Erythrocyte sedimentation rate revisited: Evaluation of the clinical relevance of elevated erythrocyte sedimentation rate and its correlation with the final diagnosis

The erythrocyte sedimentation rate, ESR is one of the most frequently used laboratory investigations. The usefulness of the erythrocyte sedimentation rate is becoming limited as a result of low sensitivity and specificity and emergence of new methods of evaluating disease. The aim of the current study was to assess the clinical relevance of a simple, rapid, cost-effective diagnostic tool, the elevated ESR and its correlation with the final diagnosis in the present day routine clinical practice. A cross-sectional, observational, prospective and retrospective study was conducted in the department of clinical pathology providing laboratory services to a tertiary care centre in coastal India. Of the total 11674 patients, whose samples were sent for estimation of ESR, a total of 270 patients with ESR above 50 mm/hr were evaluated and ESR was compared with age, sex and final diagnosis. The ESR was found to be more elevated in the elderly as compared to the younger age groups. The mean ESR was found to be significantly higher in males as compared to females (p=0.031.) In our study, 210 patients had ESR in the range of 50-100mm/hr and 60 had ESR above 100mm/hr. Out of the 210 patients, the leading cause for elevated ESR was chronic systemic diseases like chronic liver disease, chronic obstructive pulmonary disease, followed in frequency by acute inflammatory conditions like abscess, cellulitis. Malignancy and tuberculosis had a higher percentage of patients in the ESR group > 100mm/hr as compared to chronic inflammatory disease where more patients had elevated ESR in the range of 50-100mm/hr.