RespRespiratory

SMART-COP Score for Severe CAP

Predicts need for intensive respiratory or vasopressor support (IRVS) in community-acquired pneumonia to identify ICU candidates early.

S — Systolic BP < 90 mmHg?

M — Multilobar chest X-ray infiltrates?

A — Albumin < 35 g/L?

R — Respiratory rate elevated? (≥25/min if age <50; ≥30/min if age ≥50)

T — Tachycardia (heart rate > 125 bpm)?

C — New-onset confusion?

O — Hypoxaemia? (PaO₂ <70 mmHg; or SpO₂ <94% on air; or PaO₂/FiO₂ <333 if age <50; or <250 if age ≥50)

P — Arterial pH < 7.35?

SMART-COP Score/ 11

Low risk — IRVS probability ~0.5%

Probability of requiring intensive respiratory or vasopressor support (IRVS): ~0.5%. Standard ward-based management with oral antibiotics is appropriate. Routine ICU assessment is not indicated.

Reference: Charles PG et al. Clin Infect Dis 2008

Medical Disclaimer: This calculator is a clinical decision support tool for qualified healthcare professionals. It does not replace clinical judgement. Always interpret results in the full clinical context. Reference: Charles PG et al. Clin Infect Dis 2008.

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