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The Role of Monocyte Distribution Width in the Early Prediction of Sepsis in Patients Undergoing Cardiovascular
Abdullah Özer1, Sercan Tak1, Hüseyin Demirtaş1
1Department of Cardiovascular Surgery, Gazi University Faculty of Medicine, 06500 Ankara, Turkey.
Insights
Monocyte distribution width (MDW) effectively predicts sepsis after cardiovascular surgery. Elevated MDW levels indicate a higher risk of developing sepsis post-operation.
Area of Science:
- Cardiology
- Critical Care Medicine
- Laboratory Medicine
Background:
- Sepsis is a life-threatening complication following cardiovascular surgery.
- Early detection of sepsis is crucial for improving patient outcomes.
- The diagnostic utility of monocyte distribution width (MDW) in this context remains under-investigated.
Purpose of the Study:
- To evaluate the role of monocyte distribution width (MDW) as an early predictor of sepsis in patients undergoing cardiovascular surgery.
- To compare MDW with other inflammatory markers in sepsis prediction.
Main Methods:
- A prospective study included 43 patients undergoing cardiovascular surgery.
- Blood samples were collected preoperatively, 24 hours postoperatively, and at discharge.
- Monocyte distribution width (MDW), leukocyte count, neutrophil-to-lymphocyte ratio (NLR), C-reactive protein (CRP), and procalcitonin (PCT) were measured.
- Sepsis diagnosis was based on Sepsis-3 criteria.
Main Results:
- MDW levels were significantly elevated in patients who developed sepsis compared to those who did not.
- MDW showed significant correlations with other inflammatory markers (CRP, PCT, NLR).
- An MDW cutoff value of 20.5 demonstrated high sensitivity and specificity for predicting postoperative sepsis.
Conclusions:
- Elevated monocyte distribution width (MDW) is a promising and valuable biomarker for predicting sepsis in the postoperative period after cardiovascular surgery.
- MDW can serve as an accessible and effective tool for early sepsis detection in this patient population.
Abstract:
Background and Objectives: This is the first study to examine the role of monocyte distribution width (MDW) in predicting sepsis after cardiovascular surgery. Methods: This study included 43 consecutive patients who had undergone cardiovascular surgery between July 2021 and July 2022. All patients were examined at the following three time points (TPs): preoperative period (TP1), postoperative at 24 h (TP2), and discharge (TP3). SOFA score, leukocyte count, neutrophil-to-lymphocyte ratio (NLR), MDW, C-reactive protein (CRP), and procalcitonin (PCT) levels were tested at each TPs. The Sepsis-3 criteria were used to diagnose patients with sepsis. Results: The mean values of all variables (leukocyte count, NLR, MDW, CRP, and PCT levels) were significantly higher at TP2 and TP3 than at TP1 (p < 0.05). All these values were significantly higher at TP2 than at TP3 (p < 0.05). Patients with sepsis had significantly higher mean values for leukocyte count, NLR, MDW, CRP, and PCT levels than those without sepsis (p < 0.05). There was a significant correlation between MDW and inflammatory markers (CRP, PCT, and NLR) during the three time periods (p < 0.05). According to the ROC analysis, the optimal MDW cutoff value with the highest sensitivity and specificity for predicting sepsis in the postoperative period was 20.5. Conclusions: Our findings indicate that elevated MDW levels may be a valuable predictor of sepsis in patients following cardiovascular surgery.
