Detect Sepsis Earlier, and Act with More Confidence

Diagnostic uncertainty is a major challenge for patients presenting to emergency department with low number of signs and symptoms. What if there was a way to aid emergency departments in early sepsis detection?


A Global Crisis

Over 49

million people worldwide are affected by sepsis1




billion healthcare-related costs to manage sepsis
annually in the U.S.2


Difficult to Diagnose

Over 30%

of septic shock patients present with vague symptoms and
may be missed by the EMR alerts3

Sepsis Detection Using Monocyte Distribution Width

Monocyte Distribution Width (MDW) is a measure of increased morphological variability of monocytes in response to bacterial, viral or fungal infections. The quantitative analysis of MDW has received regulatory clearances as an aid for early detection in adult patients with or developing sepsis in emergency departments.

Considered with other signs and symptoms, the value of MDW helps differentiate sepsis from non-septic presentations, including non-infectious systemic inflammatory response.4 This sepsis biomarker is automatically reported with the complete blood count (CBC) with differential* for adult emergency department patients, without any additional test ordering.

Monocyte distribution width

Increased Sensitivity

Sensitivity of technologies is critical. When considered alone, the discriminating power of MDW is similar to that of White Blood-cell Count (WBC).

However, when MDW is considered together with WBC, MDW may add to the sensitivity and specificity of sepsis detection, as part of the standard assessment protocol in the emergency department.4,5

Sepsis parameters

The Challenge of Low Symptom Presentation

Diagnostic uncertainty is a major challenge for patients presenting to the emergency department with a low number of signs and symptoms.

  • 60% of emergency department patients who were diagnosed with sepsis in a pivotal study presented with zero or one symptom used for sepsis screening
  • Abnormal MDW was present in up to 70% of septic "gray zone" patients4,5

Sepsis symptoms

MDW Modulates the Probability of Sepsis

Considered with other parameters, abnormal MDW at presentation increases the odds of sepsis.

The study determined that, when considered along with the standard physiologic parameters at the time of patient presentation, abnormal values of MDW signify a 4-6x increase in probability of sepsis diagnosis. In patients with a low level of symptoms and highest diagnostic uncertainty at presentation, abnormal MDW increased the odds of sepsis by ~3x.6

Sepsis probability based on SIRS

Resources on Sepsis Progression and Detection

MDW Adds Value to Sepsis Detection

Novel protocols and biomarkers are being studied to improve sepsis detection time. A clinical study evaluates the diagnostic accuracy of MDW for early sepsis detection.

The Role of Monocytes in the Progression of Sepsis

Find out how MDW can aid emergency department physicians in sepsis-related clinical decision-making by measuring morphological changes in monocytes.

BARDA Funding to Aid in Early Sepsis Detection

Beckman Coulter receives BARDA funding to develop a next-generation analytic algorithm to predict and detect sepsis earlier, with the goal of reducing sepsis mortality rates through earlier intervention.

The value of MDW is that it provides physicians with an earlier indication of sepsis during the initial encounter, which is especially important when a patient’s symptoms are mild and alternative diagnosis are being considered.
Elliott Crouser, M.D., professor of Critical Care Medicine
Ohio State University Wexler Medical Center

Latest Webinars

Improved Detection of Sepsis
in the Emergency Department

Join Dr. Vincent Esguerra, assistant professor of internal medicine at the Ohio State Wexner Medical Center, to learn about the role of cell morphology and volume changes in early sepsis identification in the emergency department.

Watch webinar ›

Infection and Sepsis Diagnostic Challenges

In this webinar, Professor Pierre Hausfater, head of the emergency department at Pitie-Salpetriere hospital, will discuss the challenges faced by laboratories and clinicians when detecting infections and sepsis.

Watch webinar ›

*Using Early Sepsis Indicator application on Beckman Coulter DxH 900 and DxH 690T analyzers. Activation is required.

1Rudd, et al., Lancet. 2020 Jan 18; 395 (10219): 200-211.
2Torio C, Moore B. “National Inpatient Hospital Costs: The Most Expensive Conditions by Payer.”, May 2016. Accessed 15 Jan. 2018.
3Filbin, M. R., Lynch, J., Gillingham, T. D., Thorsen, J. E., Pasakarnis, C. L., Nepal, S., et al. Presenting Symptoms Independently Predict Mortality in Septic Shock. Critical Care Medicine, 2018; 46(10), 1592-1599.
4UniCel DxH 900 Coulter Cellular Analysis System Early Sepsis Indicator (ESId) Application AddendumPN C42014AA.
5Sepsis Pivotal Repository PN C54726 Rev. AB located in CPDM.
6Crouser, E. D., Parrillo, J. E., Martin, G. S., Huang, D. T., Hausfater, P., Grigorov, I., Careaga, D., Osborn, T., Hasan, M, Tejidor, L. Monocyte Distribution Width Enhances Early Sepsis Detection in the Emergency Department Beyond SIRS and qSOFA. Journal of Intensive Care, 2020; 8(1).