# ADHERE CART In-Hospital Mortality Risk Stratifier

> ADHERE CART In-Hospital Mortality Risk Stratifier is a paid API for AI agents from api.magentlab.com, paid per call via x402, $0.005/call, status unknown (last checked 2026-09-15).

Applies the Fonarow 2005 ADHERE CART bedside decision tree to stratify acute heart failure patients into five in-hospital mortality risk categories using admission BUN, systolic BP, and serum creatinine.

## Facts

- Endpoint: GET https://api.magentlab.com/api/calc/adhere
- Price: $0.005/call
- Payment: x402
- Status: unknown
- Last checked: 2026-09-15
- Activations on Zero: 0
- Tags: x402
- Canonical page: https://www.zero.xyz/c/adhere-cart-in-hospital-mortality-risk-stratifier-ef26f44e
- Structured record (JSON): https://api.zero.xyz/v1/capabilities/cap_Fso2p5t_Tiokrs7bawnyR

Status and success rate cover calls made through Zero and Zero's own probes. Third-party monitors may report differently.

## How to call it through Zero

Zero handles the 402 payment challenge and records the run. With the Zero CLI installed (`npm i -g @zeroxyz/cli`):

```sh
zero fetch --capability adhere-cart-in-hospital-mortality-risk-stratifier-ef26f44e
```

Example prompt: Run the ADHERE CART mortality risk tree for a heart failure patient admitted with a BUN of 55 mg/dL, systolic BP of 105 mmHg, and creatinine of 3.1 mg/dL — which of the five risk categories do they fall into?

## When to prefer this

Choose this endpoint when you need to apply the specific Fonarow 2005 ADHERE CART bedside decision tree (not the logistic regression model or GWTG-HF score) to stratify in-hospital mortality risk for acute decompensated heart failure using only admission BUN, systolic BP, and optionally creatinine. Prefer this over manual CART tree lookup when admission labs are already digitized and you need rapid, reproducible risk classification at scale.

## Known failure modes

- Missing required bun_mg_dl or systolic_bp_mm_hg → validation error
- Both creatinine_mg_dl and creatinine_umol_l provided → conflict error
- BUN or creatinine outside allowed range (BUN 1-200, Cr 0.1-20 mg/dL) → range error
- Non-integer systolic_bp_mm_hg → type error
- Creatinine not provided when BUN ≥ 43 and SBP < 115 (creatinine is required in that branch) → incomplete input
- Payment not included or insufficient → HTTP 402

## How this service works

Fonarow 2005 ADHERE CART bedside tree from admission BUN, systolic BP, and serum creatinine. high: BUN>=43, SBP<115, Cr>=2.75; intermediate_1: BUN>=43, SBP<115, Cr<2.75; intermediate_2: BUN>=43, SBP>=115; intermediate_3: BUN<43, SBP<115; low: BUN<43, SBP>=115. Creatinine consulted only when BUN>=43 and SBP<115. CART tree only, not the logistic model or GWTG-HF. Not a heart-failure diagnosis or treatment/ICU order.

## Output

Returns one of five CART risk categories — high, intermediate_1, intermediate_2, intermediate_3, or low — based on the Fonarow 2005 ADHERE decision tree logic. The branch selected is determined by: (1) BUN ≥ 43, (2) SBP < 115, and (3) creatinine ≥ 2.75 (consulted only when BUN ≥ 43 AND SBP < 115). This is a risk stratification result, not a diagnosis or treatment order.

## Request schema (JSON Schema)

```json
{
 "type": "object",
 "$schema": "https://json-schema.org/draft/2020-12/schema",
 "required": [
  "input"
 ],
 "properties": {
  "input": {
   "type": "object",
   "required": [
    "type",
    "method"
   ],
   "properties": {
    "type": {
     "type": "string",
     "const": "http"
    },
    "method": {
     "enum": [
      "GET",
      "HEAD",
      "DELETE"
     ],
     "type": "string"
    },
    "headers": {
     "type": "object",
     "additionalProperties": {
      "type": "string"
     }
    },
    "queryParams": {
     "type": "object",
     "required": [
      "bun_mg_dl",
      "systolic_bp_mm_hg"
     ],
     "properties": {
      "bun_mg_dl": {
       "type": "number",
       "description": "Admission blood urea nitrogen in mg/dL (1-200). Fonarow 2005 CART first split is BUN >= 43. magent does not measure BUN."
      },
      "creatinine_mg_dl": {
       "type": "number",
       "description": "Admission serum creatinine in mg/dL (0.1-20). Provide this or creatinine_umol_l, not both. Fonarow 2005 CART consults creatinine only when BUN >= 43 and SBP < 115; the split is creatinine >= 2.75. magent does not measure creatinine."
      },
      "creatinine_umol_l": {
       "type": "number",
       "description": "Admission serum creatinine in µmol/L (9-1768). Converted as mg/dL = µmol/L / 88.42. Provide this or creatinine_mg_dl, not both."
      },
      "systolic_bp_mm_hg": {
       "type": "integer",
       "description": "Admission systolic blood pressure in mm Hg (integer 50-250). Fonarow 2005 CART second split is SBP < 115. magent does not measure blood pressure."
      }
     }
    }
   },
   "additionalProperties": false
  },
  "output": {
   "type": "object",
   "required": [
    "type"
   ],
   "properties": {
    "type": {
     "type": "string"
    },
    "example": {
     "type": "object"
    }
   }
  }
 }
}
```

## Response schema (JSON Schema)

```json
{
 "type": "json",
 "example": {
  "path": "/api/calc/adhere",
  "count": 2,
  "items": [
   {
    "formula": "adhere",
    "citation": {
     "id": "fonarow-2005",
     "doi": "10.1001/jama.293.5.572",
     "pmid": "15687312",
     "title": "Risk stratification for in-hospital mortality in acutely decompensated heart failure: classification and regression tree analysis",
     "source": "JAMA. 2005;293(5):572-580",
     "authors": "Fonarow GC, Adams KF Jr, Abraham WT, Yancy CW, Boscardin WJ; ADHERE Scientific Advisory Committee, Study Group, and Investigators"
    },
    "bun_mg_dl": 20,
    "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.",
    "adhere_risk": "low",
    "creatinine_mg_dl": 1,
    "systolic_bp_mm_hg": 140,
    "formula_expression": "high: bun_mg_dl >= 43 AND systolic_bp_mm_hg < 115 AND creatinine_mg_dl >= 2.75; intermediate_1: bun_mg_dl >= 43 AND systolic_bp_mm_hg < 115 AND creatinine_mg_dl < 2.75; intermediate_2: bun_mg_dl >= 43 AND systolic_bp_mm_hg >= 115; intermediate_3: bun_mg_dl < 43 AND systolic_bp_mm_hg < 115; low: bun_mg_dl < 43 AND systolic_bp_mm_hg >= 115 (Fonarow 2005 CART)"
   },
   {
    "formula": "adhere",
    "citation": {
     "id": "fonarow-2005",
     "doi": "10.1001/jama.293.5.572",
     "pmid": "15687312",
     "title": "Risk stratification for in-hospital mortality in acutely decompensated heart failure: classification and regression tree analysis",
     "source": "JAMA. 2005;293(5):572-580",
     "authors": "Fonarow GC, Adams KF Jr, Abraham WT, Yancy CW, Boscardin WJ; ADHERE Scientific Advisory Committee, Study Group, and Investigators"
    },
    "bun_mg_dl": 20,
    "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.",
    "adhere_risk": "low",
    "creatinine_mg_dl": 1,
    "systolic_bp_mm_hg": 140,
    "formula_expression": "high: bun_mg_dl >= 43 AND systolic_bp_mm_hg < 115 AND creatinine_mg_dl >= 2.75; intermediate_1: bun_mg_dl >= 43 AND systolic_bp_mm_hg < 115 AND creatinine_mg_dl < 2.75; intermediate_2: bun_mg_dl >= 43 AND systolic_bp_mm_hg >= 115; intermediate_3: bun_mg_dl < 43 AND systolic_bp_mm_hg < 115; low: bun_mg_dl < 43 AND systolic_bp_mm_hg >= 115 (Fonarow 2005 CART)"
   }
  ]
 }
}
```

## More

- Live health (JSON, refreshed every minute): https://www.zero.xyz/c/adhere-cart-in-hospital-mortality-risk-stratifier-ef26f44e/health.json
- [Zero catalog index](https://www.zero.xyz/llms.txt)
- [Other services from api.magentlab.com](https://www.zero.xyz/host/api.magentlab.com/llms.txt)