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[Chest发表论文]：单核细胞分布宽度作为诊断感染的标志物

2023年08月15日 ⁄ 时讯速递, 进展交流 ⁄ 已关闭评论

CRITICAL CARE: ORIGINAL RESEARCH| VOLUME 164, ISSUE 1, P101-113, JULY 2023Download Full Issue

Monocyte Distribution Width as a Diagnostic Marker for Infection: A Systematic Review and Meta-analysis

Alexandra Malinovska, Benjamin Hernried, Andrew Lin, et al

Chest 2023; 164: 101-113 Published:January 18, 2023

DOI:https://doi.org/10.1016/j.chest.2022.12.049

Background

Monocyte distribution width (MDW) is an emerging biomarker for infection. It is available easily and quickly as part of the CBC count, which is performed routinely on hospital admission. The increasing availability and promising results of MDW as a biomarker in sepsis has prompted an expansion of its use to other infectious diseases.

Research Question

What is the diagnostic performance of MDW across multiple infectious disease outcomes and care settings?

Study Design and Methods

A systematic review of the diagnostic performance of MDW across multiple infectious disease outcomes was conducted by searching PubMed, Embase, Scopus, and Web of Science through February 4, 2022. Meta-analysis was performed for outcomes with three or more reports identified (sepsis and COVID-19). Diagnostic performance measures were calculated for individual studies with pooled estimates created by linear mixed-effects models.

Results

We identified 29 studies meeting inclusion criteria. Most examined sepsis (19 studies) and COVID-19 (six studies). Pooled estimates of diagnostic performance for sepsis differed by reference standard (Second vs Third International Consensus Definitions for Sepsis and Septic Shock criteria) and tube anticoagulant used and ranged from an area under the receiver operating characteristic curve (AUC) of 0.74 to 0.94, with mean sensitivity of 0.69 to 0.79 and mean specificity of 0.57 to 0.86. For COVID-19, the pooled AUC of MDW was 0.76, mean sensitivity was 0.79, and mean specificity was 0.59.

Interpretation

MDW exhibited good diagnostic performance for sepsis and COVID-19. Diagnostic thresholds for sepsis should be chosen with consideration of reference standard and tube type used.