Inclusion of MDW during the initial patients’ triage enhances the odds of early sepsis detection by up to 6-fold


A retrospective analysis of prospectively collected clinical data in 3 major academic centers: Hackensack University Medical Center, The Ohio State University, University of Pittsburgh Medical Center. Under the leadership of Dr. Elliot Crouse, researchers sought to determine the predictive value of Monocyte Distribution Width (MDW) for sepsis when combined with the presenting clinical parameters that are commonly used to screen for the initial detection of sepsis in the emergency department (ED) (SIRS or qSOFA). The study enrolled 2158 adults in the ED, age 18 to 89 years, whose evaluation included a CBC with differential upon presentation to the ED. Of these patients, 385 fulfilled Sepsis-2 criteria, and 243 fulfilled Sepsis-3 criteria within 12 hours of admission.

The study concluded:

  • The study determined that, when considered along with the standard physiologic parameters at the time of patient presentation, abnormal MDW signified a 4-6x increase in probability of sepsis diagnosis.
  • In patients with low level of symptoms and highest diagnostic uncertainty at presentation abnormal MDW increased the odds of sepsis by ~3x
  • MDW augments diagnostic accuracy for early sepsis detection during which sepsis screening and early detection are a high priority

Source: Crouser, E.D., Parrillo, J.E., Martin, G.S. et al. Monocyte distribution width enhances early sepsis detection in the emergency department beyond SIRS and qSOFA. j intensive care 8, 33 (2020).

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