The Complete Blood Count Sepsis Index Using Monocyte Distribution Width for Early Detection of Sepsis in Patients...

Area of Science:

• Emergency Medicine
• Clinical Pathology
• Sepsis Diagnostics

Background:

• Early sepsis detection in emergency departments (EDs) is crucial, especially for patients lacking obvious symptoms.
• The complete blood count with differential (CBC-diff) offers potential for rapid sepsis screening.
• Monocyte distribution width (MDW) is an emerging parameter within CBC-diff that may enhance sepsis identification.

Purpose of the Study:

• To develop and validate the CBC Sepsis Index (CBC-SI) for early sepsis detection.
• To assess the diagnostic performance of CBC-SI, particularly in patients with subtle or absent early signs of sepsis.
• To evaluate the utility of CBC-SI in a high-volume ED setting.

Main Methods:

• Retrospective observational study design.
• Utilized data from adult patients (≥18 years) presenting to the ED between August 2020 and April 2022.
• Developed CBC-SI using monocyte distribution width (MDW), white blood cell (WBC) count, and neutrophil-to-lymphocyte ratio.

Main Results:

• The study analyzed 51,407 ED visits, with 3.3% meeting sepsis criteria.
• The CBC-SI demonstrated an overall area under the curve (AUC) of 0.83.
• For patients without obvious signs of sepsis, a CBC-SI ≥ 1 showed 81.1% sensitivity and 69.1% specificity, identifying a subgroup with delayed treatment and worse outcomes.

Conclusions:

• The CBC-SI is a robust tool for early sepsis detection in the ED.
• CBC-SI exhibits superior performance in identifying sepsis among patients with non-obvious presentations.
• This index holds significant potential for improving timely interventions and patient outcomes in vulnerable sepsis populations.