Conclusion
CHF is the most common cause of ARF in the elderly but half of the patients had more than two diagnoses. As inappropriate treatment is associated with increased morbidity and mortality, accurate diagnostic tools, such as BNP, should be available in an ED 24 h a day. We should consider non-invasive ventilation (NIV) in elderly patients hospitalised with acidotic COPD exacerbations or CHF who do not improve with medical treatment. ICU admission decisions should not be based on age alone but on factors such as the patient’s baseline level of function and co-morbidities, severity of illness, and preferences for life support.