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Early Determination of ESR: How Accurate Is It?

Caroline L. Altergott, MD; Mary A. Letourneau, MD; Mark K. O'Connor, MD; Cheryl Vance, MD; Linda S. Chan, PhD; Nancy Schonfeld-Warden, MD
Arch Pediatr Adolesc Med. 2003;157(5):487-489. doi:10.1001/archpedi.157.5.487-a.
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Although the measurement of the erythrocyte sedimentation rate (ESR) is a highly debatable test, it has clinical relevance in many specific disease processes. It may be useful in predicting prognosis and determining response to treatment in such diseases as rheumatic arthritis, Hodgkin disease, osteomyelitis, and septic arthritis.1

Several different methods have been used to measure the ESR. The 3 most important and commonly used methods include Westergren, Rourke and Enrstene, and Wintrobe and Landsberg. The Westergren method remains the reference standard for measuring the ESR,25 as it is simple, inexpensive, easily available, and accurate; however, the 60-minute time requirement is a disadvantage. Other methods have a quicker turnaround time, but they are either cumbersome, expensive, or require special equipment. In an emergency department, time is of the essence, and the need for rapid disposition is pressing. In this study, we evaluated the accuracy of the Westergren method to measure ESRs at 20 and 30 minutes, using the 60-minute ESR as the reference standard.

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Figure 1.

Scatterplot for the 20-minute erythrocyte sedimentation rate (ESR) with the 60-minute ESR.

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Figure 2.

Scatter plot for the 30-minute erythrocyte sedimentation rate (ESR) with the 60-minute ESR.

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