Erythrocyte sedimentation rate as an independent prognostic marker for mortality: a prospective population‐based cohort study

Abstract

Background A very high erythrocyte sedimentation rate (ESR) is usually an indication of underlying pathology. Additionally, a moderately elevated ESR may also be attributable to biological ageing. Whether the ESR is a prognostic factor for mortality, regardless of age, has been scarcely investigated. Therefore, the objective was to analyse the association between elevated ESR levels and the risk of mortality in a prospective cohort of the general population. Methods We studied data from the Rotterdam Study (1990–2014). ESR levels were measured at baseline and individuals were followed until death or end of study. Associations between moderately (20–50 mm h−1) and markedly (>50 mm h−1) elevated ESR levels and all‐cause mortality were assessed using multivariate Cox proportional hazard models. Results In total, 5226 participants were included, and the mean age was 70.3 years. During a median follow‐up time of 14.9 years, 3749 participants died (71.7%). After adjustment, both a moderately elevated ESR and a markedly elevated ESR were associated with a significantly higher risk of overall mortality [hazard ratio (HR) 1.23, 95% confidence interval (CI) 1.12–1.35 and HR 1.89, 95% CI 1.38–2.60, respectively]. Although the ESR becomes higher with age, in a group aged above 75 years, without any comorbidities, an ESR > 20 mm h−1 remained associated with a significantly increased risk of mortality (HR 1.29, 95%CI 1.01–1.64). Conclusion An elevated ESR is an independent prognostic factor for mortality. Despite the fact that ESR increases with age, it remains associated with an increased risk of mortality and warrants close follow‐up.

Incorporating the erythrocyte sedimentation rate for enhanced accuracy of the global registry of acute coronary event score in patients with ST-segment elevated myocardial infarction

“…The ESR is a simple and inexpensive test and influenced by plasma constituents, such as fibrinogen, globulins, and hemoglobin, but generally varies with age and sex. [ 17 , 22 , 23 ] In the present study, after adjusting for gender and conventional risk factors, the independent association we observed between the ESR and cardiovascular death remained, as has been previously suggested. [ 15 – 17 , 24 ] Destabilization and rupture of plaque in the pathophysiology of STEMI may primarily be presented as an intimal hemorrhage.…”

Objectives, design and main findings until 2020 from the Rotterdam Study

“…Furthermore, cancer may be a determinant or relevant co-factor in other RSstudies [32]. With regard to etiology, research has been done on diet [33][34][35][36] or lifestyle such as smoking [37,38] as a risk factor, and laboratory assessments, for example, inflammatory markers in association with cancer [31,[39][40][41]. Furthermore, the association between cognition and cancer was studied [42,43].…”

The clinical characteristics of non-cystic fibrosis bronchiectasis patients with positive serum tumor markers: a retrospective study

“…However, the speci c mechanism remains to be further studied. A study from Spain demonstrated CRP levels in stable bronchiectasis was a predictive factor for future severe exacerbations of bronchiectasis patients, with higher CRP levels associated with an increased risk of severe exacerbations 19,20 . Elevated ESR was also reported to be an independent predictive factor for mortality 20 .…”

“…A study from Spain demonstrated CRP levels in stable bronchiectasis was a predictive factor for future severe exacerbations of bronchiectasis patients, with higher CRP levels associated with an increased risk of severe exacerbations 19,20 . Elevated ESR was also reported to be an independent predictive factor for mortality 20 . Therefore, it is hypothesized that positive STMs could exhibit poorer prognosis in bronchiectasis patients.…”