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

Biomarkers. 2012 Aug;17(5):477-81. doi: 10.3109/1354750X.2012.685953. Epub 2012 May 21.

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.

MeSH terms

  • Aged, 80 and over
  • C-Reactive Protein / metabolism*
  • Calcitonin / blood*
  • Calcitonin Gene-Related Peptide
  • Emergency Service, Hospital*
  • Female
  • Glomerular Filtration Rate*
  • Humans
  • Immunoassay
  • Inflammation / blood
  • Male
  • Prospective Studies
  • Protein Precursors / blood*
  • Reference Values

Substances

  • CALCA protein, human
  • Protein Precursors
  • Calcitonin
  • C-Reactive Protein
  • Calcitonin Gene-Related Peptide