Usefulness of monocyte distribution width in the diagnosis of sepsis in critically ill patients

Abstract

Background

The incidence and mortality of sepsis remain high in the intensive care units (ICU). WBC, CRP and PCT are frequently used as tools for sepsis detection; however, none of them is specific to sepsis. The aim of the current study was to evaluate whether monocyte distribution width (MDW) is useful for early sepsis detection in critically ill patients.

Methods

Prospective cohort study was conducted in a critical care unit. MDW, CRP, PCT and WBC were evaluated for sepsis detection at the time of intensive care unit admission.

Results

There were 344 critically ill patients enrolled consecutively and categorized as no sepsis (200), sepsis (76) and septic shock (68). MDW in patients with sepsis diagnoses in ICU was notably higher than non-sepsis group [29.7 (24.7–35.7) vs 20.4 (18.6−22.7); P < .001] under the assumption of no mean difference between the groups. Compared to other parameters, MDW was the best to discriminate sepsis from all other conditions (area under curve [AUC], 0.877; 95% CI, 0.841 0.914), sensitivity 80.6, specificity 84.5 at a cut-off point of 24. MDW adjusted for age, sex and SOFA score was associated with mortality [OR 1.056 (95% CI: 1.004–1.09) P < .01].

Conclusion

The measurement of MDW is a tool that can help in the early diagnosis of sepsis in ICU settings and its value is a factor associated with the prognosis of septic patients.