Charles et al developed the SMART-COP decision tool for identifying a patient with community-acquired pneumonia who is likely to require intensive respiratory and/or vasopressor support. An abbreviated version was termed SMRT-CO. The authors are from multiple hospitals in Australia.
Parameters:
(1) systolic blood pressure
(2) infiltrate on chest X-ray
(4) respiratory rate
(5) heart rate
(6) confusion, new onset
(7) oxygenation (oxygen saturation on pulse oximetry)
|
Parameter |
Finding |
Points |
|
systolic blood pressure |
normal or high |
0 |
|
|
low (hypotension, < 90 mm Hg) |
2 |
|
infiltrate on chest X-ray |
single lobe infiltrate |
0 |
|
|
multi-lobar |
1 |
|
respiratory rate |
low or normal |
0 |
|
|
high (tachypnea, see below) |
1 |
|
heart rate |
low or normal |
0 |
|
|
high (tachycardia, >= 125 beats/min) |
1 |
|
confusion |
absent |
0 |
|
|
present |
1 |
|
oxygenation |
< 93% if <= 50 years of age |
2 |
|
|
< 90% if > 50 years of age |
2 |
|
|
other |
0 |
where:
• Tachypnea was defined as >= 25 breaths per minute for a patient <= 50 years old and >= 30 breaths per minute for a patient > 50 years old.
• The acronym SMRT-CO was derived from the first letters for systolic, multilobar, respiratory, tachycardia, confusion, oxygenation.
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 8
• The higher the score the more severe the pneumonia.
• A score >= 2 identified a patient at risk for intensive respiratory or vasopressor support..
Specialty: Infectious Diseases, Pulmonology
ICD-10: ,
