Diagnostic Performance of Monocyte Distribution Width for the Detection of Sepsis: A Systematic Review and Meta-Analysis

Journal of the American College of Emergency Physicians Open, Journal Year: 2025, Volume and Issue: 6(2), P. 100073 - 100073

Published: Feb. 21, 2025

To aggregate literature on the diagnostic performance of monocyte distribution width (MDW) for sepsis detection among adults in emergency department and inpatient settings. We searched MEDLINE, EMBASE, SCOPUS, Cochrane databases studies evaluating MDW diagnosis hospital setting through October 19, 2024. Two authors (G.E. Q.H.) independently performed eligibility assessment, data extraction, risk bias assessment. evaluated sepsis-2 sepsis-3 separately applied separate thresholds depending anticoagulant used blood collection. Data were pooled using a random-effects model. multiple sensitivity analyses to evaluate stability our findings. Twenty-five observational comprising 39,041 patients included. The area under summary receiver operating curve (AUC) was 0.82 (95% CI, 0.78-0.85) both sepsis-3. Sensitivity specificity 0.79 0.74-0.83) 0.7 0.61-0.78) 0.83 0.78-0.88) 0.64 0.55-0.71) threshold-independent weighted-average AUC 0.76 (SD, 0.1) 0.77 0.07) negative predictive value 94% 96% observed similar across all analyses. assessed overall quality evidence be low. performs similarly other biomarkers such as procalcitonin sepsis, with unique advantage rapid availability part routine testing.

Language: Английский

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Monocyte distribution width as a biomarker of sepsis in the intensive care unit: A pilot study

Annals of Clinical Biochemistry International Journal of Laboratory Medicine, Journal Year: 2020, Volume and Issue: 58(1), P. 70 - 72

Published: Oct. 20, 2020

Monocyte distribution width has been recently proposed as a sepsis biomarker in the emergency department. The aim of this study was to assess role monocyte diagnostic intensive care unit.In prospective observational study, we included all consecutive patients admitted unit University Hospital "P. Giaccone" Palermo. Patients were classified into three groups according Sepsis-3 criteria: (1) without sepsis; (2) developing during their hospital stay; (3) with sepsis. measured at admission (groups 1, 2, 3) and daily until (group 2) or end hospitalization 1).Monocyte significantly higher group 3 than 1 2 (30.9 [25.6-36.0] vs. 20.3 [18.3-23.6] 21.4 [19.4-25.2]). Among belonging values, day when clinically diagnosed, those found admission: 29.4 (26.7-36.0) (19.4-25.2), P = 0.001.Monocyte could represent reliable unit.

Language: Английский

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Reference interval of monocyte distribution width (MDW) in healthy blood donors

Clinica Chimica Acta, Journal Year: 2020, Volume and Issue: 510, P. 272 - 277

Published: July 23, 2020

Language: Английский

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Identification of Potential Biomarkers and Immune Features of Sepsis Using Bioinformatics Analysis

Mediators of Inflammation, Journal Year: 2020, Volume and Issue: 2020, P. 1 - 12

Published: Oct. 9, 2020

Sepsis remains a major global concern and is associated with high mortality morbidity despite improvements in its management. Markers currently use have shortcomings such as lack of specificity failures the early detection sepsis. In this study, we aimed to identify key genes involved molecular mechanisms sepsis search for potential new biomarkers treatment targets using bioinformatics analyses. Three datasets (GSE95233, GSE57065, GSE28750) were downloaded from public functional genomics data repository Gene Expression Omnibus. Differentially expressed (DEGs) identified R packages (Affy limma). Functional enrichment DEGs was analyzed DAVID database. Protein-protein interaction networks derived STRING database visualized Cytoscape software. Potential biomarker receiver operating characteristic (ROC) curves package (pROC). The three included 156 whole blood RNA samples 89 patients 67 healthy controls. Between two groups, 568 identified, among which 315 upregulated 253 downregulated septic group. These enriched pathways mainly innate immune response, T-cell biology, antigen presentation, natural killer cell function. ROC analyses nine genes—LRG1, ELANE, TP53, LCK, TBX21, ZAP70, CD247, ITK, FYN—as Real-time PCR confirmed that expression seven these accordance microarray results. This study revealed imbalanced responses at transcriptomic level during

Language: Английский

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A new tool for sepsis screening in the Emergency Department

Clinical Chemistry and Laboratory Medicine (CCLM), Journal Year: 2021, Volume and Issue: 59(9), P. 1600 - 1605

Published: April 13, 2021

Abstract Objectives In this study, we developed and evaluated the diagnostic accuracy of Sepsis Index for early sepsis screening in Emergency Department (ED). Methods is based on combination monocyte distribution width (MDW) mean volume (MMV). Index≥1 was selected to define sepsis. We tested its an ED population stratified four groups: controls, Systemic Inflammatory Response Syndrome (SIRS), infection, sepsis, according Sepsis-2 criteria. Results Patients with displayed higher median value than patients without At receiver operating characterictis (ROC) curve analysis prediction area under (AUC) MDW were similar: 0.966 (95%CI 0.947–0.984), 0.964 0.942–0.985), respectively. showed increased specificity (94.7 vs. 90.6%), any decrease sensitivity (92.0%). Additionally, LR+ from 9.8 17.4 (Sepsis Index), substantial change LR− (respectively 0.09 0.08). Finally, PPV 0.286 0.420 Index). Conclusions improves alone screening.

Language: Английский

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Proadrenomedullin in Sepsis and Septic Shock: A Role in the Emergency Department

Medicina, Journal Year: 2021, Volume and Issue: 57(9), P. 920 - 920

Published: Sept. 1, 2021

Sepsis and septic shock represent a leading cause of mortality in the Emergency Department (ED) Intensive Care Unit (ICU). For these life-threating conditions, different diagnostic prognostic biomarkers have been studied. Proadrenomedullin (MR-proADM) is biomarker that can predict organ damage risk imminent death patients with shock, as shown by large amount data literature. The aim our narrative review to evaluate role MR-proADM context Medicine summarize current knowledge serum indicator useful determine an early diagnosis long-term sepsis shock. We performed electronic literature investigate ED. searched papers on PubMed®, Cochrane®, UptoDate®, Web Science® had published last 10 years. Data extracted from this are not conclusive, but they show may be helpful stratify cases degrees damage, guiding emergency physicians succeeding therapeutic workup. conditions high complexity mortality. In ED, crucial order provide treatment improve patient survival. Diagnosis prognosis often result combination several tests. opinion, testing for directly ED could contribute improving assessment patients, facilitating subsequent clinical management intensive physicians, more studies needed confirm results.

Language: Английский

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Conventional and unconventional T-cell responses contribute to the prediction of clinical outcome and causative bacterial pathogen in sepsis patients

Clinical & Experimental Immunology, Journal Year: 2024, Volume and Issue: 216(3), P. 293 - 306

Published: Feb. 28, 2024

Sepsis is characterized by a dysfunctional host response to infection culminating in life-threatening organ failure that requires complex patient management and rapid intervention. Timely diagnosis of the underlying cause sepsis crucial, identifying those at risk complications death imperative for triaging treatment resource allocation. Here, we explored potential explainable machine learning models predict mortality causative pathogen patients. By using modelling pipeline employing multiple feature selection algorithms, demonstrate feasibility integrative patterns from clinical parameters, plasma biomarkers, extensive phenotyping blood immune cells. While no single variable had sufficient predictive power, combined five more features showed macro area under curve (AUC) 0.85 90-day after diagnosis, AUC 0.86 discriminate between Gram-positive Gram-negative bacterial infections. Parameters associated with cellular contributed most mortality, notably, proportion T cells among PBMCs, together expression CXCR3 CD4+ CD25 mucosal-associated invariant (MAIT) Frequencies Vδ2+ γδ profound impact on prediction infections, alongside other T-cell-related variables total neutrophil count. Overall, our findings highlight added value measuring activation conventional unconventional patients combination immunological, biochemical, parameters.

Language: Английский

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Navigating the Modern Landscape of Sepsis: Advances in Diagnosis and Treatment

International Journal of Molecular Sciences, Journal Year: 2024, Volume and Issue: 25(13), P. 7396 - 7396

Published: July 5, 2024

Sepsis poses a significant threat to human health due its high morbidity and mortality rates worldwide. Traditional diagnostic methods for identifying sepsis or causative organisms are time-consuming contribute rate. Biomarkers have been developed overcome these limitations currently used diagnosis, prognosis prediction, treatment response assessment. Over the past few decades, more than 250 biomarkers identified, of which in clinical decision-making. Consistent with diagnosing sepsis, there is no specific sepsis. Currently, general conservative includes timely antibiotic use hemodynamic support. When planning sepsis-specific treatment, it important select most suitable patient, considering heterogeneous nature This comprehensive review summarizes current evolving therapeutic approaches

Language: Английский

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Plasma miR‐125a and miR‐125b in sepsis: Correlation with disease risk, inflammation, severity, and prognosis

Journal of Clinical Laboratory Analysis, Journal Year: 2020, Volume and Issue: 34(2)

Published: Feb. 1, 2020

Abstract Objective This study aimed to explore the predictive value of microRNA (miR)‐125a and miR‐125b for sepsis risk, their correlations with inflammation, disease severity, 28‐day mortality in patients. Methods Totally, 150 patients healthy controls (HCs) were enrolled. Plasma samples separated from blood obtained HCs detect miR‐125a expressions by real‐time quantitative polymerase chain reaction. Besides, was assessed. MiR‐125a elevated compared HCs, further receiver operating characteristics (ROC) curve analysis displayed that (area under (AUC): 0.749, 95% CI: 0.695‐0.803) (AUC: 0.839, 0.795‐0.882) could predict risk. As no correlation C‐reactive protein (CRP), tumor necrosis factor‐α (TNF‐α), interleukin (IL)‐6, IL‐17, IL‐23 observed patients, while positively associated CRP, TNF‐α, IL‐6, IL‐23. Regarding correlated acute physiology chronic health care evaluation II sequential organ failure assessment score ROC exhibited failed risk 0.588, 0.491‐0.685) had a potential predicting 0.699, 0.603‐0.795). Conclusion Both only exhibits potency management prognosis prediction

Language: Английский

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Effects of impaired microvascular flow regulation on metabolism‐perfusion matching and organ function

Microcirculation, Journal Year: 2020, Volume and Issue: 28(3)

Published: Nov. 25, 2020

Impaired tissue oxygen delivery is a major cause of organ damage and failure in critically ill patients, which can occur even when systemic parameters, including cardiac output arterial hemoglobin saturation, are close to normal. This review addresses transport mechanisms at the microcirculatory scale, how hypoxia may spite adequate convective supply. The structure microcirculation intrinsically heterogeneous, with wide variations vessel diameters flow pathway lengths, consequently also blood rates levels. dynamic processes structural adaptation regulation continually adjust microvessel compensate for heterogeneity, redistributing according metabolic needs ensure oxygenation. A key role played by conducted responses, generated propagated endothelial cells signal upstream arterioles dilate response local hypoxia. Several pathophysiological conditions impair regulation, causing leading failure. Therapeutic measures targeted parameters not address or worsen oxygenation microvascular level. Restoration patients depend on restoration cell function, responses.

Language: Английский

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