Monocyte distribution width (MDW) parameter as a sepsis indicator in intensive care units

Area of Science:

• Critical Care Medicine
• Hematology
• Infectious Diseases

Background:

• Sepsis is a leading cause of mortality in Intensive Care Units (ICUs).
• Early and accurate diagnosis of sepsis is crucial for patient outcomes.
• Monocyte distribution width (MDW) is a parameter derived from complete blood counts.

Purpose of the Study:

• To evaluate the diagnostic accuracy of MDW for sepsis in ICU patients.
• To assess the prognostic value of MDW in relation to sepsis severity.
• To investigate MDW changes in relation to disease progression and patient survival.

Main Methods:

• A prospective observational study involving 506 adult patients admitted to the ICU.
• MDW was measured daily in 2,367 routine complete blood count samples.
• Sepsis diagnosis was based on Sepsis-3 criteria, classifying patients into no sepsis, sepsis, and septic shock groups.

Main Results:

• MDW values were significantly higher in patients with sepsis or septic shock compared to those without sepsis.
• ROC analysis yielded an AUC of 0.785, with a sensitivity of 66.88% and specificity of 77.79% at a cutoff of 24.63.
• MDW increased in patients who developed ICU-acquired sepsis and decreased in survivors, irrespective of sepsis etiology, including COVID-19.

Conclusions:

• MDW is a valuable tool for enhancing sepsis detection in the ICU.
• MDW levels are correlated with the severity of sepsis.
• MDW can serve as a prognostic marker for sepsis patients in critical care settings.