{"uid":"cap_xBYNdonwuYGJ_slaccEDy","slug":"king-s-college-criteria-calculator-for-fulminant-hepatic-failure-18f8dcff","name":"King's College Criteria Calculator for Fulminant Hepatic Failure","description":"King's College criteria (O'Grady 1989) for poor prognosis in fulminant hepatic failure. Acetaminophen: arterial pH <7.30, or PT >100 s plus creatinine >300 umol/L plus grade III/IV encephalopathy. Non-acetaminophen: PT >100 s, or any 3 of age <11 or >40, unfavorable etiology (non-A non-B or drug reaction), jaundice-to-encephalopathy >7 days, bilirubin >300 umol/L, PT >50 s. PT seconds, not INR. Not a transplant listing order.","url":"https://api.magentlab.com/api/calc/kings_college","method":"GET","headers":{},"bodySchema":{"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":["etiology","arterial_ph","pt_sec","creatinine_umol_l","encephalopathy_grade","age_years","unfavorable_etiology","jaundice_to_encephalopathy_days","bilirubin_umol_l"],"properties":{"pt_sec":{"type":"number","description":"Prothrombin time in seconds (8-120) as published in 1989. INR is not accepted. Acetaminophen combo uses PT > 100; non-acetaminophen uses PT > 100 alone or PT > 50 as one of five factors."},"etiology":{"enum":["acetaminophen","non_acetaminophen"],"type":"string","description":"acetaminophen or non_acetaminophen (O'Grady 1989). Selects the paracetamol or non-paracetamol poor-prognosis tree. Required on every request."},"age_years":{"type":"integer","description":"Age in years (0-120). Non-acetaminophen factor met when age < 11 or age > 40 (1989 abstract, not a later <10 restatement). Required even on the acetaminophen tree; not scored there."},"arterial_ph":{"type":"number","description":"Arterial pH (6.80-7.80). Acetaminophen criterion met when pH < 7.30, independent of encephalopathy. Required even on the non-acetaminophen tree; not scored there."},"bilirubin_umol_l":{"type":"number","description":"Serum bilirubin in umol/L (2-684). Non-acetaminophen factor met when > 300. Required even on the acetaminophen tree; not scored there."},"creatinine_umol_l":{"type":"number","description":"Serum creatinine in umol/L (9-1768). Acetaminophen combo criterion met when > 300. Required even on the non-acetaminophen tree; not scored there."},"encephalopathy_grade":{"type":"integer","description":"Hepatic encephalopathy grade 0-4 as assigned by the caller (Conn 1977 / West Haven). Acetaminophen combo uses grade >= 3 (grade III/IV). Required even on the non-acetaminophen tree; not scored there. magent does not examine the patient."},"unfavorable_etiology":{"type":"boolean","description":"Unfavorable etiology as assigned by the caller (paper: non-A non-B hepatitis or drug reaction). true or false. Non-acetaminophen any-3 factor. Required even on the acetaminophen tree; not scored there."},"jaundice_to_encephalopathy_days":{"type":"integer","description":"Days from jaundice to encephalopathy (integer 0-90). Non-acetaminophen factor met when > 7. Required even on the acetaminophen tree; not scored there."}}}},"additionalProperties":false},"output":{"type":"object","required":["type"],"properties":{"type":{"type":"string"},"example":{"type":"object"}}}}},"responseSchema":{"type":"json","example":{"path":"/api/calc/kings_college","count":2,"items":[{"formula":"kings_college","citation":{"id":"ogrady-1989","doi":"10.1016/0016-5085(89)90081-4","pmid":"2490426","title":"Early indicators of prognosis in fulminant hepatic failure","source":"Gastroenterology. 1989;97(2):439-445","authors":"O'Grady JG, Alexander GJ, Hayllar KM, Williams R"},"criteria":[{"met":false,"value":7.4,"factor":"arterial_ph_lt_7_30"},{"met":false,"value":20,"factor":"pt_sec_gt_100"},{"met":false,"value":80,"factor":"creatinine_umol_l_gt_300"},{"met":false,"value":1,"factor":"encephalopathy_grade_ge_3"}],"etiology":"acetaminophen","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.","criteria_met":false,"formula_expression":"acetaminophen: arterial_ph < 7.30, or (pt_sec > 100 and creatinine_umol_l > 300 and encephalopathy_grade >= 3); non_acetaminophen: pt_sec > 100, or at least 3 of (age_years < 11 or > 40; unfavorable_etiology; jaundice_to_encephalopathy_days > 7; bilirubin_umol_l > 300; pt_sec > 50)"},{"formula":"kings_college","citation":{"id":"ogrady-1989","doi":"10.1016/0016-5085(89)90081-4","pmid":"2490426","title":"Early indicators of prognosis in fulminant hepatic failure","source":"Gastroenterology. 1989;97(2):439-445","authors":"O'Grady JG, Alexander GJ, Hayllar KM, Williams R"},"criteria":[{"met":false,"value":7.4,"factor":"arterial_ph_lt_7_30"},{"met":false,"value":20,"factor":"pt_sec_gt_100"},{"met":false,"value":80,"factor":"creatinine_umol_l_gt_300"},{"met":false,"value":1,"factor":"encephalopathy_grade_ge_3"}],"etiology":"acetaminophen","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.","criteria_met":false,"formula_expression":"acetaminophen: arterial_ph < 7.30, or (pt_sec > 100 and creatinine_umol_l > 300 and encephalopathy_grade >= 3); non_acetaminophen: pt_sec > 100, or at least 3 of (age_years < 11 or > 40; unfavorable_etiology; jaundice_to_encephalopathy_days > 7; bilirubin_umol_l > 300; pt_sec > 50)"}]}},"example":null,"exampleRequest":null,"tags":["x402"],"displayCostAmount":"0.005","displayCostAsset":"USDC","priceDynamic":false,"priceHint":null,"priceStatus":"priced","priceSource":"probe","requiresHandshake":false,"reviewCount":0,"rating":{"score":"0.00","successRate":"0.00","reviews":0,"stars":null,"state":"unrated"},"availabilityStatus":"unknown","priceObserved":null,"sessionDeposit":null,"pricing":{"kind":"static","summary":"$0.005/call","primary":{"kind":"static","protocol":"x402","network":"base","amountUsd":"0.005","per":"call","confidence":"exact"},"accepted":[{"kind":"static","protocol":"x402","network":"base","amountUsd":"0.005","per":"call","confidence":"exact"}]},"paymentMethods":[{"uid":"pm_4rNZPwaFDY6O4q41uu2hG","protocol":"x402","methodType":"crypto","chain":"base","mode":"charge","costAmount":"0.005","costPer":"request","priority":0,"asset":"0x833589fCD6eDb6E08f4c7C32D4f71b54bdA02913","unit":"request","depositMicros":null,"planRef":null}],"brandName":null,"brandSlug":null,"brandBaseUrl":null,"brandDocsUrl":null,"whatItDoes":"Applies the King's College Hospital (O'Grady 1989) poor-prognosis criteria for fulminant hepatic failure, supporting both acetaminophen and non-acetaminophen etiologies using prothrombin time in seconds.","exampleAgentPrompt":"Run the King's College criteria for a non-acetaminophen fulminant hepatic failure patient: age 45, PT 105 seconds, bilirubin 340 umol/L, arterial pH 7.35, creatinine 180 umol/L, grade III encephalopathy, unfavorable etiology (drug reaction), jaundice-to-encephalopathy interval 9 days.","exampleUseCases":[{"title":"Acetaminophen overdose ICU prognosis","prompt":"My ICU patient took a Tylenol overdose — arterial pH is 7.28, PT is 112 seconds, creatinine is 320 umol/L, and encephalopathy grade is IV. Age is 34. Run the King's College acetaminophen criteria and tell me if they meet the poor prognosis threshold."},{"title":"Non-acetaminophen hepatitis poor prognosis check","prompt":"I have a 52-year-old with non-A non-B hepatitis — PT is 55 seconds, bilirubin is 310 umol/L, encephalopathy grade is II, jaundice appeared 10 days before encephalopathy, arterial pH 7.38, creatinine 130 umol/L. Does this patient meet King's College non-acetaminophen poor prognosis criteria?"},{"title":"Drug-induced liver failure transplant evaluation triage","prompt":"Patient has drug-reaction fulminant hepatic failure, age 9, PT 108 seconds, bilirubin 280 umol/L, grade III encephalopathy, pH 7.40, creatinine 95 umol/L, jaundice-to-encephalopathy 8 days. Use the King's College O'Grady 1989 non-acetaminophen tree to see if they meet poor prognosis criteria."}],"resultDescription":"Returns a structured result indicating whether the patient meets the King's College poor-prognosis criteria for fulminant hepatic failure, which tree was applied (acetaminophen vs. non-acetaminophen), which individual criteria were met or not met, and an overall poor-prognosis flag. Does not constitute a transplant listing order.","failureModes":["Missing required query parameters returns a validation error","PT supplied as INR instead of seconds will produce incorrect scoring — INR is explicitly not accepted","Etiology field missing causes request to fail","Values outside accepted numeric ranges (e.g. pH outside 6.80-7.80) may cause rejection or inaccurate results","Encephalopathy grade outside 0-4 integer range causes validation failure"],"whenToPreferThis":"Use this endpoint when you need a reproducible, evidence-based computation of the King's College (O'Grady 1989) poor-prognosis criteria for fulminant hepatic failure, specifically when PT is expressed in seconds (not INR). Prefer this over manual calculation to avoid transcription errors, and over generic liver scoring tools (MELD, Child-Pugh) when the clinical question is specifically whether a patient meets King's College criteria for transplant evaluation referral.","instructions":null,"reviewSummary":null,"reviewSummaryHighlights":null,"reviewSummaryConcerns":null,"reviewSummaryGeneratedAt":null,"activationCount":0,"lastUsedAt":null,"lastSuccessfullyRanAt":null,"lastHealthCheckAt":"2026-09-15T00:53:56.372Z","isFirstParty":false}