Etiological classification of high sedimentation rate and relation with other inflammatory markers

This study describes the causes of significantly increased erythrocyte sedimentation rate (ESR) and compares the etiological categories based on inflammatory markers. We collected data from the patients who applied between March 2020 and August 2023. Patients were categorized into five groups based on their identified etiology. Categories were sorted as infection, inflammatory, malignancy, renal, and others. Inflammation markers were compared between groups and ROC analysis was performed if there was a significant difference. The cause of the elevated ESR levels in 291 patients was determined. The median age was 58 (18-92). ESR levels were lower in females (113, 106-120) than in males (119, 109-120) (p=0.015). The distribution of etiological disease categories was as follows: inflammatory (41.9%), infection (35.1%), malignancy (18.2%), renal (3.1%), and others (1.7%). Albumin levels were lower in the malignancy group than in the inflammatory group (p<0.005). Platelet counts of the inflammatory group were higher than other groups (p=0.005). Neutrophil-lymphocyte ratio (NLR) was higher in the malignancy group than in the inflammatory group (p=0.001). Monocyte-lymphocyte ratio (MLR) was, NLPR, and SIRI were lower in the inflammatory group than others (p<0.001). ROC curves for inflammatory markers have been calculated. MLR had the highest area under the curve (AUC: 0.655, p<0.001), and the cut-off value of MLR which is 0.2775 had 65.3% sensitivity and 65.5% specificity to identify the cases without the inflammatory disease. This study presents the causes of significantly increased ESR and its correlation with inflammatory markers. We aim to highlight the differences between etiological groups using cost-effective and accessible blood test results.