SMART COP Score for Pneumonia Severity

 

Blood pressure, CXR and nutrition factors
		Systolic BP <90 mmHg (2 points)
		Multiple lobes involved on chest x-ray (1 point)
		Albumin level less than 3.5 g/dL (1 point)
Respiration/Age factor
		Any age: respiratory rate less than 25 breaths/minute (0 points)
		50 years old or younger: respiratory rate 25 breaths/minute or more (1 point)
		Over 50 years old: respiratory rate 30 breaths/minute or more (1 point)
Cardiovascular factor
		Tachycardia of 125 beats/minute or more (1 point)
Mental status factor
		Confusion (acute) (1 point)
Oxygenation/Age and acid-base factors
		Any age: PaO2 ≥70 mmHg or O2 Saturation ≥94% or PaO2/FiO2 ≥333 if receiving O2 (0 points)
		50 years old or younger: PaO2 <70 mmHg or O2 Saturation ≤93% or PaO2/FiO2 <333 if receiving O2 (2 points)
		Over 50 years old: PaO2 <60 mmHg or O2 Saturation ≤90% or PaO2/FiO2 <250 if receiving O2 (2 points)
		pH (arterial) <7.35 (2 points)

 

Total Criteria Point Count:
 

 

SMART COP Score and Risk for Ventilation or Vasopressor Support

 

0 to 2 points:	Low risk
3 to 4 points:	Moderate risk (approximately 12.5%)
5 to 6 points:	High risk (approximately 33%)
7 to 11 points:	Very high risk (approximately 67%)

 

 

References

1. Charles PG, Wolfe R, Whitby M, Fine MJ, Australian Community-Acquired Pneumonia Study Collaboration, et al. SMART-COP: a tool for predicting the need for intensive respiratory or vasopressor support in community-acquired pneumonia. Clin Infect Dis. 2008 Aug 1;47(3):375-84. doi: 10.1086/589754. PubMed ID: 18558884