SMART-COP Score for Pneumonia Severity
Predicts need for intensive respiratory or vasopressor support (IRVS) in community-acquired pneumonia (CAP).
Tips for COVID-19: Use to determine floor vs. ICU. Perhaps best performing to predict ICU admissions for CAP, but unclear applicability in COVID/viral pneumonias/ARDS.
Use in patients ≥18 years with clinical and radiographic findings consistent with community acquired pneumonia (CAP). Does not apply to patients with significant immunosuppression.
- Patients who do not meet criteria for ICU admission using the SMART-COP Score should still be evaluated for the need for inpatient admission.
- They should also receive timely and appropriate empiric antibiotics for CAP, generally a beta-lactam plus a macrolide, or a fluoroquinolone.
- Goals of care and other variables may recommend against ICU admission even if the SMART-COP Score is high.
For patients with high SMART-COP Scores, consider broadening antibiotic regimen to include MRSA coverage (for ICU admission, necrotizing or cavitary infiltrates, or empyema, previous MRSA infection) and/or to include antipseudomonal coverage (for history of structural lung disease, immunocompromise, or previous Pseudomonas infection). Also, consider if the patient has associated sepsis and treat accordingly.