Erythrocyte Sedimentation Rate And C-Reactive Protein As Marker Of Acute Versus Chronic Medical Conditions.

BACKGROUND: The erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) are frequently requested investigations that aid health professionals in precisely diagnosing and following a number of complicated disease conditions. The aim of this study is to ascertain whether a rise in any of these acute phase reactants has predilection for an acute illness versus chronic disease..

METHODS: Current study includes 144 patients admitted to Medical ward and Intensive care unit of Khan Research Laboratory (KRL) Hospital Islamabad from January to April 2017. ESR was measured using conventional Westergren method. CRP level (mg/L) was measured from venous or capillary blood using a point of care testing (POCT) device. SPSS version 20 was used for data analysis.

RESULTS: Out of 144 patients who participated in this study 60.5% (n=87) were males while 39.6% (n=57) were females. Mean age was 53.4±18.9 years. Among acute medical conditions, Pneumonia and Enteric fever were common 13.2% (n=12) each. Diabetes Mellitus (DM) with complications was the commonest chronic medical condition 22.6% (n=12). Thirty-two patients had ESR <15 mm/Hour; out of them 71.8% (n=23) had acute while 28.2% (n=9) had chronic medical conditions. Thirty-four patients had ESR ≥15 & <30 mm/Hour; out of them 52.9% (n=18) had acute while 47.1% (n=16) had chronic medical conditions. Seventy-eight patients had ESR ≥30 mm/Hour; out of them 64.1% (n=50) had acute while 35.9% (n=28) had chronic medical conditions. All results were statistically significant with p-value ≤0.05. 75 patients had CRP <10 mg/L; out of them 66.7% (n=50) had acute while 33.3% (n=25) had chronic medical conditions. Sixty-nine patients had CRP ≥10 & <100 mg/L; out of them 59.4% (n=41) had acute while 40.6% (n=28) had chronic medical conditions. All results were statistically significant with p-value ≤0.05. In acute medical conditions mean CRP was 16.8±17.7 mg/L and average ESR was 35.9±25.6 mm/Hour. In chronic medical conditions mean CRP was 16.3±17.2 mg/L and mean ESR was 40.8±32.5 mm/Hour.

CONCLUSIONS: No difference was found between CRP and ESR as markers of acute versus chronic medical conditions. Both CRP and ESR have positive association with acute as well as chronic medical conditions. Elevated ESR was seen more frequently in acute medical conditions as compared to CRP..