Comparison of Scoring Systems (SMART-COP vs. CURB-65) in Predicting the Need for Vasopressor and Mechanical Ventilation Support in Patients with Community-Acquired Pneumonia (Code-T0344)

Introduction: Community-acquired pneumonia (CAP) remains a major cause of morbidity and 
mortality worldwide. Early and accurate risk assessment is crucial to determine the need for 
critical interventions such as vasopressor support and mechanical ventilation. SMART-COP and 
CURB-65 are widely used severity scoring systems; however, their predictive accuracy in 
identifying patients requiring intensive respiratory or vasopressor support (IRVS) varies. 
Aims and Objectives:  
Aim: 
The aim of the present study is to predict  vasopressor and mechanical ventilation support in 
patients with community acquired pneumonia using 8 variable scoring system called-SMART 
COP 
Objective:  
• The objective of the present study is to determine the efficacy of SMART-COP score in 
predicting vasopressor and mechanical ventilation support in CAP. 
• To compare pneumonia severity scores like CURB 65 with SMART-COP score 
• To assess the severity and outcomes in CAP and it’s correlation with SMART-COP 
scoring system 
Methods: A prospective observational study was conducted at SRM Medical College Hospital 
over nine months. A total of 98 adult CAP patients were enrolled based on clinical and 
radiological criteria. Both SMART-COP and CURB-65 scores were calculated at admission. The 
predictive accuracy of both scoring systems was analyzed using sensitivity, specificity, logistic 
regression, and receiver operating characteristic (ROC) curve analysis. 
Results: SMART-COP demonstrated higher sensitivity (85.7% for vasopressor need; 80% for 
mechanical ventilation) and specificity compared to CURB-65. The area under the ROC curve 
(AUC) for SMART-COP was significantly higher (0.782 for vasopressor need; 0.745 for 
mechanical ventilation) than CURB-65 (0.612 and 0.595, respectively), indicating superior 
predictive capability. 
Conclusion: SMART-COP is a more effective tool than CURB-65 in predicting the need for 
critical interventions in CAP patients. Its higher sensitivity and specificity suggest its integration 
into clinical protocols for improved risk stratification and timely interventions. 
Keywords: Community-acquired pneumonia, SMART-COP, CURB-65, vasopressor support, 
mechanical ventilation, severity assessment.