MONOCYTE DISTRIBUTION WIDTH (MDW) FOR INDICATED IN PATIENT SEPSIS

Abstract

Sepsis and septic shock are the leading cause of in-hospital death. Early diagnosis and treatment of patients with sepsis reduce mortality significantly. C-reactive protein (CRP), white blood cell count (WBC) and monocyte distribution width (MDW) were used as sepsis indicator. Increased MDW has been shown a reliable indicator of sepsis detection. This study aimed to evaluate MDW as a biomarker for sepsis. Cross-sectional study was performed between October 2021 and September 2022, medical records of IPD and ED were enrolled. Complete blood count (CBC), MDW, CRP and hemoculture were determined in all patients. Data was tested by using diagnostic statistics and area under the receiver operating characteristic curve (AUROC).

508 medical records were screened, hemoculture results presented positive 58.1% and negative 41.9 %. Biomarkers in hemoculture positive cases were CRP 138.4 ± 135.9 mg/dl, WBC 15,592.9 ± 9,952.9 x10³/ul and MDW 30.7 ± 10.9. AUROC of MDW, CRP and WBC count were 0.910, 0.770, and 0.762 respectively. For diagnosis of the sepsis, the optimum MDW cut-off was 21.66 with sensitivity 87.46 %, specificity 80.28 %, positive predictive value 86.00 % and negative predictive value 82.21 %. The AUROC curve analysis for the prediction of sepsis between MDW and WBC count showed statistic significant precise and comparable diagnostic sensitivity of the MDW better than WBC count in sepsis cases (p<0.001).

Our data suggested that MDW reflected high performance diagnostic test and useful parameter comparable to conventional markers. The combination of MDW and clinical information improves the diagnostic performance for early sepsis.