A new tool for sepsis screening in the Emergency Department

Luisa Agnello, Alessandro Iacona, Bruna Lo Sasso, Concetta Scazzone, Michele Pantuso, Rosaria Vincenza Giglio, Caterina Maria Gambino, Anna Maria Ciaccio, Giulia Bivona, Matteo Vidali, Marcello Ciaccio

Research output: Contribution to journalArticlepeer-review

Abstract

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

Original languageEnglish
Pages (from-to)1600-1605
Number of pages6
JournalClinical Chemistry and Laboratory Medicine
Volume59
Issue number9
DOIs
Publication statusPublished - Aug 1 2021
Externally publishedYes

Keywords

  • biomarker
  • Emergency Department
  • mean monocyte volume (MMV)
  • monocyte distribution width (MDW)
  • sepsis

ASJC Scopus subject areas

  • Clinical Biochemistry
  • Biochemistry, medical

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