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Monocyte distribution width (MDW) as an infection indicator in severe patients attending in the Emergency Department:
M Encabo, E Hernández-Álvarez, D Oteo
1Dr. Juan González del Castillo, Emergency Department, Hospital Clinico Universitario San Carlos. Calle Profesor Martín Lagos, s/n. 28040 Madrid, Spain. jgonzalezcast@gmail.com.
Objective:
The aim of the present study was to evaluate the diagnostic performance of monocyte distribution width (MDW) as a biomarker for sepsis diagnosis in severe patients attended in the Emergency Department for different conditions and not only infections.
Methods:
We performed an observational study in a consecutive prospective cohort including severe patients attending the Emergency Department with different conditions. MDW and other biomarkers were determined from samples obtained during the first care of patients. The diagnostic performance of the different biomarkers was determined based on the final diagnosis at patient discharge.
Results:
One hundred two patients, with a mean age of 76.7 (SD 16.5) years were included, 53 being (51.9%) male. Among the patients included, 65 (63.7%) had an infectious disease while the remaining had other different conditions. A MDW cut-off of 20.115 provided the best accuracy to identify infected patients, with a sensitivity of 89.2 (95% CI 79.4-94.7), a specificity of 89.2 (95% CI 75.3-95.7), a positive predictive value of 93.5 (95% CI 84.6-97.5), a negative predictive value of 82.5% (95% CI 68.0-91.3), a positive likelihood ratio of 8.25 (3.26-20.91), and a negative likelihood ratio of 0.12 (0.06-0.24). The area under the receiver operating characteristic curve for infection according to MDW was 0.943 (95% CI 0.897-0.989; p<0.001).
Conclusions:
A MDW > 20.115 may be associated with infection and could help to distinguish between infected and non-infected patients in severe patients. These results must be confirmed in new studies due to the limited patient sample included.
Insights
Monocyte distribution width (MDW) shows high accuracy in identifying infections in severe emergency department patients. An MDW value over 20.115 can help distinguish between infected and non-infected individuals.
Area of Science:
- Emergency Medicine
- Clinical Diagnostics
- Biomarker Research
Background:
- Sepsis diagnosis in emergency departments is critical for patient outcomes.
- Identifying reliable biomarkers for early sepsis detection remains a challenge.
Purpose of the Study:
- To evaluate the diagnostic performance of monocyte distribution width (MDW) as a sepsis biomarker.
- To assess MDW's utility in differentiating infection from other conditions in severe patients.
Main Methods:
- Observational study of a prospective cohort of severe emergency department patients.
- MDW and other biomarkers measured during initial patient care.
- Diagnostic performance assessed against final discharge diagnoses.
Main Results:
- A cohort of 102 severe patients (mean age 76.7 years) was analyzed.
- MDW > 20.115 demonstrated high accuracy (AUC 0.943) for infection detection.
- Sensitivity and specificity for MDW were both 89.2%, with strong predictive values.
Conclusions:
- MDW > 20.115 is associated with infection in severe patients.
- MDW may aid in distinguishing infected from non-infected patients in emergency settings.
- Further studies with larger cohorts are needed to confirm these findings.
