The Erythrocyte Sedimentation Rate: Old and New Clinical Applications

Saadeh, Constantine

doi:10.1097/00007611-199803000-00001

Cited by 113 publications

(111 citation statements)

References 27 publications

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“…However, regardless of the diagnostic criteria, measurement of ESR and CRP has been deemed an important part of the workup of patients suspected of PJI [42]. These valuable markers can be performed rapidly, inexpensively, [12,25,32,36,37,41]. Therefore, it seems to be impossible to convert these quantitative tests into absolute binary systems (ie, infected versus noninfected).…”

Section: Discussionmentioning

confidence: 99%

Diagnosis of Periprosthetic Joint Infection: The Threshold for Serological Markers

Alijanipour

Bakhshi

Parvızı

2013

Clinical Orthopaedics &Amp; Related Research

117

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Background Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) have recently been suggested as diagnostic criteria for periprosthetic joint infection (PJI) diagnosis. Thresholds for these markers should be reexamined since they have been determined arbitrarily. Questions/purposes Based on recently defined criteria for PJI, we determined (1) whether there is a difference in the threshold value of ESR and CRP between hips and knees, (2) whether the threshold value for ESR and CRP should be different for early-postoperative and late-chronic PJI, and (3) the optimal thresholds for ESR and CRP in PJI diagnosis. Methods We retrospectively reviewed 1962 patients with revision arthroplasty for aseptic failure (1095 hips, 594 knees) or first onset of PJI (108 hips, 165 knees) between 2000 and 2009. The PJI diagnosis was made independent of ESR and CRP using criteria recently proposed by the Musculoskeletal Infection Society. Patients with comorbidities that confound ESR and CRP were not included. Receiver operating characteristic (ROC) analysis was performed to determine thresholds. Results ESR and CRP levels in late-chronic PJI were higher in knees than in hips. Optimal thresholds for ESR and CRP were 48.5 mm/hour and 13.5 mg/L in hips and 46.5 mm/hour and 23.5 mg/L in knees, respectively. In early-postoperative PJI, ESR and CRP were similar in both joints with common thresholds of 54.5 mm/hour and 23.5 mg/L, respectively. Conclusions The data suggest a similar threshold for ESR but not for CRP should be implemented for late-chronic hips and knees. Optimal magnitudes are higher than conventional thresholds, indicating the need for refinement of thresholds if ESR and CRP are to be criteria for PJI diagnosis. Early-postoperative and late-chronic PJI might require different thresholds. Level of Evidence Level III, diagnostic study. See Instructions for Authors for a complete description of levels of evidence.

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Section: Discussionmentioning

confidence: 99%

Diagnosis of Periprosthetic Joint Infection: The Threshold for Serological Markers

Alijanipour

Bakhshi

Parvızı

2013

Clinical Orthopaedics &Amp; Related Research

117

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“…It has physiochemical properties such as isotonicity, colloid osmotic pressure and viscosity as characteristics, rheological properties influenced by the rouleaux formation of erythrocyte all of which collectively permit circulation and formation of the blood constituent (Hall and Malia, 1998).Erythrocyte sedimentation rate (ESR) also called the Sed rate determination is a simple, inexpensive non-specific laboratory test that is frequently ordered in clinical medicine. The test measures the distance erythrocytes fall after an hour in a vertical column of anticoagulated blood under the influence of gravity (Saadeh, 1998). The basic factors influencing the ESR have been understood since the early part of this century; the amount of fibrinogen in the blood directly correlates with the ESR (Wetteland et al, 1996).…”

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confidence: 99%

“…ESR is said to be non-specific because its increase do not tell exactly where the inflammation or what is causing it, and also because it can be affected by other conditions besides inflammation. For this reason, ESR is typically used in conjunction with other tests (Saadeh, 1998). The test is best carried out within two hours of blood collection although a delay of up to 6 hours is permissible provided that the blood is kept at 4 o C (Emeribe and Ukonu, 1992).…”

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confidence: 99%

Comparative Study of Erythrocyte Sedimentation Rate (ESR) Using Trisodium Citrate, Normal Saline and Whole Blood in Ethylene Di Amine Tetra Acetic Acid (EDTA)

Emelike¹,

Akpan²,

Obigwe³

et al. 2010

Journal of Applied Sciences and Environmental Management

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Erythrocyte sedimentation rate (ESR) was carried out on 200 apparently healthy individuals (131 males and 69 females) in Ekpoma using trisodium citrate, normal saline diluents and whole blood suspension in EDTA without any diluents. The Westergren method was adopted for this study as recommended by the International Committee for Standardization in Haematology (ICSH). The tests were read at 30 minutes and 1 hour intervals and results recorded as mm in 30mins and mm in 1hr respectively. The Mean ± SD of ESR values in males using trisodium citrate and normal saline were 11.99±9.48 and 12.12±9.46, while for females it was 13.69±8.5 and 13.97±8.97 respectively. This difference was statistically significant (P< 0.05). There was also a statistically significant difference between the ESR values obtained using trisodium citrate and whole blood (P< 0.05). Males had lower ESR values compared to females. There was a statistically significant difference between the ESR values obtained in 30mins and 1hour (P< 0.05). In conclusion, the use of normal saline and whole blood cannot be a good substitute for trisodium citrate in estimating ESR. Secondly, ESR is time dependent; therefore, the conventional time of 1 hour should be maintained. @ JASEM

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“…White blood cell count is another marker that has been investigated and both pre-and post-operative increased values were the independent predictors of AF incidence following cardiac surgery [24,25]. ESR is an inexpensive marker for acute phase response accompanied with diagnostic and prognostic values, especially in the rheumatic diseases and newly found non-inflammatory conditions such as stork and coronary artery disease [26,27]. In our study, for the first time, we showed that increased baseline ESR was a risk factor for AF development, and also based on multivariate analysis it was an independent predictor of postoperative AF, although it had partially low sensitivity and specificity.…”

Section: Discussionmentioning

confidence: 99%

Effect of oral vitamin C on atrial fibrillation development after isolated coronary artery bypass grafting surgery: A prospective randomized clinical trial

et al. 2014

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C and control groups, respectively (p = 0.002). The hospital stay was significantly lower in vitamin C group compared with that of the control group (5.32 ± 0.59 vs. 5.74 ± 1.30 days, respectively, p = 0.041). Baseline erythrocyte sedimentation rate (OR 1.030, p = 0.030) and taking vitamin C (OR 8.068, p = 0.007) were the independent predictors of postoperative AF. Conclusions: Oral vitamin C can be safely used to decrease the incidence of postoperative AF in patients undergoing elective isolated on-pump CABG surgery. (Cardiol J 2014; 21, 5: 492-499)

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The Erythrocyte Sedimentation Rate: Old and New Clinical Applications

Cited by 113 publications

References 27 publications

Diagnosis of Periprosthetic Joint Infection: The Threshold for Serological Markers

Diagnosis of Periprosthetic Joint Infection: The Threshold for Serological Markers

Comparative Study of Erythrocyte Sedimentation Rate (ESR) Using Trisodium Citrate, Normal Saline and Whole Blood in Ethylene Di Amine Tetra Acetic Acid (EDTA)

Effect of oral vitamin C on atrial fibrillation development after isolated coronary artery bypass grafting surgery: A prospective randomized clinical trial

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