Monocyte distribution width as an early predictor of short-term outcome in adult patients with sepsis

Abstract

Objectives Monocyte distribution width (MDW) is a quantitative measurement of monocyte anisocytosis and has been proposed as an efficient marker for early sepsis detection. This study aimed to assess the prognostic potential of MDW in septic patients. Methods In this study, a total of 252 adult septic patients were enrolled. Demographic, clinical, and laboratory finding including MDW and traditional inflammatory biomarkers detected at three time points (day 1, day 3 and day 6) after admission were collected and compared between 28-day survivors and non-survivors. Receiver operating characteristic (ROC) curves, Kaplan-Meier survival curve and Cox regression analyses were performed to assess and compare their predictive values. Group-based trajectory modeling was applied to identify MDW trajectory endotypes. Basic characteristics and 28-day outcomes were compared between the trajectories. Results ROC curve analysis showed that MDW levels measured on day 3 after admission (D3-MDW) had moderate prognostic value and was independently associated with 28-day mortality in patients with sepsis. A D3-MDW value of 26.20 allowed discrimination between survivors and non-survivors with a sensitivity of 77.8 % and a specificity of 67.6 %. However, the prognostic accuracy of D3-MDW was diminished in immune-compromised patients and patients who already received antibiotics before admission. Group-based trajectory modeling indicated that excessively elevated and delayed decreased MDW levels during the first week after admission inversely correlated with prognosis. Conclusions MDW values detected on day 3 after admission and its kinetic change might be potential markers for predicting short-term outcome in adult septic patients.

The exploration of cell population data in clinical use: Beyond infectious diseases

“…However, MDW was superior to CRP and WBC for this purpose. Moreover, MDW was found to serve as a prognostic predictor of sepsis in ICU patients [35,36].…”

Monocyte distribution width as a promising biomarker for differential diagnosis of chronic hepatitis, cirrhosis, and hepatocellular carcinoma

“…Human monocytic cells in circulation can be categorized into three subsets, each showing different percentages in various diseases ( 12 ). During inflammatory conditions like sepsis ( 13 , 14 ), viral infection ( 15 , 16 ), and other inflammatory diseases ( 17 , 18 ), the changes in the number, volume, and function of monocytes in these subsets differ. Recent research has shown that MDW has been utilized for the early detection of sepsis ( 19 ), with MDW levels increasing with the severity of the condition ( 11 ).…”