The SMART-COP score performs well for pneumonia risk stratification in Australia's Tropical Northern Territory: A prospective cohort study

Karen L. Robins-Browne, Allen C. Cheng, Kathleen A S Thomas, Didier J. Palmer, Bart J. Currie, Joshua S. Davis

    Research output: Contribution to journalArticlepeer-review

    Abstract

    Objective: To prospectively compare a modified pneumonia severity scoring system, SMARTACOP, with other severity scores in patients presenting with pneumonia to the emergency department (ED) of a tertiary referral hospital in tropical Australia.

    Methods: We conducted a prospective observational study of adult patients presenting with radiologically confirmed pneumonia over a 12-month period. The sensitivity of risk stratification scores were assessed against the need for intensive respiratory or vasopressor support (IRVS).

    Results: There were 367 ED attendances for pneumonia of whom 77.1% were admitted to hospital, 10% required intensive respiratory or vasopressor support and 2.8% died. Mean age was 50.0years, 52% were men and 59% were Indigenous. The sensitivity of a SMART-COP score ≥3, a SMARTACOP score ≥3 and a pneumonia severity index (PSI) class ≥3 for predicting IRVS was 97%, 97% and 78% respectively.

    Conclusions: We found no significant advantage of the SMARTACOP over the SMART-COP score for the prediction of intensive respiratory or vasopressor support, but both scores significantly outperformed PSI. The SMART-COP score should replace the PSI in tropical Australia and should be assessed in other tropical areas for pneumonia risk stratification in emergency departments.

    Original languageEnglish
    Pages (from-to)914-919
    Number of pages6
    JournalTropical Medicine and International Health
    Volume17
    Issue number7
    DOIs
    Publication statusPublished - Jul 2012

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