The Cardiovascular
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SMART-COP Score for Pneumonia Severity

Predicts need for intensive respiratory or vasopressor support in CAP.

SMART-COP Score for Pneumonia Severity
Systolic BP <90 mmHg
Multilobar involvement on chest imaging
Albumin <3.5 g/dL
Respiratory rate high (>=25/min if age <=50, >=30/min if age >50)
Tachycardia >=125 /min
Confusion (new onset)
Oxygen low (PaO2 <70 / SpO2 <=93% / PF <333 if age <=50; PaO2 <60 / SpO2 <=90% / PF <250 if age >50)
Arterial pH <7.35
Result0 points

Low risk of needing intensive respiratory or vasopressor support (IRVS).

Risk of IRVS
Low risk

When to use

  • Identifying patients with community-acquired pneumonia who may need ICU-level respiratory or circulatory support.

Formula

Points: SBP <90 (2), Multilobar infiltrates (1), Albumin <3.5 g/dL (1), age-adjusted high RR (1), Tachycardia >=125 (1), Confusion (1), age-adjusted low Oxygen (2), pH <7.35 (2). 0-2 low, 3-4 moderate, 5-6 high, >=7 very high risk of IRVS.

Pearls and pitfalls

  • Respiratory-rate and oxygenation thresholds are stricter for patients over 50 years.
  • Designed to predict need for intensive support rather than mortality.

References

  1. Charles PGP, et al. Clin Infect Dis. 2008;47(3):375-84.