Pneumonia risk stratification in tropical Australia: does the SMART-COP score apply?

Joshua S Davis, Gail B Cross, Patrick G P Charles, Bart J Currie, Nicholas M Anstey and Allen C Cheng
Med J Aust 2010; 192 (3): 133-136.
  • Joshua S Davis1,2
  • Gail B Cross3
  • Patrick G P Charles4,5
  • Bart J Currie1,2
  • Nicholas M Anstey1,2
  • Allen C Cheng1,6,7

  • 1 Menzies School of Health Research and Charles Darwin University, Darwin, NT.
  • 2 Division of Medicine and NT Clinical School, Royal Darwin Hospital, Darwin, NT.
  • 3 Royal Darwin Hospital, Darwin, NT.
  • 4 Austin Hospital, Melbourne, VIC.
  • 5 Department of Medicine, University of Melbourne, Melbourne, VIC.
  • 6 The Alfred Hospital, Melbourne, VIC.
  • 7 Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC.


We thank Mark McMillan and Alex Humphrey for data collection and entry; Luke Diolosa and Dianne Stephens for assistance with intensive care databases; and staff in the radiology department for their assistance. This study was funded by the National Health and Medical Research Council (Program Grant 496600, Fellowships to Allen Cheng and Nicholas Anstey, and a scholarship to Joshua Davis).

Competing interests:

None identified.

  • 1. Fine MJ, Auble TE, Yealy DM, et al. A prediction rule to identify low-risk patients with community-acquired pneumonia. N Engl J Med 1997; 336: 243-250.
  • 2. Aujesky D, Auble TE, Yealy DM, et al. Prospective comparison of three validated prediction rules for prognosis in community-acquired pneumonia. Am J Med 2005; 118: 384-392.
  • 3. Ananda-Rajah MR, Charles PG, Melvani S, et al. Comparing the pneumonia severity index with CURB-65 in patients admitted with community acquired pneumonia. Scand J Infect Dis 2008; 40: 293-300.
  • 4. Man SY, Lee N, Ip M, et al. Prospective comparison of three predictive rules for assessing severity of community-acquired pneumonia in Hong Kong. Thorax 2007; 62: 348-353.
  • 5. Charles PG, Wolfe R, Whitby M, et al. SMART-COP: a tool for predicting the need for intensive respiratory or vasopressor support in community-acquired pneumonia. Clin Infect Dis 2008; 47: 375-384.
  • 6. Chalmers JD, Singanayagam A, Hill AT. Predicting the need for mechanical ventilation and/or inotropic support for young adults admitted to the hospital with community-acquired pneumonia. Clin Infect Dis 2008; 47: 1571-1574.
  • 7. Elliott JH, Anstey NM, Jacups SP, et al. Community-acquired pneumonia in northern Australia: low mortality in a tropical region using locally-developed treatment guidelines. Int J Infect Dis 2005; 9: 15-20.
  • 8. Douglas MW, Lum G, Roy J, et al. Epidemiology of community-acquired and nosocomial bloodstream infections in tropical Australia: a 12-month prospective study. Trop Med Int Health 2004; 9: 795-804.
  • 9. Anstey NM, Currie BJ, Withnall KM. Community-acquired Acinetobacter pneumonia in the Northern Territory of Australia. Clin Infect Dis 1992; 14: 83-91.
  • 10. Charles PG, Whitby M, Fuller AJ, et al. The etiology of community-acquired pneumonia in Australia: why penicillin plus doxycycline or a macrolide is the most appropriate therapy. Clin Infect Dis 2008; 46: 1513-1521.
  • 11. Bone RC, Balk RA, Cerra FB, et al. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine. Chest 1992; 101: 1644-1655.
  • 12. National Health and Medical Research Council. Australian alcohol guidelines: health risks and benefits. Canberra: NHMRC, 2001.
  • 13. Rothschild MA, Oratz M, Schreiber SS. Serum albumin. Hepatology 1988; 8: 385-401.
  • 14. Fearon KC, Falconer JS, Slater C, et al. Albumin synthesis rates are not decreased in hypoalbuminemic cachectic cancer patients with an ongoing acute-phase protein response. Ann Surg 1998; 227: 249-254.
  • 15. Australian Bureau of Statistics. National Aboriginal and Torres Strait Islander Health Survey, 2004–05. Canberra: ABS, 2006. (ABS Cat. No. 4715.0.)


remove_circle_outline Delete Author
add_circle_outline Add Author

Do you have any competing interests to declare? *

I/we agree to assign copyright to the Medical Journal of Australia and agree to the Conditions of publication *
I/we agree to the Terms of use of the Medical Journal of Australia *
Email me when people comment on this article

Responses are now closed for this article.