by Huang, Yu-Hsuan;
Chen, Ching-Jung; Shao, Shih-Chieh; Li, Chih‑Huang; Hsiao, Chien-Han; Niu,
Kuang-Yu; Yen, Chieh-Ching
Critical Care Medicine ():10.1097/CCM.0000000000005820,
March 06, 2023.
Objectives:
We performed a systemic review and meta‐analysis to evaluate
the diagnostic accuracy of monocyte distribution width (MDW) and to compare
with procalcitonin and C‐reactive protein (CRP), in adult patients with sepsis.
Data Sources:
A systematic literature search was performed in PubMed,
Embase, and the Cochrane Library to identify all relevant diagnostic accuracy
studies published before October 1, 2022.
Study Selection:
Original articles reporting the diagnostic accuracy of MDW
for sepsis detection with the Sepsis-2 or Sepsis-3 criteria
were included.
Data Extraction:
Study data were abstracted by two independent reviewers
using a standardized data extraction form.
Data Synthesis:
Eighteen studies were included in the meta‐analysis. The
pooled sensitivity and specificity of MDW were 84% (95% CI [79–88%]) and 68%
(95% CI [60–75%]). The estimated diagnostic odds ratio and the area under the
summary receiver operating characteristic curve (SROC) were 11.11 (95% CI
[7.36–16.77]) and 0.85 (95% CI [0.81–0.89]). Significant heterogeneity was
observed among the included studies. Eight studies compared the diagnostic
accuracies of MDW and procalcitonin, and five studies compared the diagnostic
accuracies of MDW and CRP. For MDW versus procalcitonin, the area under the
SROC was similar (0.88, CI = 0.84–0.93 vs 0.82, CI = 0.76–0.88). For MDW versus
CRP, the area under the SROC was similar (0.88, CI = 0.83–0.93 vs 0.86, CI =
0.78–0.95).
Conclusions:
The results of the meta-analysis indicate that MDW is a
reliable diagnostic biomarker for sepsis as procalcitonin and CRP.
Further studies investigating the combination of MDW and other biomarkers are
advisable to increase the accuracy in sepsis detection.
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