SMART-COP for pneumonia
Predicts need for intensive respiratory or vasopressor support in pneumonia.
Inputs
Systolic BP below 90
Multilobar involvement on chest X-ray
Albumin below 3.5 g/dL
High respiratory rate (25 or more if age ≤ 50; 30 or more if older)
Heart rate 125 or higher
New confusion
Low oxygen (age ≤ 50: PaO₂ < 70, SpO₂ ≤ 93%, or P/F < 333; older: PaO₂ < 60, SpO₂ ≤ 90%, or P/F < 250)
Arterial pH below 7.35
Worked calculation
Your values are highlighted.
- Points
When to use
- Community-acquired pneumonia.
Pearls and pitfalls
- Respiratory rate and oxygenation thresholds depend on age (50 or younger vs older).
Why use
Targets ICU need rather than mortality.
| Criterion | Points |
|---|---|
| Systolic BP below 90 | +2 |
| Multilobar involvement on chest X-ray | +1 |
| Albumin below 3.5 g/dL | +1 |
| High respiratory rate (25 or more if age ≤ 50; 30 or more if older) | +1 |
| Heart rate 125 or higher | +1 |
| New confusion | +1 |
| Low oxygen (age ≤ 50: PaO₂ < 70, SpO₂ ≤ 93%, or P/F < 333; older: PaO₂ < 60, SpO₂ ≤ 90%, or P/F < 250) | +2 |
| Arterial pH below 7.35 | +2 |