Decisional procalcitonin thresholds are not adapted to elderly patients admitted to the emergency room.

CONTEXT

Diagnosis of sepsis in elderly is challenging.

OBJECTIVES

We investigated whether procalcitonin concentrations in elderly differed from values for the general population.

METHODS

Procalcitonin measurement was assessed prospectively in 307 apyretic patients ≥75 years visiting the emergency department.

RESULTS

Median age was 86 years [IQR81-90] and 222 (72%) were female. Procalcitonin concentration was 0.057 µg/L [0.040-0.092]; 99th percentile was 0.661 µg/L. Patients with procalcitonin concentrations above decisional thresholds had lower glomerular filtration rate and higher C-reactive protein concentrations.

CONCLUSIONS

Baseline procalcitonin levels are increased in elderly. Elevated values are common and associated to low-grade inflammation and lower eGFR.