Extremely Elevated Erythrocyte Sedimentation Rates: Associations With Patients' Diagnoses, Demographic Characteristics, and Comorbidities

Daniels, Lisa M.; Tosh, Pritish K.; Fiala, Justin A.; Schleck, Cathy D.; Mandrekar, Jayawant N.; Beckman, Thomas J.

doi:10.1016/j.mayocp.2017.07.018

Cited by 26 publications

(26 citation statements)

References 29 publications

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“…We believe that in order to establish a correct nomogram to best interpret the ESR, the reference interval of MINIPET represents a starting point to investigate ESR-MC in samples collected from diseased animals including those with Hct below the reference interval. It would also be interesting to investigate whether the ESR can be used to diagnose the occurrence of infectious, immune-mediated, and neoplastic diseases in canine medicine as effectively as in human medicine [ 18 ]. Additionally, it would be useful to evaluate ESR-MP in terms of its prognostic value and effectiveness in monitoring the course of several disorders [ 19 – 21 ].…”

Section: Discussionmentioning

confidence: 99%

The Canine Erythrocyte Sedimentation Rate (ESR): Evaluation of a Point-of-Care Testing Device (MINIPET DIESSE)

Militello

Pasquini

Valentin

et al. 2020

Veterinary Medicine International

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The erythrocyte sedimentation rate (ESR) in canine medicine has been replaced by the evaluation of a few sensitive markers of the acute-phase proteins. The aim of the study was to evaluate the ESR using a point-of-care (MINIPET, DIESSE Diagnostica Senese S.p.A.) device (ESR-MP) and to compare the results with the gold standard Westergren method (ESR-W) in dogs. One hundred and nineteen K3-EDTA blood samples for complete blood count were randomly selected and assayed for ESR. The reference interval (RI) was established using the percentile method. The coefficient of variation (CV) in intra-assay and interassay precision of ESR-MP was calculated. The analytical sensitivity (Se), specificity (Sp), positive predictive values (PPVs), and negative predictive values (NPVs) were calculated. Agreement between ESR-MP and ESR-W was assessed with Pearson correlation coefficient (r), Cohen concordance test (K), Passing-Bablok regression, and Bland–Altman plots. Ten canine samples (8.4%) were ruled out because of flag-error by the MINIPET instrument (4.2%) or because they showed the diphasic pattern in ESR-W (4.2%). The canine RI of ESR-MP was 0–10 mm/h. Precision was excellent in intra-assay (CV = 0.02) and interassay (CV = 0.32). The analytical characteristics of ESR-MP in nonanemic samples were as follows: Se = 0.82, Sp = 0.95, PPV = 0.82, and NPV = 0.95. The accuracy of ESR-MP was better than ESR-W in nonanemic samples (r = 0.87; K = 0.77) and lower in anemic subjects (Hct <37%) (r = 0.76; K = 0.69). The Passing-Bablok regression showed the presence of systematic error and the absence of proportional error only in nonanemic blood samples. The Bland–Altman plots gave negative average values due to the difference in RIs and an agreement in both ESRs. The ESR-MP results can be obtained with the same K3-EDTA tubes used for the blood count, in shortcut time, and at reduced costs using the MINIPET device. These investigations highlight that ESR-MP could be useful in canine clinical settings.

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Section: Discussionmentioning

confidence: 99%

The Canine Erythrocyte Sedimentation Rate (ESR): Evaluation of a Point-of-Care Testing Device (MINIPET DIESSE)

Militello

Pasquini

Valentin

et al. 2020

Veterinary Medicine International

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“…Second, the leading cause associated with ESR elevation is infection. 28 Wound infection per se can delay wound healing. In addition, pneumonia is known to be a leading infectious cause underlying the high levels of ESR.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Major Amputation on Hindfoot Ulcers in Hospitalized Diabetic Patients

Moon

Kim

Han

et al. 2019

Advances in Wound Care

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The purpose of this study was to investigate the risk factors for major amputation in patients hospitalized with diabetic foot ulcers involving the hindfoot. Approach: Between January 2003 and October 2017, a total of 1,657 diabetic patients were admitted to the diabetic wound center of Korea University Guro Hospital, for the management of foot ulcers. Among the admitted patients, 117 diabetic patients with hindfoot ulcers were included in this study. One hundred and four patients (89%) healed without major amputation, while 13 patients (11%) healed with major amputation. Data related to 88 potential risk factors, including demographics, ulcer condition, vascularity, bioburden, neurology, and serology, were collected from patients in these two groups for comparison. Results: Among the 88 potential risk factors, 15 showed statistically significant differences between the two groups. In univariate analysis of 88 potential risk factors, nine showed statistically significant differences. In stepwise multiple logistic regression analysis, three of the nine risk factors remained statistically significant. Multivariate-adjusted odds ratios for pulmonary disorders, erythrocyte sedimentation rate (ESR) levels, and total iron-binding capacity (TIBC) levels were 38.525, 1.047, and 0.976, respectively. Innovation: Compared with forefoot and midfoot ulcers, diabetic foot ulcers involving the hindfoot are at increased risk of major amputation because infection may spread proximal to the ankle. However, large-scale cohort studies that specifically discuss the outcomes and characteristics of diabetic hindfoot ulcers are not widely available. Conclusion: Risk factors for major amputation in patients hospitalized with diabetic hindfoot ulcers include pulmonary disorders, high levels of ESR, and decreased TIBC levels.

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“…ESR is a laboratory test that measures the vertical distance erythrocytes travel in a column of blood over 1 hour; in the setting of inflammation, cells form clumps and travel more quickly than individual cells, resulting in a higher value. While moderate elevations in ESR may occur without an identifiable cause, extreme ESR levels—those above 100 mm/hr, as observed in our patient—are highly suggestive of certain serious conditions, including infection, malignancy, and autoimmune disease such as GCA 12,13 . Temporal artery biopsy is the gold standard test to diagnose GCA.…”

Section: Discussionmentioning

confidence: 60%

“…While moderate elevations in ESR may occur without an identifiable cause, extreme ESR levels-those above 100 mm/hr, as observed in our patient-are highly suggestive of certain serious conditions, including infection, malignancy, and autoimmune disease such as GCA. 12,13 Temporal artery biopsy is the gold standard test to diagnose GCA. However, because of noncontiguous inflammation of the temporal artery, biopsies may be falsely negative.…”

Section: Discussionmentioning

confidence: 99%

A Jaw‐Dropping Diagnosis

Griauzde

Northway

Yentz

et al. 2020

Journal of Hospital Medicine

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Extremely Elevated Erythrocyte Sedimentation Rates: Associations With Patients' Diagnoses, Demographic Characteristics, and Comorbidities

Cited by 26 publications

References 29 publications

The Canine Erythrocyte Sedimentation Rate (ESR): Evaluation of a Point-of-Care Testing Device (MINIPET DIESSE)

The Canine Erythrocyte Sedimentation Rate (ESR): Evaluation of a Point-of-Care Testing Device (MINIPET DIESSE)

Risk Factors for Major Amputation on Hindfoot Ulcers in Hospitalized Diabetic Patients

A Jaw‐Dropping Diagnosis

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