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

Abstract

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.

Keywords::

• Procalcitonin
• reference values
• infection
• elderly
• immune senescence
• emergency medicine

Acknowledgments

We thank Thermo Fisher Scientific for supplying the reagents and kits for the procalcitonin assay, free of charge.

Declaration of interest

The authors report no declarations of interest.