ACS · LIVE

SEX-SHOCK ACS cardiogenic shock score

SEX-SHOCK

Sum the Wang 2024 Supplementary Table S13 sex-specific nomogram points after ACS PCI and return the integer total and printed in-hospital cardiogenic-shock probability.

LIVE $0.005 USDC GET /api/calc/sex_shock

Markdown: /docs/sex-shock.md · Canonical: https://magentlab.com/docs/sex-shock

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

What it computes

Sum the Wang 2024 Supplementary Table S13 sex-specific nomogram points after ACS PCI and return the integer total and printed in-hospital cardiogenic-shock probability.

When to use

When an agent needs the published SEX-SHOCK point total after ACS treated by PCI and must not invent a shock-treatment order, a cath-lab or MCS protocol, or the ORBI score.

When not to use

Not a medical device and not a diagnosis, cath-lab, reperfusion, MCS, or shock-treatment order. magent does not examine the patient, read the ECG, or assign TIMI flow.
Sex is caller-assigned female or male. magent does not assign sex. The two S13 nomograms are not ORBI.
Killip is the S13 Killip class III flag only. Killip I and II score as No. Derivation excluded cardiogenic shock on admission.
creatinine_log and crp_log are the S13 printed log-transformed nomogram levels (Figure 6 axes), not raw µmol/L or mg/L. magent does not convert units or invent biomarker cutoffs. Values outside the printed ticks are rejected; between ticks, points are linearly interpolated and rounded.
in_hospital_cs_probability is the S13 total-points to Pr(CS) table (linear between printed totals; clamp below 500 and above the last printed total). Not a later website.

Formula

SEX-SHOCK = S13 sex-specific nomogram points (female|male): post_pci_timi_lt_3 (F 49/67, M 49/61) + left_main_culprit (F 49/65, M 49/71) + glucose_gt_10_mmol_l (F 49/59, M 49/69) + sbp_lt_125_and_pp_lt_45 (F 49/70, M 49/66) + heart_rate_gt_90 (F 49/55, M 49/62) + killip_class_iii (F 49/76, M 49/66) + cardiac_arrest_on_admission (F 49/81, M 49/77) + age_years (<70: 49; >=70 F 54 M 55) + lvef_band (gt_50: 0; 35_to_50 F 22 M 18; lt_35: 49) + st_segment_elevation (F 49/50, M 49/68) + creatinine_log ticks (F 4:15 5:31 6:46 7:62 8:77 9:92; M 4.5:21 5.5:35 6.5:50 7.5:65 8.5:80 9.5:94; linear interpolate, round) + crp_log ticks (F 0:43 4:52 8:61; M 0:45 6:55 10:61; linear interpolate, round); sum; in_hospital_cs_probability is S13 Pr(CS) at printed totals (F 500-720, M 500-740; linear between ticks; clamp outside); max F 779 M 799; Wang 2024 Table S13; not ORBI; not CS-on-admission

Citation

Title: Sex-specific prediction of cardiogenic shock after acute coronary syndromes: the SEX-SHOCK score
Authors: Wang Y, Zeller M, Auffret V, Georgiopoulos G, Räber L, Roffi M, Templin C, Muller O, Liberale L, Ministrini S, Stamatelopoulos K, Stellos K, Camici GG, Montecucco F, Rickli H, Maza M, Radovanovic D, Cottin Y, Chague F, Niederseer D, Lüscher TF, Kraler S; AMIS-Plus, SPUM-ACS and RICO investigators
Source: Eur Heart J. 2024;45(43):4564-4578
DOI: 10.1093/eurheartj/ehae593

Worked example

Female S13 row, ST elevation, LVEF >50%, creatinine_log 4, crp_log 0

Given: age_years=65cardiac_arrest_on_admission=falsecreatinine_log=4crp_log=0glucose_gt_10_mmol_l=falseheart_rate_gt_90=falsekillip_class_iii=falseleft_main_culprit=falselvef_band=gt_50post_pci_timi_lt_3=falsesbp_lt_125_and_pp_lt_45=falsesex=femalest_segment_elevation=true

female: TIMI No 49 + left main No 49 + glycaemia No 49 + SBP/PP No 49 + HR No 49 + Killip III No 49 + arrest No 49 + age 65 (<70) 49 + LVEF >50% 0 + ST elevation Yes 50 + creatinine_log 4 → 15 + crp_log 0 → 43
score = 500 (max 779); S13 Pr(CS) at 500 = 0.001342

Female S13 theoretical maximum

Given: age_years=71cardiac_arrest_on_admission=truecreatinine_log=9crp_log=8glucose_gt_10_mmol_l=trueheart_rate_gt_90=truekillip_class_iii=trueleft_main_culprit=truelvef_band=lt_35post_pci_timi_lt_3=truesbp_lt_125_and_pp_lt_45=truesex=femalest_segment_elevation=true

all Yes flags + age >=70 54 + LVEF <35% 49 + creatinine_log 9 → 92 + crp_log 8 → 61
score = 779 (max 779); S13 Pr(CS) clamped at printed 720 = 0.8911

Also searched as

SEX-SHOCK score
Wang 2024 cardiogenic shock ACS
in-hospital CS after ACS
sex-specific CS nomogram
AMIS-Plus SEX-SHOCK
SEX-SHOCK Table S13
ACS PCI cardiogenic shock prediction
female male CS score

Try

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

/api/calc/sex_shock?sex=female&post_pci_timi_lt_3=false&left_main_culprit=false&glucose_gt_10_mmol_l=false&sbp_lt_125_and_pp_lt_45=false&heart_rate_gt_90=false&killip_class_iii=false&cardiac_arrest_on_admission=false&age_years=65&lvef_band=gt_50&st_segment_elevation=true&creatinine_log=4&crp_log=0

Full URL: https://api.magentlab.com/api/calc/sex_shock?sex=female&post_pci_timi_lt_3=false&left_main_culprit=false&glucose_gt_10_mmol_l=false&sbp_lt_125_and_pp_lt_45=false&heart_rate_gt_90=false&killip_class_iii=false&cardiac_arrest_on_admission=false&age_years=65&lvef_band=gt_50&st_segment_elevation=true&creatinine_log=4&crp_log=0

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/sex_shock?sex=female&post_pci_timi_lt_3=false&left_main_culprit=false&glucose_gt_10_mmol_l=false&sbp_lt_125_and_pp_lt_45=false&heart_rate_gt_90=false&killip_class_iii=false&cardiac_arrest_on_admission=false&age_years=65&lvef_band=gt_50&st_segment_elevation=true&creatinine_log=4&crp_log=0"

Parameters

Name	Type	Required	Description
`sex`	string	required · female, male	Caller-assigned sex for the Wang 2024 S13 female or male nomogram. female or male. magent does not assign sex.
`post_pci_timi_lt_3`	boolean	required	Post-PCI TIMI flow <3 (Wang 2024 S13: female No 49 / Yes 67; male No 49 / Yes 61). Caller-assigned. magent does not assign TIMI flow.
`left_main_culprit`	boolean	required	Culprit lesion of the left main (Wang 2024 S13: female No 49 / Yes 65; male No 49 / Yes 71). Caller-assigned. magent does not read the angiogram.
`glucose_gt_10_mmol_l`	boolean	required	Admission glycaemia >10 mmol/L (Wang 2024 S13: female No 49 / Yes 59; male No 49 / Yes 69). true or false. magent does not convert units.
`sbp_lt_125_and_pp_lt_45`	boolean	required	Systolic BP <125 mm Hg and pulse pressure <45 mm Hg together (Wang 2024 S13: female No 49 / Yes 70; male No 49 / Yes 66). Single caller-assigned boolean.
`heart_rate_gt_90`	boolean	required	Heart rate >90/min (Wang 2024 S13: female No 49 / Yes 55; male No 49 / Yes 62). true or false.
`killip_class_iii`	boolean	required	Killip class III (Wang 2024 S13: female No 49 / Yes 76; male No 49 / Yes 66). Killip I and II score as No. magent does not examine the patient.
`cardiac_arrest_on_admission`	boolean	required	Presentation as cardiac arrest (Wang 2024 S13: female No 49 / Yes 81; male No 49 / Yes 77). true or false.
`age_years`	integer	required	Age in years (18-120). Wang 2024 S13 levels: <70 scores 49; >=70 scores 54 (female) or 55 (male).
`lvef_band`	string	required · lt_35, 35_to_50, gt_50	Caller-assigned LVEF band (Wang 2024 S13): lt_35 (49), 35_to_50 (female 22, male 18), or gt_50 (0). magent does not measure LVEF.
`st_segment_elevation`	boolean	required	ST-segment elevation (Wang 2024 S13: female No 49 / Yes 50; male No 49 / Yes 68). Caller-assigned. magent does not read the ECG.
`creatinine_log`	number	required	Wang 2024 S13 log-transformed creatinine nomogram level (Figure 6 axis), not raw µmol/L. Female printed ticks 4-9; male 4.5-9.5. magent does not convert units or invent cutoffs.
`crp_log`	number	required	Wang 2024 S13 log-transformed CRP nomogram level (Figure 6 axis), not raw mg/L. Female printed ticks 0, 4, 8; male 0, 6, 10. magent does not assay CRP or invent cutoffs.

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/sex_shock 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": "65",
      "cardiac_arrest_on_admission": "false",
      "creatinine_log": "4",
      "crp_log": "0",
      "glucose_gt_10_mmol_l": "false",
      "heart_rate_gt_90": "false",
      "killip_class_iii": "false",
      "left_main_culprit": "false",
      "lvef_band": "gt_50",
      "post_pci_timi_lt_3": "false",
      "sbp_lt_125_and_pp_lt_45": "false",
      "sex": "female",
      "st_segment_elevation": "true"
    },
    {
      "age_years": "65",
      "cardiac_arrest_on_admission": "false",
      "creatinine_log": "4",
      "crp_log": "0",
      "glucose_gt_10_mmol_l": "false",
      "heart_rate_gt_90": "false",
      "killip_class_iii": "false",
      "left_main_culprit": "false",
      "lvef_band": "gt_50",
      "post_pci_timi_lt_3": "false",
      "sbp_lt_125_and_pp_lt_45": "false",
      "sex": "female",
      "st_segment_elevation": "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/sex_shock",
  "items": [
    {
      "components": [
        {
          "value": false,
          "factor": "post_pci_timi_lt_3",
          "points": 49,
          "present": false
        },
        {
          "value": false,
          "factor": "left_main_culprit",
          "points": 49,
          "present": false
        },
        {
          "value": false,
          "factor": "glucose_gt_10_mmol_l",
          "points": 49,
          "present": false
        },
        {
          "value": false,
          "factor": "sbp_lt_125_and_pp_lt_45",
          "points": 49,
          "present": false
        },
        {
          "value": false,
          "factor": "heart_rate_gt_90",
          "points": 49,
          "present": false
        },
        {
          "value": false,
          "factor": "killip_class_iii",
          "points": 49,
          "present": false
        },
        {
          "value": false,
          "factor": "cardiac_arrest_on_admission",
          "points": 49,
          "present": false
        },
        {
          "value": true,
          "factor": "st_segment_elevation",
          "points": 50,
          "present": true
        },
        {
          "value": 65,
          "factor": "age_years",
          "points": 49,
          "present": false
        },
        {
          "value": "gt_50",
          "factor": "lvef_band",
          "points": 0,
          "present": false
        },
        {
          "value": 4.0,
          "factor": "creatinine_log",
          "points": 15,
          "present": true
        },
        {
          "value": 0.0,
          "factor": "crp_log",
          "points": 43,
          "present": true
        }
      ],
      "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": "Wang Y, Zeller M, Auffret V, Georgiopoulos G, Räber L, Roffi M, Templin C, Muller O, Liberale L, Ministrini S, Stamatelopoulos K, Stellos K, Camici GG, Montecucco F, Rickli H, Maza M, Radovanovic D, Cottin Y, Chague F, Niederseer D, Lüscher TF, Kraler S; AMIS-Plus, SPUM-ACS and RICO investigators",
        "doi": "10.1093/eurheartj/ehae593",
        "id": "wang-2024-sex-shock",
        "pmid": "39217456",
        "source": "Eur Heart J. 2024;45(43):4564-4578",
        "title": "Sex-specific prediction of cardiogenic shock after acute coronary syndromes: the SEX-SHOCK score"
      },
      "formula": "sex_shock",
      "formula_expression": "SEX-SHOCK = S13 sex-specific nomogram points (female|male): post_pci_timi_lt_3 (F 49/67, M 49/61) + left_main_culprit (F 49/65, M 49/71) + glucose_gt_10_mmol_l (F 49/59, M 49/69) + sbp_lt_125_and_pp_lt_45 (F 49/70, M 49/66) + heart_rate_gt_90 (F 49/55, M 49/62) + killip_class_iii (F 49/76, M 49/66) + cardiac_arrest_on_admission (F 49/81, M 49/77) + age_years (<70: 49; >=70 F 54 M 55) + lvef_band (gt_50: 0; 35_to_50 F 22 M 18; lt_35: 49) + st_segment_elevation (F 49/50, M 49/68) + creatinine_log ticks (F 4:15 5:31 6:46 7:62 8:77 9:92; M 4.5:21 5.5:35 6.5:50 7.5:65 8.5:80 9.5:94; linear interpolate, round) + crp_log ticks (F 0:43 4:52 8:61; M 0:45 6:55 10:61; linear interpolate, round); sum; in_hospital_cs_probability is S13 Pr(CS) at printed totals (F 500-720, M 500-740; linear between ticks; clamp outside); max F 779 M 799; Wang 2024 Table S13; not ORBI; not CS-on-admission",
      "max_score": 779,
      "score": 500,
      "age_years": 65,
      "sex": "female",
      "lvef_band": "gt_50",
      "creatinine_log": 4.0,
      "crp_log": 0.0,
      "in_hospital_cs_probability": 0.001342
    },
    {
      "components": [
        {
          "value": false,
          "factor": "post_pci_timi_lt_3",
          "points": 49,
          "present": false
        },
        {
          "value": false,
          "factor": "left_main_culprit",
          "points": 49,
          "present": false
        },
        {
          "value": false,
          "factor": "glucose_gt_10_mmol_l",
          "points": 49,
          "present": false
        },
        {
          "value": false,
          "factor": "sbp_lt_125_and_pp_lt_45",
          "points": 49,
          "present": false
        },
        {
          "value": false,
          "factor": "heart_rate_gt_90",
          "points": 49,
          "present": false
        },
        {
          "value": false,
          "factor": "killip_class_iii",
          "points": 49,
          "present": false
        },
        {
          "value": false,
          "factor": "cardiac_arrest_on_admission",
          "points": 49,
          "present": false
        },
        {
          "value": true,
          "factor": "st_segment_elevation",
          "points": 50,
          "present": true
        },
        {
          "value": 65,
          "factor": "age_years",
          "points": 49,
          "present": false
        },
        {
          "value": "gt_50",
          "factor": "lvef_band",
          "points": 0,
          "present": false
        },
        {
          "value": 4.0,
          "factor": "creatinine_log",
          "points": 15,
          "present": true
        },
        {
          "value": 0.0,
          "factor": "crp_log",
          "points": 43,
          "present": true
        }
      ],
      "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": "Wang Y, Zeller M, Auffret V, Georgiopoulos G, Räber L, Roffi M, Templin C, Muller O, Liberale L, Ministrini S, Stamatelopoulos K, Stellos K, Camici GG, Montecucco F, Rickli H, Maza M, Radovanovic D, Cottin Y, Chague F, Niederseer D, Lüscher TF, Kraler S; AMIS-Plus, SPUM-ACS and RICO investigators",
        "doi": "10.1093/eurheartj/ehae593",
        "id": "wang-2024-sex-shock",
        "pmid": "39217456",
        "source": "Eur Heart J. 2024;45(43):4564-4578",
        "title": "Sex-specific prediction of cardiogenic shock after acute coronary syndromes: the SEX-SHOCK score"
      },
      "formula": "sex_shock",
      "formula_expression": "SEX-SHOCK = S13 sex-specific nomogram points (female|male): post_pci_timi_lt_3 (F 49/67, M 49/61) + left_main_culprit (F 49/65, M 49/71) + glucose_gt_10_mmol_l (F 49/59, M 49/69) + sbp_lt_125_and_pp_lt_45 (F 49/70, M 49/66) + heart_rate_gt_90 (F 49/55, M 49/62) + killip_class_iii (F 49/76, M 49/66) + cardiac_arrest_on_admission (F 49/81, M 49/77) + age_years (<70: 49; >=70 F 54 M 55) + lvef_band (gt_50: 0; 35_to_50 F 22 M 18; lt_35: 49) + st_segment_elevation (F 49/50, M 49/68) + creatinine_log ticks (F 4:15 5:31 6:46 7:62 8:77 9:92; M 4.5:21 5.5:35 6.5:50 7.5:65 8.5:80 9.5:94; linear interpolate, round) + crp_log ticks (F 0:43 4:52 8:61; M 0:45 6:55 10:61; linear interpolate, round); sum; in_hospital_cs_probability is S13 Pr(CS) at printed totals (F 500-720, M 500-740; linear between ticks; clamp outside); max F 779 M 799; Wang 2024 Table S13; not ORBI; not CS-on-admission",
      "max_score": 779,
      "score": 500,
      "age_years": 65,
      "sex": "female",
      "lvef_band": "gt_50",
      "creatinine_log": 4.0,
      "crp_log": 0.0,
      "in_hospital_cs_probability": 0.001342
    }
  ]
}

Response

Field	Type	Description
`formula`	string	sex_shock
`formula_expression`	string	Exact expression used
`score`	integer	S13 nomogram total points
`max_score`	integer	779 female or 799 male
`in_hospital_cs_probability`	number	Wang 2024 S13 Pr(CS) for the total (printed totals 500-720 female / 500-740 male; linear between ticks; clamp outside)
`sex`	string	Caller-assigned female or male
`age_years`	integer	Age in years used
`lvef_band`	string	Caller-assigned lt_35, 35_to_50, or gt_50
`creatinine_log`	number	S13 log-transformed creatinine level used
`crp_log`	number	S13 log-transformed CRP level used
`components`	array	Per-factor S13 points
`citation`	object	Wang et al. Eur Heart J 2024 citation
`disclaimer`	string	Not-a-device notice

Example JSON

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

{
  "components": [
    {
      "value": false,
      "factor": "post_pci_timi_lt_3",
      "points": 49,
      "present": false
    },
    {
      "value": false,
      "factor": "left_main_culprit",
      "points": 49,
      "present": false
    },
    {
      "value": false,
      "factor": "glucose_gt_10_mmol_l",
      "points": 49,
      "present": false
    },
    {
      "value": false,
      "factor": "sbp_lt_125_and_pp_lt_45",
      "points": 49,
      "present": false
    },
    {
      "value": false,
      "factor": "heart_rate_gt_90",
      "points": 49,
      "present": false
    },
    {
      "value": false,
      "factor": "killip_class_iii",
      "points": 49,
      "present": false
    },
    {
      "value": false,
      "factor": "cardiac_arrest_on_admission",
      "points": 49,
      "present": false
    },
    {
      "value": true,
      "factor": "st_segment_elevation",
      "points": 50,
      "present": true
    },
    {
      "value": 65,
      "factor": "age_years",
      "points": 49,
      "present": false
    },
    {
      "value": "gt_50",
      "factor": "lvef_band",
      "points": 0,
      "present": false
    },
    {
      "value": 4.0,
      "factor": "creatinine_log",
      "points": 15,
      "present": true
    },
    {
      "value": 0.0,
      "factor": "crp_log",
      "points": 43,
      "present": true
    }
  ],
  "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": "Wang Y, Zeller M, Auffret V, Georgiopoulos G, Räber L, Roffi M, Templin C, Muller O, Liberale L, Ministrini S, Stamatelopoulos K, Stellos K, Camici GG, Montecucco F, Rickli H, Maza M, Radovanovic D, Cottin Y, Chague F, Niederseer D, Lüscher TF, Kraler S; AMIS-Plus, SPUM-ACS and RICO investigators",
    "doi": "10.1093/eurheartj/ehae593",
    "id": "wang-2024-sex-shock",
    "pmid": "39217456",
    "source": "Eur Heart J. 2024;45(43):4564-4578",
    "title": "Sex-specific prediction of cardiogenic shock after acute coronary syndromes: the SEX-SHOCK score"
  },
  "formula": "sex_shock",
  "formula_expression": "SEX-SHOCK = S13 sex-specific nomogram points (female|male): post_pci_timi_lt_3 (F 49/67, M 49/61) + left_main_culprit (F 49/65, M 49/71) + glucose_gt_10_mmol_l (F 49/59, M 49/69) + sbp_lt_125_and_pp_lt_45 (F 49/70, M 49/66) + heart_rate_gt_90 (F 49/55, M 49/62) + killip_class_iii (F 49/76, M 49/66) + cardiac_arrest_on_admission (F 49/81, M 49/77) + age_years (<70: 49; >=70 F 54 M 55) + lvef_band (gt_50: 0; 35_to_50 F 22 M 18; lt_35: 49) + st_segment_elevation (F 49/50, M 49/68) + creatinine_log ticks (F 4:15 5:31 6:46 7:62 8:77 9:92; M 4.5:21 5.5:35 6.5:50 7.5:65 8.5:80 9.5:94; linear interpolate, round) + crp_log ticks (F 0:43 4:52 8:61; M 0:45 6:55 10:61; linear interpolate, round); sum; in_hospital_cs_probability is S13 Pr(CS) at printed totals (F 500-720, M 500-740; linear between ticks; clamp outside); max F 779 M 799; Wang 2024 Table S13; not ORBI; not CS-on-admission",
  "max_score": 779,
  "score": 500,
  "age_years": 65,
  "sex": "female",
  "lvef_band": "gt_50",
  "creatinine_log": 4.0,
  "crp_log": 0.0,
  "in_hospital_cs_probability": 0.001342
}

Client errors (HTTP 400)

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

HTTP	Code	When
400	`invalid_sex_shock`	SEX-SHOCK inputs must match Wang 2024 Supplementary Table S13 sex-specific predictors including CRP, creatinine, LVEF, and ST-segment elevation. 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

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.
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.
GRACE — Sum the Granger 2003 in-hospital GRACE 1.0 nomogram points from eight admission predictors and return that paper's printed in-hospital mortality readout.

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.