A rapid and accurate method for estimating the erythrocyte sedimentation rate using a hematocrit-corrected optical aggregation index

Although both the erythrocyte sedimentation rate (ESR) and optically measured erythrocyte aggregation parameters are affected by the hematocrit, this interaction is not considered by the method used to estimate ESR that considers aggregation parameters. In this study, we investigated the relationship between the ESR obtained by the Westergren method and that obtained with an aggregation parameter, namely, the aggregation index (AI) of multiple hematocrit values and fibrinogen-spiked samples with an analysis time of 5-60 s, and attempted to develop a rapid and accurate ESR estimation method. The AIs obtained from 5- and 10-s optical measurements with a fixed hematocrit were highly correlated with the erythrocyte sedimentation velocity. Furthermore, the rate of the AI increase with an increasing hematocrit was not significantly affected by the fibrinogen concentration at these measurement times. On the basis of these results, we defined the hematocrit-corrected aggregation index (HAI). The exponential function of the HAI obtained from the 5-s measurement agreed well with the sedimentation velocity calculated to eliminate the effect of hindered settling, and the HAI and hematocrit could be used to calculate the time constant of the sedimentation curve with a linear regression equation. The ESR value at 1 h was calculated based on the modified Stokes' law and the HAI obtained from the 5-s measurement and showed an excellent correlation (R = 0.966) with the ESR value obtained by the Westergren method over a wide range of hematocrit and fibrinogen concentrations.