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Updated: Jun 24, 2026
A Data-Driven Approach to Quantifying Immune States in Sepsis
Published on: February 7, 2025
Emerging Role of Monocyte Distribution Width for Early Sepsis Detection in Adult Intensive Care
Ayushi Raghuvanshi1, Amit Nisal1, Reena Bharadwaj1
1Department of Pathology, Bharati Vidyapeeth (DTU) Medical College Hospital and Research Centre, Pune, Maharashtra 411043 India.
Abstract:
A dysregulated host response to infection results in sepsis, where the mortality rate is high. A crucial component of managing sepsis is early detection and diagnosis. Advanced Haematology analyzers use volume, conductivity, and scatter (VCS) parameters to measure monocyte distribution width (MDW). An abnormal monocyte distribution width (MDW) greater than 20 U is considered a sign of sepsis. This study was done to utilize the potential of MDW as an early sepsis marker in ICU patients. Venous blood samples were collected from seventy-four patients suspected of having sepsis during a two-year prospective observational study. Sepsis cases were identified using the Systemic Inflammatory Response Syndrome (SIRS) criteria. Patients who received blood transfusions were excluded from this study. The DxH900 Haematology Analyzer (Beckman Coulter Inc., Miami, FL) was used to measure the MDW value. Procalcitonin (PCT), C-reactive protein (CRP), and total leucocyte count (TLC) were among the other conventional biomarkers of sepsis that were assessed. Seventy-four patients met the criteria for sepsis, of which twenty-three had septic shock. MDW was highest for patients in septic shock (P-value = 0.018). We have observed that as TLC, CRP, and PCT levels increased, so did MDW. As the SIRS score rose, it was discovered that the mean MDW value increased. In advanced Haematology analyzers, MDW, a new hematological parameter, is computed along with the complete blood count. When combined with other sepsis biomarkers, MDW is anticipated to be a helpful indicator for early sepsis screening in intensive care unit patients.
Insights
Monocyte distribution width (MDW) shows potential as an early sepsis marker in ICU patients. Elevated MDW levels correlate with sepsis severity and other biomarkers, aiding in early detection.
Area of Science:
- Critical Care Medicine
- Hematology
- Infectious Diseases
Background:
- Sepsis, a life-threatening organ dysfunction from infection, requires early diagnosis for improved outcomes.
- Current sepsis detection methods can be time-consuming, highlighting the need for rapid diagnostic markers.
- Monocyte distribution width (MDW) is a novel parameter from advanced hematology analyzers potentially indicating sepsis.
Purpose of the Study:
- To evaluate the utility of Monocyte distribution width (MDW) as an early sepsis detection marker in intensive care unit (ICU) patients.
- To assess the correlation between MDW values and sepsis severity, including septic shock.
- To compare MDW performance against established sepsis biomarkers such as procalcitonin (PCT), C-reactive protein (CRP), and total leucocyte count (TLC).
Main Methods:
- A prospective observational study involving 74 ICU patients suspected of sepsis.
- MDW values were measured using the DxH900 Haematology Analyzer.
- Sepsis diagnosis was confirmed using Systemic Inflammatory Response Syndrome (SIRS) criteria; patients receiving transfusions were excluded.
Main Results:
- MDW values were significantly higher in patients with septic shock (P=0.018).
- MDW demonstrated a positive correlation with increasing levels of TLC, CRP, and PCT.
- Higher SIRS scores correlated with increased mean MDW values.
Conclusions:
- MDW is a promising hematological marker for early sepsis detection in ICU settings.
- The combination of MDW with conventional biomarkers may enhance sepsis screening accuracy.
- MDW's accessibility through advanced hematology analyzers makes it a valuable tool for timely sepsis management.
