Department of Biomedicine, Neurosciences and Advanced Diagnostics, Institute of Clinical Biochemistry, Clinical Molecular Medicine, and Clinical Laboratory Medicine, 18998 University of Palermo Palermo, Italy.
Internal Medicine and Medical Specialties "G. D'Alessandro", Department of Health Promotion, Maternal and Infant Care, University of Palermo, Palermo, Italy.
Diagnosis (Berl). 2024 Apr 22;11(4):422-429. doi: 10.1515/dx-2024-0019. Print 2024 Nov 26.
Monocyte distribution width (MDW) is a measure of monocyte anisocytosis. In this study, we assessed the role of MDW, in comparison to C-reactive protein (CRP), procalcitonin (PCT), and lactate, as a screening and prognostic biomarker of sepsis in intensive care unit (ICU) by longitudinally measuring it in the first 5 days of hospital stay.
We considered all consecutive patients admitted to the ICU. At admission, patients were classified as septic or not according to Sepsis-3 criteria. MDW, CRP, PCT, and lactate were measured daily in the first 5 days of hospitalization. ICU mortality was also recorded.
We included 193 patients, 62 with sepsis and 131 without sepsis (controls). 58% and 26 % of the patients, with and without sepsis respectively, died during ICU stay. MDW showed the highest accuracy for sepsis detection, superior to CRP, PCT, and lactate (AUC of 0.840, 0.755, 0.708, 0.622, respectively). At admission, no biomarker predicts ICU mortality in patients with sepsis. The kinetic of all biomarkers during the first 5 days of hospitalization was associated with ICU mortality. Noteworthy, above all, the kinetic of MDW showed the best accuracy. Specifically, an increase or decrease in MDW from day 1-4 and 5 was significantly associated with mortality or survival, respectively.
MDW is a reliable diagnostic and prognostic sepsis biomarker, better than traditional biomarkers.
单核细胞分布宽度（MDW）是衡量单核细胞不均一性的指标。在本研究中，我们通过在住院的前 5 天内对其进行纵向测量，评估了 MDW 在与 C 反应蛋白（CRP）、降钙素原（PCT）和乳酸相比，作为重症监护病房（ICU）中脓毒症的筛查和预后生物标志物的作用。
我们纳入了所有连续入住 ICU 的患者。在入院时，根据 Sepsis-3 标准将患者分为脓毒症组和非脓毒症组。在住院的前 5 天内，每天测量 MDW、CRP、PCT 和乳酸。还记录了 ICU 死亡率。
我们纳入了 193 名患者，其中 62 名患有脓毒症，131 名没有脓毒症（对照组）。在 ICU 住院期间，分别有 58%和 26%的患者死亡。MDW 对脓毒症的检测准确性最高，优于 CRP、PCT 和乳酸（AUC 分别为 0.840、0.755、0.708、0.622）。在入院时，没有生物标志物可以预测脓毒症患者的 ICU 死亡率。所有生物标志物在住院前 5 天内的动力学与 ICU 死亡率相关。值得注意的是，MDW 的动力学显示出最佳的准确性。具体来说，MDW 在第 1-4 天和第 5 天的升高或降低与死亡率或生存率显著相关。
MDW 是一种可靠的诊断和预后脓毒症生物标志物，优于传统生物标志物。
