SCAP score

Q; All of the following are the part of the severe community-acquired pneumonia (SCAP) score EXCEPT? (select one)

A) Systolic blood pressure 

B) Respiratory rate

C) Altered mental status

D) Age 

E) Pulse ox saturation

Answer: E

The severe community-acquired pneumonia (SCAP) is a validated score designed to predict in-hospital mortality, need for mechanical ventilation, and risk for septic shock. It consists of two major criteria and 6 minor criteria.

Major criteria:

• Arterial pH <7.30 – 13 points
• Systolic blood pressure <90 mmHg – 11 points

Minor criteria:

• Respiratory rate >30 breaths/minute – 9 points
• PaO2/FiO2 <250 mmHg – 6 points
• Blood urea nitrogen >30 mg/dL (10.7 mmol/L) – 5 points
• Altered mental status – 5 points
• Age ≥80 years – 5 points
• Multilobar/bilateral infiltrates on radiograph – 5 points

A SCAP score ≥10 counting at least one major or at least two minor criteria was found reliable for predicting ICU admission, need for mechanical ventilation, progression to severe sepsis, and treatment failure.

Choice E is wrong as score requires P/F ratio (see above), just not the pulse ox saturation.

  

  

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References:

  

1. España PP, Capelastegui A, Gorordo I, et al. Development and validation of a clinical prediction rule for severe community-acquired pneumonia. Am J Respir Crit Care Med 2006; 174:1249.

  

2. Yandiola PPE, Capelastegui A, Quintana J, et al. Prospective comparison of severity scores for predicting clinically relevant outcomes for patients hospitalized with community-acquired pneumonia. Chest 2009; 135:1572.