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
Abstract 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 Inte...
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2021
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oai:doaj.org-article:f12de00c9e884dcc8b1de67b70b3e6ed2021-11-28T12:14:15ZMonocyte distribution width (MDW) as a new tool for the prediction of sepsis in critically ill patients: a preliminary investigation in an intensive care unit10.1186/s12873-021-00521-41471-227Xhttps://doaj.org/article/f12de00c9e884dcc8b1de67b70b3e6ed2021-11-01T00:00:00Zhttps://doi.org/10.1186/s12873-021-00521-4https://doaj.org/toc/1471-227XAbstract 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.Ennio PolilliAntonella FrattariJessica Elisabetta EspositoAndrea StanzialeGiuliana GiurdanellaGiancarlo Di IorioFabrizio CarinciGiustino ParrutiBMCarticleSepsisMDWProcalcitoninEarly diagnosisIntensive Care UnitSpecial situations and conditionsRC952-1245Medical emergencies. Critical care. Intensive care. First aidRC86-88.9ENBMC Emergency Medicine, Vol 21, Iss 1, Pp 1-11 (2021) |
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DOAJ |
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EN |
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Sepsis MDW Procalcitonin Early diagnosis Intensive Care Unit Special situations and conditions RC952-1245 Medical emergencies. Critical care. Intensive care. First aid RC86-88.9 |
| spellingShingle |
Sepsis MDW Procalcitonin Early diagnosis Intensive Care Unit Special situations and conditions RC952-1245 Medical emergencies. Critical care. Intensive care. First aid RC86-88.9 Ennio Polilli Antonella Frattari Jessica Elisabetta Esposito Andrea Stanziale Giuliana Giurdanella Giancarlo Di Iorio Fabrizio Carinci 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 |
| description |
Abstract 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. |
| format |
article |
| author |
Ennio Polilli Antonella Frattari Jessica Elisabetta Esposito Andrea Stanziale Giuliana Giurdanella Giancarlo Di Iorio Fabrizio Carinci Giustino Parruti |
| author_facet |
Ennio Polilli Antonella Frattari Jessica Elisabetta Esposito Andrea Stanziale Giuliana Giurdanella Giancarlo Di Iorio Fabrizio Carinci Giustino Parruti |
| author_sort |
Ennio Polilli |
| 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 |
| title_short |
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 |
| title_full |
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 |
| title_fullStr |
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 |
| title_full_unstemmed |
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 |
| title_sort |
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 |
| publisher |
BMC |
| publishDate |
2021 |
| url |
https://doaj.org/article/f12de00c9e884dcc8b1de67b70b3e6ed |
| work_keys_str_mv |
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