Inflammatory indexes in emergency patients with hypertensive pulmonary Oedema: A critical insight

Heart failure (HF) is a prevalent and severe condition with high hospitalization and mortality rates, especially in developing countries. Inflammation plays a crucial role in its aetiology. Hypertensive pulmonary oedema, a severe form of acute decompensated heart failure (ADHF), lacks a definitive scoring system for predicting hospital admission outcomes. This study aims to evaluate the prognostic value of systemic inflammatory indexes (SII), systemic inflammation response index (SIRI), neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and multi-inflammatory indexes (MII-1, MII-2, MII-3) in patients with hypertensive pulmonary oedema.

We conducted a retrospective observational study at Izmir Atatürk Training and Research Hospital from March 1, 2023, to March 1, 2024. We included 150 patients aged ≥18 with hypertensive pulmonary oedema, excluding those with incomplete data or conditions affecting inflammation. Various inflammatory indices were calculated from blood parameters. We used ROC curve analysis to analyse their correlation with hospital outcomes, including discharge and mortality.

Among the 150 patients (mean age 70.14 ± 11.47 years), 25 (16.7 %) experienced in-hospital mortality. Significant differences between discharged and deceased patients were found in systolic blood pressure, neutrophil count, and inflammatory indices. ROC curve analysis showed NLR, SIRI, MII-1, MII-2, and MII-3 as significant predictors of in-hospital mortality, with MII-1 having the highest AUC (0.697) and sensitivity (60.00 %).

SIRI, NLR, MII-1, MII-2, and MII-3 may help predict in-hospital mortality in hypertensive pulmonary oedema. Further research is needed to validate these markers and explore their utility in clinical practice.