SMART-COP Score for Pneumonia Severity
Predicts need for intensive respiratory or vasopressor support (IRVS) in community-acquired pneumonia. Identifies patients who may require ICU-level care.
Score interpretation
SMART-COP 0–2: Low risk of needing intensive respiratory or vasopressor support.
→ Ward-level care. Oral or IV antibiotics. Monitor SpO₂ and clinical response.
SMART-COP 3–4: Moderate risk of needing IRVS (~1 in 8).
→ HDU-level monitoring. IV antibiotics. Early senior review. Daily reassessment.
SMART-COP 5–6: High risk of needing IRVS (~1 in 3).
→ HDU/ICU assessment. Senior respiratory/intensivist review. IV antibiotics. Consider NIV.
SMART-COP ≥ 7: Very high risk — majority require IRVS.
→ Immediate ICU admission. Invasive ventilation likely. Vasopressors if haemodynamically compromised. Intensivist + respiratory team.
Interpretation bands for the SMART-COP. Apply clinical judgement and local guidance.
References
- Charles PGP, et al. SMART-COP: a tool for predicting the need for intensive respiratory or vasopressor support in community-acquired pneumonia. Clin Infect Dis. 2008;47(3):375–384.
Related
Curated clinical cross-links plus same-class fallbacks.
- Pneumonia Severity Index (PSI/PORT) · Pneumonia
- CRB-65 Score for Community Pneumonia · Pneumonia
- CURB-65 Score for Community-Acquired Pneumonia · Pneumonia
- MuLBSTA Score for Viral Pneumonia Mortality · Pneumonia
- DRIP Score for Drug-Resistant Pneumonia · Pneumonia
- SCAP Score for Severe Community-Acquired Pneumonia · Pneumonia
- Doxapram hydrochloride · Respiratory stimulant
- Folinic Acid (Calcium Folinate / Leucovorin) · Antidote / Chemotherapy Support
- Enteral feeds · Nutritional support
- Folinic Acid (Calcium Folinate / Leucovorin) · Antidote / Chemotherapy Support
- Cefuroxime · Second-Generation Cephalosporin — Respiratory / Surgical Prophylaxis
- Clarithromycin · Macrolide Antibiotic — Respiratory / H. pylori / MAC
- Acute Asthma in Adults · BTS/SIGN British Guideline on Asthma 2019; NICE NG80
- Pulmonary Embolism Assessment · NICE NG158; ESC 2019 PE Guidelines
- Acute Exacerbation of COPD (AECOPD) · NICE NG115; GOLD 2024
- Spontaneous Pneumothorax (Adult) · BTS Pleural Disease 2023
- Atypical Pneumonia (Legionella / Mycoplasma / Chlamydophila) · BTS 2023; IDSA
- COPD Exacerbation Management · NICE NG115 / GOLD 2024
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.