot_vessel (2; blood in the upper GI tract, adherent clot, visible or spurting vessel). magent does not assign stigmata.

## 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/rockall`
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": "50",
      "comorbidity": "none",
      "diagnosis": "none",
      "heart_rate_bpm": "80",
      "stigmata": "none_or_spot",
      "systolic_mm_hg": "120"
    },
    {
      "age": "50",
      "comorbidity": "none",
      "diagnosis": "none",
      "heart_rate_bpm": "80",
      "stigmata": "none_or_spot",
      "systolic_mm_hg": "120"
    }
  ]
}
```

Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/rockall

Example 200:

```json
{
  "count": 2,
  "path": "/api/calc/rockall",
  "items": [
    {
      "components": [
        {
          "value": 50,
          "factor": "age",
          "points": 0,
          "present": false
        },
        {
          "value": {
            "systolic_mm_hg": 120.0,
            "heart_rate_bpm": 80
          },
          "factor": "shock",
          "points": 0,
          "present": false
        },
        {
          "value": "none",
          "factor": "comorbidity",
          "points": 0,
          "present": false
        },
        {
          "value": "none",
          "factor": "diagnosis",
          "points": 0,
          "present": false
        },
        {
          "value": "none_or_spot",
          "factor": "stigmata",
          "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": "Rockall TA, Logan RF, Devlin HB, Northfield TC",
        "doi": "10.1136/gut.38.3.316",
        "id": "rockall-1996",
        "pmid": "8675081",
        "source": "Gut. 1996;38(3):316-321",
        "title": "Risk assessment after acute upper gastrointestinal haemorrhage"
      },
      "formula": "rockall",
      "formula_expression": "Rockall = age (<60: 0, 60-79: 1, >=80: 2) + shock (SBP<100: 2; else HR>=100: 1; else 0) + comorbidity (none: 0, cardiac: 2, renal_liver_metastatic: 3) + diagnosis (none: 0, mallory_weiss: 0, other: 1, malignancy: 2) + stigmata (none_or_spot: 0, blood_clot_vessel: 2); max 11",
      "max_score": 11,
      "score": 0,
      "systolic_mm_hg": 120.0,
      "age_years": 50,
      "heart_rate_bpm": 80,
      "comorbidity": "none",
      "diagnosis": "none",
      "stigmata": "none_or_spot"
    },
    {
      "components": [
        {
          "value": 50,
          "factor": "age",
          "points": 0,
          "present": false
        },
        {
          "value": {
            "systolic_mm_hg": 120.0,
            "heart_rate_bpm": 80
          },
          "factor": "shock",
          "points": 0,
          "present": false
        },
        {
          "value": "none",
          "factor": "comorbidity",
          "points": 0,
          "present": false
        },
        {
          "value": "none",
          "factor": "diagnosis",
          "points": 0,
          "present": false
        },
        {
          "value": "none_or_spot",
          "factor": "stigmata",
          "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": "Rockall TA, Logan RF, Devlin HB, Northfield TC",
        "doi": "10.1136/gut.38.3.316",
        "id": "rockall-1996",
        "pmid": "8675081",
        "source": "Gut. 1996;38(3):316-321",
        "title": "Risk assessment after acute upper gastrointestinal haemorrhage"
      },
      "formula": "rockall",
      "formula_expression": "Rockall = age (<60: 0, 60-79: 1, >=80: 2) + shock (SBP<100: 2; else HR>=100: 1; else 0) + comorbidity (none: 0, cardiac: 2, renal_liver_metastatic: 3) + diagnosis (none: 0, mallory_weiss: 0, other: 1, malignancy: 2) + stigmata (none_or_spot: 0, blood_clot_vessel: 2); max 11",
      "max_score": 11,
      "score": 0,
      "systolic_mm_hg": 120.0,
      "age_years": 50,
      "heart_rate_bpm": 80,
      "comorbidity": "none",
      "diagnosis": "none",
      "stigmata": "none_or_spot"
    }
  ]
}
```

## Response fields

- `formula` (string): rockall
- `formula_expression` (string): Exact expression used
- `score` (integer): Total points 0-11
- `max_score` (integer): Always 11
- `age_years` (integer): Age used for the age band
- `heart_rate_bpm` (integer): Heart rate used, bpm
- `systolic_mm_hg` (number): Systolic pressure used, mm Hg
- `comorbidity` (string): none, cardiac, or renal_liver_metastatic as supplied by the caller
- `diagnosis` (string): none, mallory_weiss, other, or malignancy as supplied by the caller
- `stigmata` (string): none_or_spot or blood_clot_vessel as supplied by the caller
- `components` (array): Age, shock, comorbidity, diagnosis, and stigmata points
- `citation` (object): Rockall 1996 citation
- `disclaimer` (string): Not-a-device notice

## Example JSON

Frozen fixture. Not a live lookup.

```json
{
  "components": [
    {
      "value": 50,
      "factor": "age",
      "points": 0,
      "present": false
    },
    {
      "value": {
        "systolic_mm_hg": 120.0,
        "heart_rate_bpm": 80
      },
      "factor": "shock",
      "points": 0,
      "present": false
    },
    {
      "value": "none",
      "factor": "comorbidity",
      "points": 0,
      "present": false
    },
    {
      "value": "none",
      "factor": "diagnosis",
      "points": 0,
      "present": false
    },
    {
      "value": "none_or_spot",
      "factor": "stigmata",
      "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": "Rockall TA, Logan RF, Devlin HB, Northfield TC",
    "doi": "10.1136/gut.38.3.316",
    "id": "rockall-1996",
    "pmid": "8675081",
    "source": "Gut. 1996;38(3):316-321",
    "title": "Risk assessment after acute upper gastrointestinal haemorrhage"
  },
  "formula": "rockall",
  "formula_expression": "Rockall = age (<60: 0, 60-79: 1, >=80: 2) + shock (SBP<100: 2; else HR>=100: 1; else 0) + comorbidity (none: 0, cardiac: 2, renal_liver_metastatic: 3) + diagnosis (none: 0, mallory_weiss: 0, other: 1, malignancy: 2) + stigmata (none_or_spot: 0, blood_clot_vessel: 2); max 11",
  "max_score": 11,
  "score": 0,
  "systolic_mm_hg": 120.0,
  "age_years": 50,
  "heart_rate_bpm": 80,
  "comorbidity": "none",
  "diagnosis": "none",
  "stigmata": "none_or_spot"
}
```

## Errors

- HTTP 400 `invalid_age`: age must be an integer from 18 to 120 Returned before settlement; you are not charged.
- HTTP 400 `invalid_heart_rate`: heart_rate_bpm must be an integer from 30 to 220 Returned before settlement; you are not charged.
- HTTP 400 `invalid_systolic_bp`: systolic_mm_hg or systolic_bp_mm_hg must be a number from 50 to 250. Returned before settlement; you are not charged.
- HTTP 400 `invalid_rockall_comorbidity`: comorbidity must be none, cardiac, or renal_liver_metastatic. Returned before settlement; you are not charged.
- HTTP 400 `invalid_rockall_diagnosis`: diagnosis must be none, mallory_weiss, other, or malignancy (Rockall 1996). Returned before settlement; you are not charged.
- HTTP 400 `invalid_rockall_stigmata`: stigmata must be none_or_spot or blood_clot_vessel (Rockall 1996). 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

- [Pre-endoscopy Rockall](https://magentlab.com/docs/rockall-pre) — Compute the Rockall 1996 pre-endoscopy (admission) score from age, heart rate, systolic blood pressure, and caller-assigned comorbidity after acute upper gastrointestinal haemorrhage.
- [Glasgow-Blatchford score](https://magentlab.com/docs/glasgow-blatchford) — Compute the Blatchford 2000 Glasgow-Blatchford score from urea, haemoglobin, systolic BP, heart rate, and four clinical flags.
- [AIMS65](https://magentlab.com/docs/aims65) — Compute the Saltzman 2011 AIMS65 score for in-hospital mortality in acute upper GI bleeding from albumin, INR, caller-assigned altered mental status, systolic blood pressure, and age.

## 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 echoing accepted, payload, and extensions when present).
- 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.
- 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.