Comparison of Monocyte Distribution Width (MDW) and Procalcitonin for early recognition of sepsis

Ennio Polilli, Federica Sozio, Antonella Frattari, Laura Persichitti, Marina Sensi, Raffaella Posata, Marco Di Gregorio, Antonina Sciacca, Maria Elena Flacco, Lamberto Manzoli, Giancarlo Di Iorio, Giustino Parruti, Ennio Polilli, Federica Sozio, Antonella Frattari, Laura Persichitti, Marina Sensi, Raffaella Posata, Marco Di Gregorio, Antonina Sciacca, Maria Elena Flacco, Lamberto Manzoli, Giancarlo Di Iorio, Giustino Parruti

Abstract

We carried out a prospective observational study to evaluate whether Monocyte Distribution Width (MDW) may play a role in identifying patients with sepsis in comparison with Procalcitonin (PCT). We prospectively enrolled all consecutive patients hospitalized at the Infectious Diseases Unit of Pescara General Hospital for bacterial infection or sepsis. MDW values were collected for all patients. Clinical characteristics, demographic data, past and present medical history, microbiological results, PCT, as well as neutrophil and monocytes indices at entry were compared in the 2 groups. Two-hundred-sixty patients were enrolled, 63.5% males, aged 59.1±19.5 years. Sepsis was diagnosed in 105 (40.4%); in 60 (57.1%) at least 1 microorganism was isolated from blood cultures. In multivariate models, MDW as a continuous variable (OR:1.57 for each unit increase; 95%CI: 1.31-1.87, p<0.001) and PCT˃1 ng/mL (OR: 48.5; 95%CI: 14.7-160.1, p<0.001) were independently associated with sepsis. Statistical best cut points associated with sepsis were 22.0 for MDW and 1.0 ng/mL for PCT whereas MDW values<20 were invariably associated with negative blood cultures. At ROC curve analysis, the AUC of MDW (0.87) was nearly overlapping that of PCT (0.88). Our data suggest that incorporating MDW within current routine WBC counts and indices may be of remarkable use for detection of sepsis. Further research is warranted.

Conflict of interest statement

The authors have declared that no competing interests exist

Figures

Fig 1. Dot plot analysis of MDW…
Fig 1. Dot plot analysis of MDW values compared between patients with infection and patients with sepsis.
Fig 2. ROC curve analysis for comparison…
Fig 2. ROC curve analysis for comparison of MDW and PCT in their strength in sepsis prediction.
Procalcitonin (●); Monocytes Distribution Width (▲).

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