JPSIM Journal of Pakistan Society of Internal Medicine J Pak Soc Intern Med 2709-8729 2710-0804 Pakistan Society of Internal Medicine 10.70302/jpsim.v6i4.2565 jpsim.v6i4.2565 Original Research Is SMaRTCOP really smart? Validity of SMaRTCOP in the Severity & Prognosis of Community Acquired Pneumonia in the Emergency Department Ambreen Sobia sobia.ambreen683@gmail.com * Muhammad Yar Khan Muhammad Akif Ali Niazi Suhail Niaz Khan Safdar Muhammad Naeem Jehangir Hafiz Muhammad Sajid Department of Emergency Medicine, King Edward Medical University/ Mayo Hospital *Correspondence: Sobia Ambreen (sobia.ambreen683@gmail.com) 21 11 2025 2025 6 4 354 358 18 12 2024 25 02 2025 11 10 2025 Copyright © 2025 The Author(s) 2025 The Author(s) https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Objective

To evaluate the validity of the SMaRT-COP score, excluding the indigenous serum albumin levels, in the prognosis and severity of community-acquired pneumonia (CAP) in the emergency department (ED).

 Methodology

A prospective observational study of patients presenting with clinical signs and symptoms of pneumonia to ED of a tertiary care hospital. Without taking into consideration the albumin levels of the admitting patients with community acquired pneumonia, the sensitivity and specificity of the modified SMaRTCOP score for intensive respiratory & vasopressor support (IRVS) requirements and ICU admissions were determined.

 Results

In this study, 55.6% and 44.4% of patients were males and females respectively. The mean age of patients was 53.49±15.84 years old. Among the participants, 41.6% required ICU care, and 70.2% received IRVS as part of their treatment. The SMaRTCOP score of 5 or higher demonstrated a sensitivity of 95.12% and a specificity of 85.45% for predicting the need for IRVS, while, for predicting ICU admission, the sensitivity and specificity were 51.22% and 98.18% respectively, with a p-value of 0.001.

 Conclusion

Even without using the indigenous serum albumin levels, we can accurately predict the severity and prognosis of community-acquired pneumonia (CAP) using the SMaRTCOP score in the Emergency Department.

 Keywords Community-acquired pneumonia Prognosis Emergency Department Ethics Statement

Ethics committee: Institutional Review Board, King Edward Medical University, Lahore, Pakistan. Approval number: 434/RC/KEMU, dated October 17, 2023.

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