Correlation of modified micro-ESR method with the Westergren method for the determination of erythrocyte sedimentation rate

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Mongkol Chotayaporn
Aiyada Samae
Wuttipong Yokart
Duanpen Panyasak


Background: Erythrocytes sedimentation rate (ESR) is the rate of red blood cell sedimentation. It is a non-specific measurement of inflammation. The Westergren ESR (conventional ESR) is the standard method for measuring the ESR. However, this technique requires a large blood volume. Therefore, it is not suitable for patients contributing only a small blood volume.

Objectives: The aim of this study was to verify the micro-ESR method compared to conventional Westergren method.

Materials and methods: The ESR was performed on 170 blood samples using both the standard Westergren and modified micro-ESR method. Blood samples anticoagulated in 3.8% sodium citrate at a ratio of 4 : 1 (blood : sodium citrate) were used for the Westergren method, whereas blue-tipped plain microhematocrit tubes (1.2 mm x 75 mm) were used for the modified micro-ESR method. Duration of test was 1 hr for the standard Westergren method. However, ESR values were read out at different time points for the modified micro-ESR. Correlation of ESR results obtained by both techniques were determined using Pearson and Spearman’s coefficients. A regression equation was derived to predict conventional ESR values from those obtained from the modified micro ESR results. Finally, the agreement of two measurements was demonstrated using the Bland-Altman plot.

Results: Statistical analysis demonstrated the significant correlation of results of the modified micro-ESR results read at 30 min with those obtained from the standard Westergren ESR (r=0.979, p<0.05) and the Bland-Altman plot showed an acceptable agreement (-6.6%) between the modified micro-ESR and the standard Westergren method.

Conclusion: The modified micro-ESR method appears to be a faster, cheaper, and requires a smaller blood volume than the conventional Westergren ESR method. The modified micro-ESR results read at 30 min had an acceptable correlation with the standard Westergren method. Therefore, this modified micro-ESR could be performed in pediatrics clinics.


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Chotayaporn, M., Samae, A., Yokart, W. ., & Panyasak, D. (2020). Correlation of modified micro-ESR method with the Westergren method for the determination of erythrocyte sedimentation rate. Journal of Associated Medical Sciences, 54(1), 44–46. Retrieved from
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