S — Systolic Blood Pressure < 90 mmHg

SBP ≥ 90 mmHg+0SBP < 90 mmHg+2

M — Multilobar Involvement on Chest X-ray

Single-lobe or no infiltrate+0Multilobar infiltrates on chest X-ray+1

A — Albumin < 3.5 g/dL (< 35 g/L)

Albumin ≥ 3.5 g/dL+0Albumin < 3.5 g/dL (hypoalbuminemia)+1

R — Respiratory Rate (Age-Stratified Threshold)

RR below threshold (< 25 if ≤50y, < 30 if >50y)+0RR ≥ 25 bpm (if age ≤ 50) or ≥ 30 bpm (if age > 50)+1

T — Heart Rate ≥ 125 bpm

Heart rate < 125 bpm+0Heart rate ≥ 125 bpm+1

C — Confusion (New-Onset Disorientation)

No new confusion+0New-onset confusion or disorientation+1

O — Oxygenation Failure (Age-Stratified)

Oxygenation above threshold+0SpO2 < 93% or PaO2 < 70 mmHg (age ≤50) OR PaO2 < 60 mmHg / SaO2 < 90% (age >50)+2

P — Arterial pH < 7.35

Arterial pH ≥ 7.35+0Arterial pH < 7.35 (acidosis)+2

SMART-COP Score — Severity Assessment for CAP