Monocyte distribution width (MDW) as a screening tool for sepsis in the Emergency Department

Objectives: The diagnosis of sepsis in the EmergencyDepartment (ED) is challenging and a reliable biomarker isneeded. The current study aimed to evaluate the diagnosticaccuracy of monocyte distribution width (MDW) for theearly identification of sepsis in the ED.Methods: We performed a large observational studyincluding consecutive adult patients (≥18 years of age)presenting to the ED between September and November2019, with an order for Complete Blood Count (CBC) evaluation.A total of 2,215 patients were enrolled and classifiedbased on Sepsis-2 criteria as the control group (1,855),infection group (172), Systemic Inflammatory ResponseSyndrome (SIRS) group (100), and sepsis group (88).Results: MDW levels were higher in patients with sepsisthan in all other groups (p<0.001). ROC curve analysisshowed an optimal diagnostic accuracy of MDW for sepsisprediction at a cut-off point of 23.5, with an AUC of 0.964,sensitivity and specificity of 0.920 and 0.929, respectively.Conclusions: Our findings encourage further investigationto validate the use of MDW as a screening tool for theearly identification of patients at risk of sepsis in the ED.Keywords: Emergency Department (ED); infection; monocytes;monocyte distribution width (MDW); screening;sepsis.