Lin Sheng-Feng, Lin Hui-An, Chuang Han-Chuan, Tsai Hung-Wei, Kuo Ning, Chen Shao-Chun, Hou Sen-Kuang
Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan.
School of Public Health, College of Public Health, Taipei Medical University, Taipei 110, Taiwan.
J Pers Med. 2022 Mar 12;12(3):449. doi: 10.3390/jpm12030449.
(1) Background: Our study investigated whether monocyte distribution width (MDW) could be used in emergency department (ED) settings as a predictor of prolonged length of stay (LOS) for patients with COVID-19. (2) Methods: A retrospective cohort study was conducted; patients presenting to the ED of an academic hospital with confirmed COVID-19 were enrolled. Multivariable logistic regression models were used to obtain the odds ratios (ORs) for predictors of an LOS of >14 days. A validation study for the association between MDW and cycle of threshold (Ct) value was performed. (3) Results: Fever > 38 °C (OR: 2.82, 95% CI, 1.13−7.02, p = 0.0259), tachypnea (OR: 4.76, 95% CI, 1.67−13.55, p = 0.0034), and MDW ≥ 21 (OR: 5.67, 95% CI, 1.19−27.10, p = 0.0269) were robust significant predictors of an LOS of >14 days. We developed a new scoring system in which patients were assigned 1 point for fever > 38 °C, 2 points for tachypnea > 20 breath/min, and 3 points for MDW ≥ 21. The optimal cutoff was a score of ≥2. MDW was negatively associated with Ct value (β: −0.32 per day, standard error = 0.12, p = 0.0099). (4) Conclusions: Elevated MDW was associated with a prolonged LOS.
(1) 背景：我们的研究调查了单核细胞分布宽度（MDW）是否可在急诊科（ED）环境中用作COVID-19患者住院时间延长（LOS）的预测指标。(2) 方法：进行了一项回顾性队列研究；纳入了在一家学术医院急诊科就诊且确诊为COVID-19的患者。使用多变量逻辑回归模型获得住院时间>14天的预测指标的比值比（OR）。对MDW与循环阈值（Ct）值之间的关联进行了验证研究。(3) 结果：体温>38°C（OR：2.82，95%可信区间，1.13−7.02，p = 0.0259）、呼吸急促（OR：4.76，95%可信区间，1.67−13.55，p = 0.0034）和MDW≥21（OR：5.67，95%可信区间，1.19−27.10，p = 0.0269）是住院时间>14天的有力显著预测指标。我们开发了一种新的评分系统，其中体温>38°C的患者得1分，呼吸急促>20次/分钟的患者得2分，MDW≥21的患者得3分。最佳临界值为≥2分。MDW与Ct值呈负相关（β：每天−0.32，标准误 = 0.12，p = 0.0099）。(4) 结论：MDW升高与住院时间延长相关。
