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Pneumonia IRVS Prediction Tool

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Pneumonia IRVS Prediction Tool, CAP IRVS Prediction Tool, Community Acquired Pneumonia Intensive Respiratory or Vasopressor Support Prediction Tool, SMART-COP

  • See Also
  1. Community Acquired Pneumonia
  2. Community Acquired Pneumonia Management
  • Indications
  1. Community Acquired Pneumonia assessment of severity
  • Background
  1. SMART-COP is acronym for
    1. Systolic Blood Pressure
    2. Multilobar involvement
    3. Albumin
    4. Respiratory Rate
    5. Tachycardia
    6. Confusion
    7. Oxygen level
    8. pH (arterial)
  • Criteria
  1. Major findings (2 points each)
    1. Systolic Blood Pressure <90 mmHg
    2. Oxygen level low
      1. Age <50 years
        1. paO2 <70 mmHg
        2. PaO2/FIO2 Ratio <333 if on oxygen
        3. Oxygen Saturation <94%
      2. Age >=50 years
        1. paO2 <60 mmHg
        2. PaO2/FIO2 Ratio <250 if on oxygen
        3. Oxygen Saturation <91%
  2. Minor findings (1 point each)
    1. Multilobar involvement on Chest XRay
    2. Respiratory Rate
      1. Age 50 or younger: >25 breaths/min
      2. Age over 50 years: >30 breaths/min
    3. Tachycardia with Heart Rate >125 beats/min
    4. New onset of confusion
  3. Lab findings (1 point each)
    1. Serum Albumin <3.5 g/dl
    2. Arterial pH <7.35
  • Interpretation
  • General
  1. Scoring predicts need for Intensive Respiratory or Vasopressor Support (IRVS)
  • Interpretation
  • Clinic based where lab criteria not available (does not include lab findings above)
  1. Score 0 points: Very low risk of IRVS
  2. Score 1 points: Low risk of IRVS
  3. Score 2 points: Moderate risk of IRVS (1 in 10 patients)
  4. Score 3 points: High risk of IRVS (1 in 6 patients)
  5. Score 4 points: Very high risk of IRVS (1 in 3 patients)
  • Interpretation
  • Standard scoring including lab findings
  1. Score 0-2 points: Low risk of IRVS
  2. Score 3-4 points: Moderate risk of IRVS (1 in 8 patients)
  3. Score 5-6 points: High risk of IRVS (1 in 3 patients)
  4. Score 7 points: Very high risk of IRVS (2 in 3 patients)
  • Resources
  1. LifeInTheFastLane PDF Guidelines
    1. https://lifeinthefastlane.com/wp-content/uploads/2010/07/etg-smartcop.pdf
  • References
  1. Charles (2008) Clin Infect Dis 47(3): 375-84 [PubMed]