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 mu g/L [0.040-0.092]; 99th percentile was 0.661 mu g/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.