Holoğlu Esen Nur, Uzunlulu Mehmet, Torun Cundullah
Department of Internal Medicine Goztepe Training and Research Hospital, Istanbul Medeniyet University, Kadikoy/Istanbul, Türkiye.
Rom J Intern Med. 2025 Mar 31;63(1):70-78. doi: 10.2478/rjim-2024-0034. eCollection 2025 Mar 1.
The aim of the study was to assess the etiological distribution of patients with an erythrocyte sedimentation rate (ESR) over 100 mm/hour and to evaluate differences in demographic, comorbidity, laboratory characteristics, and clinical outcomes.
This retrospective observational clinical study included patients aged 18 years and older who were admitted to the internal medicine inpatient clinic between May 1, 2015 and June 1, 2021 and had ESR values above 100 mm/h. Demographic data, comorbidities, laboratory parameters, imaging studies, histopathological findings, microbiological and serological data, along with in-hospital and post-discharge mortality, were collected from the hospital's electronic database. Two independent clinicians evaluated the data to identify diagnoses associated with elevated ESR. Patients were divided into six categories based on the most likely diagnosis.
The study included 441 patients, 52.6% of whom were female, and the mean age was 72.6 years. The etiological distribution was as follows: infectious diseases (34%), malignancies (31.5%), undiagnosed cases (15.9%), renal diseases (9.8%), other causes (5%), and rheumatologic diseases (3.8%). Etiological distributions did not differ by gender, age, or ESR ranges. The in-hospital mortality rate was 3.6%, and the overall mortality rate from hospitalization to the data collection date was 64.4%. Mortality was higher in patients with malignancies (81.3%) compared to other etiologies (p<0.001). Patients who died had higher mean age, ferritin levels, having diabetes mellitus, heart failure, or malignancy, and lower hemoglobin and lymphocyte levels compared to survivors (p<0.05 for all).
Most patients with an ESR over 100 mm/hour had significant underlying medical conditions, with infectious diseases and malignancies comprising two-thirds of the cases.
本研究的目的是评估红细胞沉降率（ESR）超过100毫米/小时的患者的病因分布，并评估人口统计学、合并症、实验室特征和临床结局的差异。
这项回顾性观察性临床研究纳入了2015年5月1日至2021年6月1日期间入住内科住院病房、年龄在18岁及以上且ESR值高于100毫米/小时的患者。从医院的电子数据库中收集人口统计学数据、合并症、实验室参数、影像学研究、组织病理学结果、微生物学和血清学数据，以及住院期间和出院后的死亡率。两名独立的临床医生评估数据以确定与ESR升高相关的诊断。根据最可能的诊断将患者分为六类。
该研究纳入了441名患者，其中52.6%为女性，平均年龄为72.6岁。病因分布如下：传染病（34%）、恶性肿瘤（31.5%）、未确诊病例（15.9%）、肾脏疾病（9.8%）、其他原因（5%）和风湿性疾病（3.8%）。病因分布在性别、年龄或ESR范围方面没有差异。住院死亡率为3.6%，从住院到数据收集日期的总死亡率为64.4%。与其他病因相比，恶性肿瘤患者的死亡率更高（81.3%）（p<0.001）。与幸存者相比，死亡患者的平均年龄、铁蛋白水平更高，患有糖尿病、心力衰竭或恶性肿瘤，血红蛋白和淋巴细胞水平更低（所有p<0.05）。
大多数ESR超过100毫米/小时的患者有严重的基础疾病，其中传染病和恶性肿瘤占病例的三分之二。
