Hematological Biomarker in the Emergency Department
Monocyte Distribution Width (MDW) is a measure of increased morphological variability of monocytes in response to bacterial, viral or fungal infections. The quantitative analysis of MDW has received regulatory-clearance as an aid in identifying severity of infection and risk of sepsis in adult patients in the ED.
Considered with other signs and symptoms, the value of MDW helps differentiate sepsis from non-septic presentations, including non-infectious systemic inflammatory response.4 This parameter is available early in patient assessment as part of a complete blood count with differential test (CBC-diff) on the DxH 900 and DxH 690T hematology analyzers*, with no impact to workflow.
What Makes Monocyte Distribution Width Unique?
MDW, proprietary to Beckman Coulter analyzers, is the only FDA-cleared hematological biomarker that helps to establish severity of infection and risk of sepsis in adult patients in the ED.
Reduce Dx Uncertainty
MDW helps reduce diagnostic uncertainty. It is available early to help clinicians escalate or de-escalate care in patients with suspected infectious etiology.
MDW is available early in patient assessment as a part of a CBC-diff, no impact to workflow.
New Society for Academic Emergency Medicine podcast series, “Current and Novel Approaches to Sepsis Detection in the ED.” SAEM Research and EMTIDE Interest Group members and academic emergency medicine providers discuss best practices for early sepsis identification and improved patient outcomes and the research surrounding biomarkers in an acute clinical setting.
Dr. Phillip Levy, Professor of Emergency Medicine at Wayne State University, published Hiding in Plain Sight: The Case for MDW Parameter in Early Sepsis Screening in Becker Health. Dr. Levy reviews sepsis screening technology and latest tools that can impact hospital metrics.
In the latest installment of “Conversations with Industry,” from the American College of Emergency Physicians, MDW is the topic of focus for sepsis identification in the ED. Dr. Nima Sarani, from the University of Kansas Medical Center, discusses the latest evidence and practical utility of MDW.
MDW Patient Case Studies
Latest Scientific Presentations
Watch the ACEP22 recording where Drs. Levy and Sarani review the latest clinical evidence for MDW derived from the series of multicenter studies, discuss implications of these results for U.S. standards of patient care and present practical aspects of MDW utility in clinical practice. Watch recording ›
MDW has been studied for the past decade with more than 16 peer-review publications and over 21,000+ patients6-16, confirming the robustness and reproducibility of MDW performance in different patient populations. View these peer-reviewed studies to learn about the clinical utility of MDW.
Peer-Reviewed Clinical Study Critical Care Medicine Study
Discover how a multicenter study validated MDW as a novel indicator for Sepsis-2 and Sepsis-3 in high-risk emergency department patients.Read study
Peer-Reviewed Clinical Study Journal of Intensive Care
New analysis from a pivotal study shows that patients with abnormal MDW values at presentation have increased odds of sepsis.Read study
Peer-Reviewed Clinical Study American College of Chest Physicians Study
Clinical research shows that MDW adds value to WBC count for early sepsis detection in the ED.Read study
* Using Early Sepsis Indicator application on Beckman Coulter DxH 900 and 690T hematology analyzer. Activation required.
1. Rudd, et al., Lancet. 2020 Jan 18; 395 (10219): 200-211.
2. Torio C, Moore B. “National Inpatient Hospital Costs: The Most Expensive Conditions by Payer.” www.hcup-us.ahrq.gov/reports/statbriefs/sb204-Most-Expensive-Hospital-Conditions.pdf, May 2016. Accessed 15 Jan. 2018.
3. Filbin, M. R., Lynch, J., Gillingham, T. D., Thorsen, J. E., Pasakarnis, C. L., Nepal, S., et al. Presenting Symptoms Independently Predict Mortality in Septic Shock. Critical Care Medicine, 2018; 46(10), 1592-1599. https://doi.org/10.1097/ccm.0000000000003260.
4. UniCel DxH 900 Coulter Cellular Analysis System Early Sepsis Indicator (ESId) Application AddendumPN C42014AA.
5. Sepsis Pivotal Repository PN C54726 Rev. AB located in CPDM.
6. Malinovska, A et al., Monocyte distribution width as part of a broad pragmatic sepsis screen in the emergency department. JACEP Open. 2022; 3:e12679. https://doi.org/10.1002/emp2.12679
7. E. Piva et al., Monocyte Distribution Width (MDW) Parameter as a Sepsis Indicator in Intensive Care Units, Clin Chem Lab Med 2021. https://doi.org/10.1515/cclm-2021-0192
8. P. Hausfater et al., Monocyte Distribution Width (MDW) Performance as an Early Sepsis Indicator in the Emergency Department: Comparison with CRP and Procalcitonin in a Multicenter International European Prospective Study, Crit Care 2021; 25, 227. https://doi.org/10.1186/s13054-021-03622-5
9. A. Woo et al., Monocyte Distribution Width Compared with C-Reactive Protein and Procalcitonin for Early Sepsis Detection in the Emergency Department, PLoS ONE 2021; 16(4): e0250101. https://doi.org/10.1371/journal.pone.0250101
10. H. Lin et al., Clinical Impact of Monocyte Distribution Width and Neutrophil-to-Lymphocyte Ratio for Distinguishing COVID-19 and Influenza from Other Upper Respiratory Tract Infections: A Pilot Study, PLoS ONE 2020 15(11): e0241262. https://doi.org/10.1371/journal.pone.0241262
11. L. Agnello et al., Monocyte Distribution Width (MDW) as a Screening Tool for Sepsis in the Emergency Department, Clin Chem Lab Med 2020; 58(11):1951-1957. https://doi:10.1515/cclm-2020-0417
12. G. Riva et al., Monocyte Distribution Width (MDW) as Novel Inflammatory Marker with Prognostic Significance in COVID 19 Patients, Scientific Report 2021; 11:12716. https://doi.org/10.1038/s41598-021-92236-6
13. Marcos-Morales, A et al., Elevated monocyte distribution width in trauma: An early cellular biomarker of organ dysfunction, Injury 2021; S0020-1383(21):00933-00935. https://doi.org/10.1016/j.injury.2021.11.026
14. E. Crouser et al., Monocyte Distribution Width: A Novel Indicator of Sepsis-2 and Sepsis-3 in High-Risk Emergency Department Patients, Critical Care Med 2019; 47:1018-1025. https://doi.org/10.1097/CCM.0000000000003799
15. E. Crouser et al., Improved Early Detection of Sepsis in the ED with a Novel Monocyte Distribution Width Biomarker, CHEST 2017; 152(3):518-526. https://doi.org/10.1016/j.chest.2017.05.039
16. A. Ognibene et al., Elevated Monocyte Distribution Width in COVID-19 Patients: The Contribution of the Novel Sepsis Indicator, Clinica Chimica Acta 2020; 509: 22-24. https://doi.org/10.1016/j.cca.2020.06.002