II. Indications
- Community Acquired Pneumonia assessment of severity
III. Background
- SMART-COP is acronym for
- Systolic Blood Pressure
- Multilobar involvement
- Albumin
- Respiratory Rate
- Tachycardia
- Confusion
- Oxygen level
- pH (arterial)
IV. Criteria
- Major findings (2 points each)
- Systolic Blood Pressure <90 mmHg
- Oxygen level low
- Age <50 years
- paO2 <70 mmHg
- PaO2/FIO2 Ratio <333 if on oxygen
- Oxygen Saturation <94%
- Age >=50 years
- paO2 <60 mmHg
- PaO2/FIO2 Ratio <250 if on oxygen
- Oxygen Saturation <91%
- Age <50 years
- Minor findings (1 point each)
- Multilobar involvement on Chest XRay
- Respiratory Rate
- Age 50 or younger: >25 breaths/min
- Age over 50 years: >30 breaths/min
- Tachycardia with Heart Rate >125 beats/min
- New onset of confusion
- Lab findings (1 point each)
- Serum Albumin <3.5 g/dl
- Arterial pH <7.35
V. Interpretation: General
- Scoring predicts need for Intensive Respiratory or Vasopressor Support (IRVS)
VI. Interpretation: Clinic based where lab criteria not available (does not include lab findings above)
- Score 0 points: Very low risk of IRVS
- Score 1 points: Low risk of IRVS
- Score 2 points: Moderate risk of IRVS (1 in 10 patients)
- Score 3 points: High risk of IRVS (1 in 6 patients)
- Score 4 points: Very high risk of IRVS (1 in 3 patients)
VII. Interpretation: Standard scoring including lab findings
- Score 0-2 points: Low risk of IRVS
- Score 3-4 points: Moderate risk of IRVS (1 in 8 patients)
- Score 5-6 points: High risk of IRVS (1 in 3 patients)
- Score 7 points: Very high risk of IRVS (2 in 3 patients)
VIII. Resources
- LifeInTheFastLane PDF Guidelines