Monocyte distribution width can enhance early sepsis detection in adult emergency department patients

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In a retrospective analysis of 2,158 adult patients admitted to emergency departments in three major academic centers, researchers sought to determine if MDW, when combined with other available clinical parameters at the time of ED presentation, improves the early detection of sepsis. Of these patients, 385 fulfilled Sepsis-2 criteria, and 243 fulfilled Sepsis-3 criteria within 12 hours of admission. Sepsis probabilities were determined based on MDW values alone or in combination with components of systemic inflammatory response syndrome (SIRS) or quick sepsis-related organ failure assessment (qSOFA) score obtained during the initial patient presentation (i.e., within 2 hours of ED admission).

The study concluded:

  • Abnormal MDW (>20.0) consistently increased sepsis probability, and normal MDW consistently reduced sepsis probability when used in combination with SIRS criteria or qSOFA
  • For MDW >20.0 there is ~6-fold increase in the odds of Sepsis-2, and ~4-fold increase in the odds of Sepsis-3
  • MDW improves the early detection of sepsis during the initial ED encounter and is complementary to SIRS and qSOFA parameters that are currently used for this purpose
  • The study supports the incorporation of MDW with other readily available clinical parameters during the initial ED encounter for the early detection of sepsis

At a Glance

2158
Adult patients enrolled from emergency departments of three major academic centers
385
Patients fulfilled Sepsis-2 criteria, and 243 fulfilled Sepsis-3 criteria within 12 h of admission
>20
For MDW >20 there is ~6-fold increase in the odds of Sepsis-2, and ~ 4-fold increase in the odds of Sepsis-3

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). https://doi.org/10.1186/s40560-020-00446-3

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