Neutrophil to Lymphocyte (N/L) and Platelet to Lymphocyte (P/L) Ratios in Differentiating Acute Heart Failure from Respiratory Infection.

Background: The clinical manifestations of acute heart failure (AHF) and respiratory infection (RI) frequently overlap in patients presenting with dyspnoea at the emergency department (ED). The neutrophil to lymphocyte (N/L) and platelet to lymphocyte (P/L) ratios have been proposed as diagnostic and prognostic indices in this setting.

Objective: To evaluate the ability of N/L and P/L ratios to discriminate the cause of dyspnoea in patients admitted with an initial diagnosis of AHF-RI.

Emergency department triage of acute heart failure triggered by pneumonia; when an intensive care unit is needed?

Community acquired pneumonia (CAP) is a frequent triggering factor for decompensation of a chronic cardiac dysfunction, leading to acute heart failure (AHF). Patients with AHF exacerbated by CAP, are often admitted through the emergency department for ICU hospitalization, even though more than half the cases do not warrant any intensive care treatment. Emergency department physicians are forced to make disposition decisions based on subjective criteria, due to lack of evidence-based risk scores for AHF combined with CAP.