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Usefulness of monocyte distribution width in the diagnosis of sepsis in critically ill patients
C Morales Indiano1, A Herraiz Ruiz2, P Marcos Neira2
1Autonomous University of Barcelona, Faculty of Medicine, Badalona (Barcelona), Spain.
Background:
The incidence and mortality of sepsis remain high in the intensive care units (ICU). WBC, CRP and PCT are frequently used as tools for sepsis detection; however, none of them is specific to sepsis. The aim of the current study was to evaluate whether monocyte distribution width (MDW) is useful for early sepsis detection in critically ill patients.
Methods:
Prospective cohort study was conducted in a critical care unit. MDW, CRP, PCT and WBC were evaluated for sepsis detection at the time of intensive care unit admission.
Results:
There were 344 critically ill patients enrolled consecutively and categorized as no sepsis (200), sepsis (76) and septic shock (68). MDW in patients with sepsis diagnoses in ICU was notably higher than non-sepsis group [29.7 (24.7-35.7) vs 20.4 (18.6-22.7); P < .001] under the assumption of no mean difference between the groups. Compared to other parameters, MDW was the best to discriminate sepsis from all other conditions (area under curve [AUC], 0.877; 95% CI, 0.841 0.914), sensitivity 80.6, specificity 84.5 at a cut-off point of 24. MDW adjusted for age, sex and SOFA score was associated with mortality [OR 1.056 (95% CI: 1.004-1.09) P < .01].
Conclusion:
The measurement of MDW is a tool that can help in the early diagnosis of sepsis in ICU settings and its value is a factor associated with the prognosis of septic patients.
Insights
Monocyte distribution width (MDW) shows promise for early sepsis detection in intensive care units. Higher MDW levels correlate with sepsis and are associated with patient mortality, aiding in diagnosis and prognosis.
Area of Science:
- Critical Care Medicine
- Hematology
- Infectious Diseases
Background:
- Sepsis incidence and mortality remain high in intensive care units (ICUs).
- Current sepsis detection markers like white blood cell count (WBC), C-reactive protein (CRP), and procalcitonin (PCT) lack specificity.
- There is a need for more specific and sensitive early sepsis detection tools in critically ill patients.
Purpose of the Study:
- To evaluate the utility of monocyte distribution width (MDW) for early sepsis detection in critically ill patients.
- To compare the diagnostic performance of MDW against established biomarkers (CRP, PCT, WBC).
- To assess the association between MDW and mortality in septic patients.
Main Methods:
- A prospective cohort study was conducted in a critical care unit.
- Monocyte distribution width (MDW), CRP, PCT, and WBC were measured upon intensive care unit admission.
- Patients were categorized into non-sepsis, sepsis, and septic shock groups.
Main Results:
- Monocyte distribution width (MDW) was significantly higher in patients with sepsis compared to the non-sepsis group (P < .001).
- MDW demonstrated superior discrimination for sepsis compared to other markers, with an area under the curve (AUC) of 0.877.
- At a cut-off of 24, MDW achieved 80.6% sensitivity and 84.5% specificity for sepsis detection. MDW was also associated with increased mortality risk (OR 1.056).
Conclusions:
- Monocyte distribution width (MDW) is a valuable tool for early sepsis diagnosis in ICU settings.
- MDW measurement can aid clinicians in identifying septic patients promptly.
- MDW levels are indicative of prognosis and associated with mortality risk in septic patients.
