Monocyte distribution width (MDW) parameter as a sepsis indicator in intensive care units.
Clin Chem Lab Med
; 59(7): 1307-1314, 2021 Jun 25.
Article
in English
| MEDLINE | ID: covidwho-1119482
ABSTRACT
OBJECTIVES:
Patients in Intensive Care Units (ICU) are a high-risk population for sepsis, recognized as a major cause of admission and death. The aim of the current study was to evaluate the diagnostic accuracy and prognostication of monocyte distribution width (MDW) in sepsis for patients admitted to ICU.METHODS:
Between January and June 2020, we conducted a prospective observational study during the hospitalization of 506 adult patients admitted to the ICU. MDW was evaluated in 2,367 consecutive samples received for routine complete blood counts (CBC) performed once a day and every day during the study. Sepsis was diagnosed according to Sepsis-3 criteria and patients enrolled were classified in the following groups no sepsis, sepsis and septic shock.RESULTS:
MDW values were significantly higher in patients with sepsis or septic shock in comparison to those within the no sepsis group [median 26.23 (IQR 23.48-29.83); 28.97 (IQR 21.27-37.21); 21.99 (IQR 19.86-24.36) respectively]. ROC analysis demonstrated that AUC is 0.785 with a sensitivity of 66.88% and specificity of 77.79% at a cut-off point of 24.63. In patients that developed an ICU-acquired sepsis MDW showed an increase from 21.33 [median (IQR 19.47-21.72)] to 29.19 [median (IQR 27.46-31.47)]. MDW increase is not affected by the aetiology of sepsis, even in patients with COVID-19. In sepsis survivors a decrease of MDW values were found from the first time to the end of their stay [median from 29.14 (IQR 26.22-32.52) to 25.67 (IQR 22.93-30.28)].CONCLUSIONS:
In ICU, MDW enhances the sepsis detection and is related to disease severity.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Monocytes
/
Sepsis
/
Intensive Care Units
Type of study:
Cohort study
/
Diagnostic study
/
Etiology study
/
Experimental Studies
/
Observational study
/
Prognostic study
/
Randomized controlled trials
Limits:
Adolescent
/
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
/
Young adult
Language:
English
Journal:
Clin Chem Lab Med
Journal subject:
Chemistry, Clinical
/
Laboratory Techniques and procedures
Year:
2021
Document Type:
Article
Affiliation country:
Cclm-2021-0192
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