The predictive value of the SMART-COP score in the management of acute pulmonary embolism in the emergency department

Introduction: The current study evaluates how well the SMART-COP score predicts the necessity for hospitalization in patients diagnosed with acute pulmonary embolism (APE) within the emergency department (ED). Methods: A prospective study was conducted between July 10, 2023, and March 10, 2024, in the ED of a tertiary care hospital and included 105 patients diagnosed with APE. The echocardiographic findings along with the clinical outcomes of the patients in the ED (hospitalization or discharge) were correlated with the SMART-COP score. Statistical analyses were conducted utilizing SPSS version 25 (IBM Corp., Armonk, NY). To assess the predictive power of the SMART-COP score in determining the need for hospitalization, receiver operating characteristic (ROC) analysis was undertaken. Results: The study found that patients requiring hospitalization had higher SMART-COP scores, which were positively associated with right ventricular (RV) dysfunction and elevated pulmonary artery pressure (PAP). The SMART-COP score demonstrated a cut-off value of 2.50, with sensitivity and specificity values of 85.1% and 71.1%, respectively. Conclusion: The findings suggest that the SMART-COP score may serve as a valuable tool for assessing the need for hospitalization in patients with APE within the ED setting. This study highlights the importance of the SMART-COP score in the management of APE, particularly along with hemodynamic instability criteria. Also, this paper introduces the clinical application of SMART-COP score in rapid and efficient evaluations in emergency care.