Evaluation of Two different Scores in Assessing the Severity of Community Acquired Pneumonia: a cross-sectional study in Ismailia, Egypt

Background and Aim of study: Several severity scores have been proposed to predict patient 
outcome and to guide initial management of patients with community acquired pneumonia (CAP). 
Most have been derived as predictors of mortality. A study was undertaken to compare the predictive 
value of these tools using different clinically meaningful outcomes as constructs for „„severe 
pneumonia‟‟. Patients and Methods: This is a descriptive study (cross sectional) was carried out at 
emergency department of Suez Canal University hospitals and outpatient clinic on 76 patients with a 
diagnosis of CAP. Clinical and laboratory features at presentation were used to calculate severity 
scores using the CURB65 score and the SMARTCOP score. The sensitivity and specificity were 
compared for two different outcomes (mortality, need for ICU admission). The scores were compared 
based on sensitivity, specificity, and area under the curve (AUC) of the receiver operating 
characteristic. Results: 76 patients were included in the analysis; 17 (22.4%) died, 1 (1.3%) has 
developed empyema and 59 (77.9%) have returned to normal activity. When the outcome was 
evaluated for CURB65 score as regard to mortality Sensitivity was: 82.4% and Specificity was: 
79.7% and as regard need for ICU admission, Sensitivity was: 94% and Specificity was: 83%. And 
when the outcome was evaluated for SMARTCOP score as regard to mortality Sensitivity was: 94.1% 
and Specificity was: 59.3% and as regard need for ICU admission Sensitivity was: 100% and 
Specificity was: 70%. So the best predictor was SMARTCOP. Conclusion: SMART-COP is a new, 
relatively simple and variable tool that appears to identify accurately patients with CAP who will 
require intensive respiratory or vasopressor support (IRVS). Our findings suggest that SMART-COP 
is likely to be a useful advance for clinicians in the accurate prediction of disease severity among 
patients with CAP. SMART-COP score was better than CURB65 score in predicting risk of mortality 
and risk of ICU admission in community acquired pneumonia. So SMART-COP score was better in 
assessing the severity of community.