[Diagnostic value of a distinct rise in sedimentation rate]

Among the 931 patients who were admitted, over a 9-month period, to an internal medicine department, a group of 84 patients (9 p. 100) whose erythrocyte sedimentation rate (ESR) was 70 mm or more at 1 hour was selected and compared to the remaining 847 patients whose ESR was below 70 mm at 1 hour. In most cases, a pathology likely to account for the distinct rise observed in ESR was found (infection in 42 p. 100 of the cases, malignant disease in 27 p. 100, inflammation in 20 p. 100), and only 5 p. 100 of these rises remained unexplained. This makes an ESR of 70 mm or more a good index of morbidity generally, without pointing at any specific disease. An ESR of 70 mm or more has very low sensitivity (always below 30 p. 100), so that no disease whatsoever can be excluded when the ESR is only slightly elevated. Moreover, in all but infectious diseases a distinctly high ESR is not an index of severity.