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Comparison of Monocyte Distribution Width (MDW) and Procalcitonin for early recognition of sepsis


Autoři: Ennio Polilli aff001;  Federica Sozio aff002;  Antonella Frattari aff003;  Laura Persichitti aff001;  Marina Sensi aff004;  Raffaella Posata aff004;  Marco Di Gregorio aff002;  Antonina Sciacca aff002;  Maria Elena Flacco aff005;  Lamberto Manzoli aff006;  Giancarlo Di Iorio aff001;  Giustino Parruti aff002
Působiště autorů: Clinical Pathology Unit, Pescara General Hospital, Pescara, Italy aff001;  Infectious Diseases Unit, Pescara General Hospital, Pescara, Italy aff002;  Unit of Intensive Care, Pescara General Hospital, Pescara, Italy aff003;  Clinical Pathology Department, University of Chieti, Chieti, Italy aff004;  Local Health Unit of Pescara, Pescara, Italy aff005;  Department of Medical Sciences, University of Ferrara, Ferrara, Italy aff006
Vyšlo v časopise: PLoS ONE 15(1)
Kategorie: Research Article
doi: https://doi.org/10.1371/journal.pone.0227300

Souhrn

We carried out a prospective observational study to evaluate whether Monocyte Distribution Width (MDW) may play a role in identifying patients with sepsis in comparison with Procalcitonin (PCT). We prospectively enrolled all consecutive patients hospitalized at the Infectious Diseases Unit of Pescara General Hospital for bacterial infection or sepsis. MDW values were collected for all patients. Clinical characteristics, demographic data, past and present medical history, microbiological results, PCT, as well as neutrophil and monocytes indices at entry were compared in the 2 groups. Two-hundred-sixty patients were enrolled, 63.5% males, aged 59.1±19.5 years. Sepsis was diagnosed in 105 (40.4%); in 60 (57.1%) at least 1 microorganism was isolated from blood cultures. In multivariate models, MDW as a continuous variable (OR:1.57 for each unit increase; 95%CI: 1.31–1.87, p<0.001) and PCT˃1 ng/mL (OR: 48.5; 95%CI: 14.7–160.1, p<0.001) were independently associated with sepsis. Statistical best cut points associated with sepsis were 22.0 for MDW and 1.0 ng/mL for PCT whereas MDW values<20 were invariably associated with negative blood cultures. At ROC curve analysis, the AUC of MDW (0.87) was nearly overlapping that of PCT (0.88). Our data suggest that incorporating MDW within current routine WBC counts and indices may be of remarkable use for detection of sepsis. Further research is warranted.

Klíčová slova:

Blood – Blood cells – Blood counts – Hematology – Monocytes – Neutrophils – Respiratory infections – Sepsis


Zdroje

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