Predictive value of erythrocyte sedimentation rate, albumin and CRP for infection risk in elderly rheumatoid arthritis patients undergoing treatment.

OBJECTIVE

To develop a predictive model for infection risk in elderly rheumatoid arthritis (RA) patients using laboratory markers, particularly erythrocyte sedimentation rate (ESR), albumin (ALB), and C-reactive protein (CRP).

METHODS

This retrospective study included 452 elderly RA patients admitted to the Hospital of Chengdu University of Traditional Chinese Medicine between January 2021 and June 2024. The patients were randomly divided into a training group (271 patients) and a validation group (181 patients) at a 6:4 ratio. Key clinical and laboratory data were collected, including ESR, ALB, CRP, and others. Lasso regression and multivariable logistic regression were employed to identify infection-related factors. Model performance was evaluated using receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA).

RESULTS

The study identified ALB<33.75 g/L, CRP≥32.75 mg/L, and ESR≥51.50 mm/h as independent risk factors for infection in elderly RA patients. A predictive model incorporating these three markers demonstrated high diagnostic accuracy, with an AUC of 0.909 in the training group and 0.880 in the validation group. DCA further confirmed the clinical utility of the model.

CONCLUSIONS

This study successfully developed a predictive model combining ESR, ALB, and CRP to assess infection risk in elderly RA patients. This model has significant potential to enhance early infection detection and support clinical decision-making, offering a valuable tool for managing this vulnerable population.