# SMART-COP Score for Pneumonia Severity Calculates the SMART-COP score to predict the need for Intensive Respiratory or Vasopressor Support (IRVS) in patients with Community-Acquired Pneumonia (CAP). The score incorporates Systolic BP, Multilobar chest radiography, Albumin, Respiratory rate, Tachycardia, Confusion, Oxygenation, and pH levels, with age-adjusted cutoffs for respiratory rate and oxygenation. ```r smart_cop_score(age, systolic_bp, multilobar_cxr, albumin_g_dl, respiratory_rate, heart_rate, confusion, arterial_ph, pao2_mmhg = NA, spo2_percent = NA, pao2_fio2_ratio = NA) ``` ## Arguments - `age`: Numeric. Patient age in years. - `systolic_bp`: Numeric. Systolic blood pressure in mmHg. (< 90 mmHg adds 2 points). - `multilobar_cxr`: Numeric (0 or 1). Multilobar involvement on chest radiograph. (1 = Yes, +1 point). - `albumin_g_dl`: Numeric. Serum albumin in g/dL. (< 3.5 g/dL adds 1 point). - `respiratory_rate`: Numeric. Respiratory rate in breaths per minute. (Age <= 50: >= 25 adds 1 point; Age > 50: >= 30 adds 1 point). - `heart_rate`: Numeric. Heart rate in beats per minute. (>= 125 bpm adds 1 point). - `confusion`: Numeric (0 or 1). New onset confusion. (1 = Yes, +1 point). - `arterial_ph`: Numeric. Arterial pH. (< 7.35 adds 2 points). - `pao2_mmhg`: Numeric (Optional). Arterial partial pressure of oxygen. Used for oxygenation scoring. - `spo2_percent`: Numeric (Optional). Oxygen saturation percentage. Used for oxygenation scoring. - `pao2_fio2_ratio`: Numeric (Optional). PaO2/FiO2 ratio. Used for oxygenation scoring. Note: Low oxygenation adds 2 points. Thresholds depend on age (<= 50: PaO2 < 70, SpO2 <= 93, P/F < 333; > 50: PaO2 < 60, SpO2 <= 90, P/F < 250). ## Returns A list containing: - **SMART_COP_Score**: The calculated total score (Range 0-11). - **Risk_Category**: Classification (Low, Moderate, High, Very High). - **Prediction**: Estimated risk of needing IRVS. ## References Charles PG, Wolfe R, Whitby M, 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. doi:10.1086/589754 ## Examples ```r # Example 1: High Risk # 45yo, SBP 85 (+2), Multilobar (+1), Alb 3.0 (+1), #RR 30 (+1), HR 110 (0), Conf (0), Low O2 (+2), pH 7.30 (+2) # Score = 9 smart_cop_score(45, 85, 1, 3.0, 30, 110, 0, 7.30, spo2_percent = 88) # Example 2: Low Risk # 60yo, SBP 120, Unilobar, Alb 4.0, RR 20, HR 80, Alert, Normal O2/pH # Score = 0 smart_cop_score(60, 120, 0, 4.0, 20, 80, 0, 7.40, spo2_percent = 98) ```

smart_cop_score function