European Journal of Cardiovascular Medicine

Background: Sepsis is an emergency state in response to an infectious process ultimately leading to multiorgan dysfunction and death. There is an urgent need for sepsis detection methods, especially in emergency settings. To fill this gap, monocyte distribution width (MDW) was studied as an early indicator of sepsis. MDW is a routinely reported component of the automated complete blood count (CBC) performed by hematology analyzers. Overwhelming patient load and scarcity of health resources are among the major challenges that are faced in resource-limited settings. Materials and methods: This is an observational prospective, monocentric cohort study to evaluate the possible association of population cell data parameters with ensuing sepsis at the intensive care unit of Tertiary Care Teaching Hospital. Patients were consecutively enrolled whenever hospitalized for suspected infection or sepsis. Clinical characteristics of patients at entry, including demographics (age and gender); vital signs (heart rate, respiratory rate, body temperature, blood pressure), past medical history and other laboratory examinations (white blood cell counts, blood gas analysis, blood biochemistry) were prospectively collected. Result: Exactly 30 patients (33.3% of total cases enrolled in the trial) belonged to the group that survived till the 28th day of hospitalization, among them were 12 women (40%) and 15 men (50%). The rest of the patients from the research, precisely 60 of them, were deceased (66.7%). Among non-survivors were 15 women (25%) and 45 men (75%). Descriptive statistics for selected variables (MDW, age, CRP, PCT, lactate, and ICU days) in certain groups are expressed as mean, standard deviation, minimum and maximum values, and interquartile range. Test of normality (Shapiro–Wilk) for all parameters p < 0.05 showed a nonparametric distribution of data. The Chi-square test was used to compare differences between groups (survived and deceased on the 28th day), with cut-off values for MDW 26.0 μm, CRP 100 mg/mL, PCT 1 ng/mL, lactate 2 mmol/L respectively. Conclusion: MDW is an inexpensive and readily available biomarker that will help emergency clinicians to promptly identify sepsis accurately and start appropriate treatment in a timely manner. MDW as an early sepsis indicator would be a strong addition to current sepsis protocols, especially in resource-limited settings.