Emergency Care Journal · Published 2026-07-15 · DOI 10.4081/ecj.2026.15933
Lucrezia Fiorentino, Andrea Piccioni, Francesco Franceschi
Background. Monocyte Distribution Width (MDW) measures the volumetric distribution width of monocytes, reflecting monocytic anisocytosis, and is detected using advanced hematological analyzers. Different studies have shown that an increased MDW value is associated with a higher risk of sepsis and that its combination with clinical parameters (such as qSOFA) and other biomarkers (CRP, PCT) can enhance diagnostic sensitivity and risk stratification capacity. Other advantages are its ease of measurement, its high negative predictive value (NPV) and the absence of correlations with demographic factors such as age, sex, or surgical conditions. Sepsis is a complex and potentially life-threatening syndrome which can lead to death. Early diagnosis is crucial to improving prognosis and reducing hospital management costs. Methods. We will set up a prospective study in ED of Policlinico Universitario A. Gemelli on the role of monocyte distribution width (MDW) as a diagnostic biomarker for sepsis, highlighting its advantages, limitations, and potential clinical applications. We will enroll patients over 18 years who are able to give informed consent. Patients with a suspected clinical condition will be asked for CBC (containing MDW). A cutoff value of 20 will be used to indicate sepsis positivity, as supported by most studies. Expected Results. The primary endpoint is based on evaluating the diagnostic performance of MDW, while the secondary endpoints involve comparison with other markers such as PCT and PSP. Finally, we may repeat MDW measurements to assess its utility in guiding antibiotic therapy management.
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Fiorentino, L., Piccioni, A., Franceschi, F. (2026). 04 | Monocyte distribution width in early diagnosis of sepsis. Emergency Care Journal. https://doi.org/10.4081/ecj.2026.15933