Monocyte Distribution Width: A Novel Indicator of Sepsis-2 and Sepsis-3 in High-Risk Emergency Department Patients*

Crouser, Elliott D.; Parrillo, Joseph E.; Seymour, Christopher W.; Angus, Derek C.; Bicking, Keri; Esguerra, Vincent; Peck-Palmer, Octavia M; Magari, Robert; Julián, M; Kleven, Jennifer M.; Raj, Paarth J.; Procopio, Gabrielle; Careaga, Diana; Tejidor, Liliana

doi:10.1097/ccm.0000000000003799

Cited by 109 publications

(68 citation statements)

References 30 publications

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“…(2017) first reported that increased MDW values correlated with sepsis in a large sample of patients presenting at an Emergency Department in Ohio [9]; they showed that a value of greater than 20.0 of MDW was effective for sepsis detection based on either Sepsis-2 criteria or Sepsis-3 criteria in a multicenter study enrolling patients from 3 emergency departments [29]. As a consequence, a 2-point difference between their better threshold and ours seems to exist.…”

Section: Discussionmentioning

confidence: 85%

“…Haydar et al (2017) reported the qSOFA score was efficacious for the identification of patients with sepsis at increased risk of mortality, while performing poorly as a screening tool for early identification of sepsis in the emergency department [33]. In low intensity settings, the use of MDW might therefore become a low-cost alternative to PCT for early detection of ongoing sepsis [9,29].…”

Section: Discussionmentioning

confidence: 99%

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

Polilli¹,

Sozio²,

Frattari³

et al. 2020

PLoS ONE

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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.

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Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 99%

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

Polilli¹,

Sozio²,

Frattari³

et al. 2020

PLoS ONE

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“…The cytokine-producing monocyte population is an element of the innate immunity undergoing transformation not only in terms of functionality but also in their morphology [14] . These changes in response to infection are at the basis of the modification of the MDW parameter observed in different types of infection [3] , [4] , [5] .…”

Section: Discussionmentioning

confidence: 97%

“…Monocyte Distribution Width (MDW) is an in vitro diagnostic parameter automatically reported in the Complete Blood Count with differential (CBC-Diff) and routinely requested at the Emergency Department. It has been demonstrated that an elevated MDW value is effective for early detection of sepsis in adult patients presenting at the Emergency Department (ED) [3] , [4] .…”

Section: Introductionmentioning

confidence: 99%

Elevated monocyte distribution width in COVID-19 patients: The contribution of the novel sepsis indicator

Ognibene

Lorubbio

Magliocca

et al. 2020

Clinica Chimica Acta

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“…Moreover, they proposed that this value may be useful to identify high-risk patients with an idiopathic pulmonary fibrosis [11]. It is supposed that the monocyte level may be a useful biomarker of other illnesses, such as coronary heart disease [12], sepsis-2 and sepsis-3 [13], amyotrophic lateral sclerosis [14], and many more. Here, the phase of tissue repair should be highly controlled and resolves quickly to restore normal tissue architecture [10].…”

Section: Subsets Of Monocytes and Their Main Functionsmentioning

confidence: 99%

A Dual Face of APE1 in the Maintenance of Genetic Stability in Monocytes: An Overview of the Current Status and Future Perspectives

Betlej

Bator

Pyrkosz

et al. 2020

Genes

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Monocytes, which play a crucial role in the immune system, are characterized by an enormous sensitivity to oxidative stress. As they lack four key proteins responsible for DNA damage response (DDR) pathways, they are especially prone to reactive oxygen species (ROS) exposure leading to oxidative DNA lesions and, consequently, ROS-driven apoptosis. Although such a phenomenon is of important biological significance in the regulation of monocyte/macrophage/dendritic cells’ balance, it also a challenge for monocytic mechanisms that have to provide and maintain genetic stability of its own DNA. Interestingly, apurinic/apyrimidinic endonuclease 1 (APE1), which is one of the key proteins in two DDR mechanisms, base excision repair (BER) and non-homologous end joining (NHEJ) pathways, operates in monocytic cells, although both BER and NHEJ are impaired in these cells. Thus, on the one hand, APE1 endonucleolytic activity leads to enhanced levels of both single- and double-strand DNA breaks (SSDs and DSBs, respectively) in monocytic DNA that remain unrepaired because of the impaired BER and NHEJ. On the other hand, there is some experimental evidence suggesting that APE1 is a crucial player in monocytic genome maintenance and stability through different molecular mechanisms, including induction of cytoprotective and antioxidant genes. Here, the dual face of APE1 is discussed.

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Monocyte Distribution Width: A Novel Indicator of Sepsis-2 and Sepsis-3 in High-Risk Emergency Department Patients*

Abstract: Supplemental Digital Content is available in the text.

Cited by 109 publications

References 30 publications

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

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

Elevated monocyte distribution width in COVID-19 patients: The contribution of the novel sepsis indicator

A Dual Face of APE1 in the Maintenance of Genetic Stability in Monocytes: An Overview of the Current Status and Future Perspectives

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