Validation of monocyte distribution width decisional cutoff for sepsis detection in the acute setting

Agnello, Luisa; Sasso, Bruna Lo; Vidali, Matteo; Scazzone, Concetta; Gambino, Caterina Maria; Giglio, Rosaria Vincenza; Ciaccio, Anna Maria; Bivona, Giulia; Ciaccio, Marcello

doi:10.1111/ijlh.13496

Cited by 21 publications

(24 citation statements)

References 10 publications

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“…It has been approved by the Food and Drug Administration (FDA) as a biomarker for the early detection of sepsis in ED. Recently, several authors showed that MDW has good diagnostic accuracy for early-identifying patients at high risk of developing sepsis, especially in the ED and the ICU [114][115][116][117][118][119][120][121][122][123]. MDW is characterized by a high negative predictive value for sepsis diagnosis.…”

Section: Monocyte Distribution Widthmentioning

confidence: 99%

The Value of a Complete Blood Count (CBC) for Sepsis Diagnosis and Prognosis

et al. 2021

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Sepsis represents an important global health burden due to its high mortality and morbidity. The rapid detection of sepsis is crucial in order to prevent adverse outcomes and reduce mortality. However, the diagnosis of sepsis is still challenging and many efforts have been made to identify reliable biomarkers. Unfortunately, many investigated biomarkers have several limitations that do not support their introduction in clinical practice, such as moderate diagnostic and prognostic accuracy, long turn-around time, and high-costs. Complete blood count represents instead a precious test that provides a wealth of information on individual health status. It can guide clinicians to early-identify patients at high risk of developing sepsis and to predict adverse outcomes. It has several advantages, being cheap, easy-to-perform, and available in all wards, from the emergency department to the intensive care unit. Noteworthy, it represents a first-level test and an alteration of its parameters must always be considered within the clinical context, and the eventual suspect of sepsis must be confirmed by more specific investigations. In this review, we describe the usefulness of basic and new complete blood count parameters as diagnostic and prognostic biomarkers of sepsis.

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Section: Monocyte Distribution Widthmentioning

confidence: 99%

The Value of a Complete Blood Count (CBC) for Sepsis Diagnosis and Prognosis

et al. 2021

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“…MDW is a cell population data (CPD) parameter, which is rapidly and automatically calculated by lastgeneration DxH haematology analysers (Beckman Coulter, Inc.), along with routine complete blood cell (CBC) count. It reflects the heterogeneity in the size of circulating monocytes, which have a key role in the pathogenesis of sepsis since very early stages [2]. Indeed, monocytes represent the first-line defence against infection.…”

Section: Introductionmentioning

confidence: 99%

Monocyte distribution width (MDW) as a screening tool for early detecting sepsis: a systematic review and meta-analysis

Agnello

Vidali

Sasso

et al. 2022

Clinical Chemistry and Laboratory Medicine (CCLM)

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Objectives Monocyte distribution has recently emerged as a promising biomarker of sepsis, especially in acute setting, such as Emergency Department and Intensive Care Unit. This study aimed to evaluate the accuracy of monocyte distribution width (MDW) for early detecting patients with sepsis by performing a systemic review and meta-analysis of published studies. Methods Relevant publications were identified by a systematic literature search on PubMed and Google Scholar from inception to September 07, 2021. Studies were divided into two groups based on the sepsis criteria applied, namely sepsis-2 or sepsis-3. Results Ten studies including 9,475 individuals, of whom 1,370 with sepsis (742 according Sepsis-2 and 628 according to Sepsis-3), met the inclusion criteria for our meta-analysis. The pooled sensitivity and specificity were 0.789 and 0.777 for Sepsis-2 criteria, 0.838 and 0.704 for Sepsis-3 criteria. Conclusions MDW represents a reliable biomarker for sepsis screening.

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“…Using the previously established decisional cut-off values of 23 and 1 for the MDW and SI, respectively [ 13 , 16 ], we found out that, in this validation cohort, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (LR+) and negative likelihood ratio (LR-) for sepsis were, respectively, 0.79 (MDW) vs. 0.79 (SI), 0.84 vs. 0.91, 0.27 vs. 0.38, 0.98 vs. 0.98, 5.08 vs. 8.52 and 0.25 vs. 0.23.…”

Section: Resultsmentioning

confidence: 99%

“…Several authors have assessed the diagnostic performance of MDW as a biomarker of sepsis in different acute clinical settings, including the ED and intensive care unit (ICU), achieving promising results [ 9 , 10 , 11 ]. We also found that the MDW had high sensitivity and specificity for sepsis screening both in the ED and in ICU [ 12 , 13 , 14 ]. Additionally, we established the reference intervals of the MDW in a healthy population of blood donors [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

Independent Validation of Sepsis Index for Sepsis Screening in the Emergency Department

et al. 2021

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(1) Background: The early detection of sepsis is still challenging, and there is an urgent need for biomarkers that could identify patients at a high risk of developing it. We recently developed an index, namely the Sepsis Index (SI), based on the combination of two CBC parameters: monocyte distribution width (MDW) and mean monocyte volume (MMV). In this study, we sought to independently validate the performance of SI as a tool for the early detection of patients at a high risk of sepsis in the Emergency Department (ED). (2) Methods: We enrolled all consecutive patients attending the ED with a request of the CBC. MDW and MMV were measured on samples collected in K3-EDTA tubes on the UniCel DxH 900 haematology analyser. SI was calculated based on the MDW and MMV. (3) Results: We enrolled a total of 703 patients stratified into four subgroups according to the Sepsis-2 criteria: control (498), infection (105), SIRS (52) and sepsis (48). The sepsis subgroup displayed the highest MDW (median 27.5, IQR 24.6–32.9) and SI (median 1.15, IQR 1.05–1.29) values. The ROC curve analysis for the prediction of sepsis showed a good and comparable diagnostic accuracy of the MDW and SI. However, the SI displayed an increased specificity, positive predictive value and positive likelihood ratio in comparison to MDW alone. (4) Conclusions: SI improves the diagnostic accuracy of MDW for sepsis screening.

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Validation of monocyte distribution width decisional cutoff for sepsis detection in the acute setting

Cited by 21 publications

References 10 publications

The Value of a Complete Blood Count (CBC) for Sepsis Diagnosis and Prognosis

The Value of a Complete Blood Count (CBC) for Sepsis Diagnosis and Prognosis

Monocyte distribution width (MDW) as a screening tool for early detecting sepsis: a systematic review and meta-analysis

Independent Validation of Sepsis Index for Sepsis Screening in the Emergency Department

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