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Erythrocyte sedimentation rate as an independent prognostic marker for mortality: a prospective population‐based cohort study
Author(s) -
Fest J.,
Ruiter R.,
Mooijaart S.P.,
Ikram M. A.,
Eijck C. H. J.,
Stricker B. H.
Publication year - 2019
Publication title -
journal of internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.625
H-Index - 160
eISSN - 1365-2796
pISSN - 0954-6820
DOI - 10.1111/joim.12853
Subject(s) - medicine , hazard ratio , prospective cohort study , erythrocyte sedimentation rate , confidence interval , population , proportional hazards model , risk factor , gastroenterology , cohort study , cohort , surgery , environmental health
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.