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Monocyte distribution width (MDW) as an infection indicator in severe patients attending in the Emergency Department: a pilot study

BACKGROUND: The aim of the present study was to evaluate the diagnostic performance of monocyte distribution width (MDW) as a biomarker for sepsis diagnosis in severe patients attended in the Emergency Department for different conditions and not only infections. METHODS: We performed an observationa...

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Autores principales: Encabo, Marta, Hernández-Álvarez, Elena, Oteo, David, García-Álvarez, Ana, González, Mercedes Martínez-Novillo, Sanz-Casla, María Teresa, Castillo, Juan González-del
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Sociedad Española de Quimioterapia 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10238791/
https://www.ncbi.nlm.nih.gov/pubmed/36935618
http://dx.doi.org/10.37201/req/108.2022
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author Encabo, Marta
Hernández-Álvarez, Elena
Oteo, David
García-Álvarez, Ana
González, Mercedes Martínez-Novillo
Sanz-Casla, María Teresa
Castillo, Juan González-del
author_facet Encabo, Marta
Hernández-Álvarez, Elena
Oteo, David
García-Álvarez, Ana
González, Mercedes Martínez-Novillo
Sanz-Casla, María Teresa
Castillo, Juan González-del
author_sort Encabo, Marta
collection PubMed
description BACKGROUND: The aim of the present study was to evaluate the diagnostic performance of monocyte distribution width (MDW) as a biomarker for sepsis diagnosis in severe patients attended in the Emergency Department for different conditions and not only infections. METHODS: We performed an observational study in a consecutive prospective cohort including severe patients attending the Emergency Department with different conditions. MDW and other biomarkers were determined from samples obtained during the first care of patients. The diagnostic performance of the different biomarkers was determined based on the final diagnosis at patient discharge. RESULTS: One hundred two patients, with a mean age of 76.7 (SD 16.5) years were included, 53 being (51.9%) male. Among the patients included, 65 (63.7%) had an infectious disease while the remaining had other different conditions. A MDW cut-off of 20.115 provided the best accuracy to identify infected patients, with a sensitivity of 89.2 (95% CI 79.4-94.7), a specificity of 89.2 (95% CI 75.3-95.7), a positive predictive value of 93.5 (95% CI 84.6-97.5), a negative predictive value of 82.5% (95% CI 68.0-91.3), a positive likelihood ratio of 8.25 (3.26-20.91), and a negative likelihood ratio of 0.12 (0.06-0.24). The area under the receiver operating characteristic curve for infection according to MDW was 0.943 (95% CI 0.897-0.989; p<0.001). CONCLUSIONS: A MDW > 20.115 may be associated with infection and could help to distinguish between infected and non-infected patients in severe patients. These results must be confirmed in new studies due to the limited patient sample included.
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spelling pubmed-102387912023-06-04 Monocyte distribution width (MDW) as an infection indicator in severe patients attending in the Emergency Department: a pilot study Encabo, Marta Hernández-Álvarez, Elena Oteo, David García-Álvarez, Ana González, Mercedes Martínez-Novillo Sanz-Casla, María Teresa Castillo, Juan González-del Rev Esp Quimioter Original BACKGROUND: The aim of the present study was to evaluate the diagnostic performance of monocyte distribution width (MDW) as a biomarker for sepsis diagnosis in severe patients attended in the Emergency Department for different conditions and not only infections. METHODS: We performed an observational study in a consecutive prospective cohort including severe patients attending the Emergency Department with different conditions. MDW and other biomarkers were determined from samples obtained during the first care of patients. The diagnostic performance of the different biomarkers was determined based on the final diagnosis at patient discharge. RESULTS: One hundred two patients, with a mean age of 76.7 (SD 16.5) years were included, 53 being (51.9%) male. Among the patients included, 65 (63.7%) had an infectious disease while the remaining had other different conditions. A MDW cut-off of 20.115 provided the best accuracy to identify infected patients, with a sensitivity of 89.2 (95% CI 79.4-94.7), a specificity of 89.2 (95% CI 75.3-95.7), a positive predictive value of 93.5 (95% CI 84.6-97.5), a negative predictive value of 82.5% (95% CI 68.0-91.3), a positive likelihood ratio of 8.25 (3.26-20.91), and a negative likelihood ratio of 0.12 (0.06-0.24). The area under the receiver operating characteristic curve for infection according to MDW was 0.943 (95% CI 0.897-0.989; p<0.001). CONCLUSIONS: A MDW > 20.115 may be associated with infection and could help to distinguish between infected and non-infected patients in severe patients. These results must be confirmed in new studies due to the limited patient sample included. Sociedad Española de Quimioterapia 2023-03-20 2023 /pmc/articles/PMC10238791/ /pubmed/36935618 http://dx.doi.org/10.37201/req/108.2022 Text en © The Author 2023 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)(https://creativecommons.org/licenses/by-nc/4.0/).
spellingShingle Original
Encabo, Marta
Hernández-Álvarez, Elena
Oteo, David
García-Álvarez, Ana
González, Mercedes Martínez-Novillo
Sanz-Casla, María Teresa
Castillo, Juan González-del
Monocyte distribution width (MDW) as an infection indicator in severe patients attending in the Emergency Department: a pilot study
title Monocyte distribution width (MDW) as an infection indicator in severe patients attending in the Emergency Department: a pilot study
title_full Monocyte distribution width (MDW) as an infection indicator in severe patients attending in the Emergency Department: a pilot study
title_fullStr Monocyte distribution width (MDW) as an infection indicator in severe patients attending in the Emergency Department: a pilot study
title_full_unstemmed Monocyte distribution width (MDW) as an infection indicator in severe patients attending in the Emergency Department: a pilot study
title_short Monocyte distribution width (MDW) as an infection indicator in severe patients attending in the Emergency Department: a pilot study
title_sort monocyte distribution width (mdw) as an infection indicator in severe patients attending in the emergency department: a pilot study
topic Original
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10238791/
https://www.ncbi.nlm.nih.gov/pubmed/36935618
http://dx.doi.org/10.37201/req/108.2022
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