# Alvarado (MANTRELS) Appendicitis Score Calculator

> Alvarado (MANTRELS) Appendicitis Score Calculator 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).

Computes the Alvarado 1986 MANTRELS score (0–10) for appendicitis risk stratification from clinical findings, temperature, WBC, and neutrophil percent.

## Facts

- Endpoint: GET https://api.magentlab.com/api/calc/alvarado
- 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/alvarado-mantrels-appendicitis-score-calculator-0375058c
- Structured record (JSON): https://api.zero.xyz/v1/capabilities/cap_zrfLlnN0iYjItos06eGLV

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 alvarado-mantrels-appendicitis-score-calculator-0375058c
```

Example prompt: Calculate the Alvarado appendicitis score for a patient with pain migration to the RLQ, anorexia, nausea, RLQ tenderness, no rebound, temperature of 38.1°C, WBC of 13,500/µL, and neutrophil percent of 80%.

## When to prefer this

Use this endpoint when you need a fast, deterministic, published Alvarado 1986 MANTRELS score computed from discrete clinical inputs for appendicitis risk stratification. Prefer it over manual calculation when integrating into clinical decision-support workflows, EHR-adjacent agents, or ED triage pipelines. It is not a replacement for physical examination, imaging, or surgical consultation.

## Known failure modes

- Missing required boolean flags (migration, anorexia, nausea_vomiting, rlq_tenderness, rebound) returns a validation error
- Temperature outside 30.0–45.0°C range is rejected
- WBC value out of range (0.01–500 k/µL or 10–500000/µL) is rejected
- Neutrophil percent outside 0–100 is rejected
- Neither wbc_k_ul nor wbc_ul provided causes an error
- Payment not included or invalid returns 402 Payment Required

## How this service works

Alvarado 1986 MANTRELS score from caller-assigned findings, temperature, WBC, and neutrophil percent (max 10). Bands 0-4, 5-6, and 7-10. Deterministic published score with citation; not a diagnosis or operating-room protocol. magent does not examine the abdomen.

## Output

Returns the integer Alvarado MANTRELS total score from 0 to 10, the corresponding risk band (low: 0–4, equivocal: 5–6, high: 7–10), and a citation to the original Alvarado 1986 publication. Does not provide a diagnosis or surgical recommendation.

## 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": [
      "migration",
      "anorexia",
      "nausea_vomiting",
      "rlq_tenderness",
      "rebound",
      "temperature_c",
      "neutrophil_percent"
     ],
     "properties": {
      "wbc_ul": {
       "type": "number",
       "description": "WBC in cells/µL (same as cells/mm^3). Provide wbc_k_ul or wbc_ul. Range 10-500000. >10000 scores 2 (10000 does not; 10001 does)."
      },
      "rebound": {
       "type": "boolean",
       "description": "Rebound tenderness (R). true or false."
      },
      "anorexia": {
       "type": "boolean",
       "description": "Anorexia (A). true or false."
      },
      "wbc_k_ul": {
       "type": "number",
       "description": "WBC in 10^3/µL (same as 10^9/L). Provide wbc_k_ul or wbc_ul. Range 0.01-500. >10000/µL scores 2."
      },
      "migration": {
       "type": "boolean",
       "description": "Pain migration to the right lower quadrant (M). true or false."
      },
      "temperature_c": {
       "type": "number",
       "description": "Temperature in °C (30.0-45.0). ≥37.3 scores 1 (37.3 scores; 37.2 does not)."
      },
      "rlq_tenderness": {
       "type": "boolean",
       "description": "Right-lower-quadrant tenderness (T). true scores 2; false scores 0."
      },
      "nausea_vomiting": {
       "type": "boolean",
       "description": "Nausea or vomiting (N). true or false."
      },
      "neutrophil_percent": {
       "type": "number",
       "description": "Neutrophil percent (0-100). Left shift scores 1 if >75 (75.0 does not; 75.1 does)."
      }
     }
    }
   },
   "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/alvarado",
  "count": 2,
  "items": [
   {
    "score": 0,
    "wbc_ul": 8000,
    "formula": "alvarado",
    "citation": {
     "id": "alvarado-1986",
     "doi": "10.1016/S0196-0644(86)80993-3",
     "title": "A practical score for the early diagnosis of acute appendicitis",
     "source": "Ann Emerg Med. 1986;15(5):557-564",
     "authors": "Alvarado A"
    },
    "max_score": 10,
    "components": [
     {
      "factor": "migration",
      "points": 0,
      "present": false
     },
     {
      "factor": "anorexia",
      "points": 0,
      "present": false
     },
     {
      "factor": "nausea_vomiting",
      "points": 0,
      "present": false
     },
     {
      "factor": "rlq_tenderness",
      "points": 0,
      "present": false
     },
     {
      "factor": "rebound",
      "points": 0,
      "present": false
     },
     {
      "value": 37,
      "factor": "temperature_c",
      "points": 0,
      "present": false
     },
     {
      "value": 8000,
      "factor": "leukocytosis",
      "points": 0,
      "present": false
     },
     {
      "value": 60,
      "factor": "left_shift",
      "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.",
    "alvarado_band": "0-4",
    "temperature_c": 37,
    "formula_expression": "Alvarado (MANTRELS) = migration + anorexia + nausea_vomiting + 2*rlq_tenderness + rebound + (temperature_c >= 37.3) + 2*(wbc_ul > 10000) + (neutrophil_percent > 75); max 10; bands 0-4 / 5-6 / 7-10",
    "neutrophil_percent": 60
   },
   {
    "score": 0,
    "wbc_ul": 8000,
    "formula": "alvarado",
    "citation": {
     "id": "alvarado-1986",
     "doi": "10.1016/S0196-0644(86)80993-3",
     "title": "A practical score for the early diagnosis of acute appendicitis",
     "source": "Ann Emerg Med. 1986;15(5):557-564",
     "authors": "Alvarado A"
    },
    "max_score": 10,
    "components": [
     {
      "factor": "migration",
      "points": 0,
      "present": false
     },
     {
      "factor": "anorexia",
      "points": 0,
      "present": false
     },
     {
      "factor": "nausea_vomiting",
      "points": 0,
      "present": false
     },
     {
      "factor": "rlq_tenderness",
      "points": 0,
      "present": false
     },
     {
      "factor": "reb
… (truncated)
```

## More

- Live health (JSON, refreshed every minute): https://www.zero.xyz/c/alvarado-mantrels-appendicitis-score-calculator-0375058c/health.json
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