Monocyte distribution width (MDW) as a new tool for the prediction of sepsis in critically ill patients: a preliminary investigation in an intensive care unit
Dublin Core
Title
Monocyte distribution width (MDW) as a new tool for the prediction of sepsis in critically ill patients: a preliminary investigation in an intensive care unit
Subject
Sepsis, MDW, Procalcitonin, Early diagnosis, Intensive Care Unit
Description
Background: Monocyte Distribution Width (MDW), a simple proxy marker of innate monocyte activation, can be
used for the early recognition of sepsis along with Procalcitonin. This study explored the added value of MDW as
an early predictor of ensuing sepsis in patients hospitalised in an Intensive Care Unit.
Methods: We performed an observational prospective monocentric study to estimate the analytical performance of
MDW in detecting ensuing sepsis in a sample of consecutive patients assisted in an Intensive Care Unit for > 48 h
for any reason. Demographic and clinical characteristics, past medical history and other laboratory measurements
were included as potential predictors of confirmed sepsis in multivariate logistic regression.
Results: A total of 211 patients were observed, 129 of whom were included in the final sample due to the suspect
of ensuing sepsis; of these, 74 (57%) had a confirmed diagnosis of sepsis, which was best predicted with the
combination of MDW > 23.0 and PCT > 0.5 ng/mL (Positive Predictive Value, PPV: 92.6, 95% CI: 82.1–97.9). The best
MDW cut-off to rule out sepsis was ≤20.0 (Negative Predictive Value, NPV: 86.4, 95% CI: 65.1–97.1). Multivariate
analyses using both MDW and PCT found a significant association for MDW > 23 only (OR:17.64, 95% CI: 5.53–67.91).
Conclusion: We found that values of MDW > 23 were associated with a high PPV for sepsis, whereas values of
MDW ≤ 20 were associated with a high NPV. Our findings suggest that MDW may help clinicians to monitor ICU
patients at risk of sepsis, with minimal additional efforts over standard of care.
used for the early recognition of sepsis along with Procalcitonin. This study explored the added value of MDW as
an early predictor of ensuing sepsis in patients hospitalised in an Intensive Care Unit.
Methods: We performed an observational prospective monocentric study to estimate the analytical performance of
MDW in detecting ensuing sepsis in a sample of consecutive patients assisted in an Intensive Care Unit for > 48 h
for any reason. Demographic and clinical characteristics, past medical history and other laboratory measurements
were included as potential predictors of confirmed sepsis in multivariate logistic regression.
Results: A total of 211 patients were observed, 129 of whom were included in the final sample due to the suspect
of ensuing sepsis; of these, 74 (57%) had a confirmed diagnosis of sepsis, which was best predicted with the
combination of MDW > 23.0 and PCT > 0.5 ng/mL (Positive Predictive Value, PPV: 92.6, 95% CI: 82.1–97.9). The best
MDW cut-off to rule out sepsis was ≤20.0 (Negative Predictive Value, NPV: 86.4, 95% CI: 65.1–97.1). Multivariate
analyses using both MDW and PCT found a significant association for MDW > 23 only (OR:17.64, 95% CI: 5.53–67.91).
Conclusion: We found that values of MDW > 23 were associated with a high PPV for sepsis, whereas values of
MDW ≤ 20 were associated with a high NPV. Our findings suggest that MDW may help clinicians to monitor ICU
patients at risk of sepsis, with minimal additional efforts over standard of care.
Creator
Ennio Polilli, Antonella Frattari, Jessica Elisabetta Esposito, Andrea Stanziale, Giuliana Giurdanella, Giancarlo Di Iorio, Fabrizio Carinci and Giustino Parruti
Publisher
BMC Emergency Medicine
Date
(2021) 21:147
Contributor
Fajar bagus W
Format
PDF
Language
English
Type
Text
Files
Collection
Citation
Ennio Polilli, Antonella Frattari, Jessica Elisabetta Esposito, Andrea Stanziale, Giuliana Giurdanella, Giancarlo Di Iorio, Fabrizio Carinci and Giustino Parruti, “Monocyte distribution width (MDW) as a new tool for the prediction of sepsis in critically ill patients: a preliminary investigation in an intensive care unit,” Repository Horizon University Indonesia, accessed March 13, 2025, https://repository.horizon.ac.id/items/show/3905.