Erythrocyte sedimentation rate as an independent prognostic marker for mortality: a prospective population‐based cohort study. (9th December 2018)

• Record Type: Journal Article
• Authors: Fest, J.; Ruiter, R.; Mooijaart, S.P.; Ikram, M. A.; van Eijck, C. H. J.; Stricker, B. H.
• Is Part Of: Journal of internal medicine. Volume 285:Number 3(2019)
• Page Start: 341
• Page End: 348
• Publication Date: 2018-12-09
• Subjects: ageing -- erythrocyte sedimentation rate -- general population -- low‐grade inflammation -- mortality; Internal medicine -- Periodicals; Medicine -- Periodicals; 616
• DOI: 10.1111/joim.12853
• Languages: English
• ISSNs: 0954-6820

Abstract

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.