Monocyte Distribution Width (MDW) as a useful indicator for early screening of sepsis and efficacy in screening patients with positive blood culture: A Prospective Observational study
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 入组人数
- 105
- 试验地点
- 1
- 主要终点
- Patients will be grouped into blood culture positive and negative and Monocyte Distribution width, C-reactive protein (CRP), and Procalcitonin (PCT) value will be correlated with the blood culture and other cultures in all the groups.
研究概览
简要总结
Monocytes can contribute to the process of inflammation or infection by secreting cytokines, however, there is increasing evidence that monocytes undergo morphological changes, including volume increase, during inflammatory or infectious processes and sepsis.
Polilli et al compared patients with no sepsis, sepsis, and septic shock and found that MDW values were significantly higher in patients with sepsis or septic shock than in the no sepsis group.
As MDW increases in response to bacterial infection in the blood, MDW is related to the blood culture results. Although the blood culture test is the gold standard in diagnosing bacterial infections in the blood, low sensitivity, and false positivity are still valid concerns
Patients to be admitted will be categorized into 3 groups: sepsis, probable sepsis, and control group according to sequential organ failure assessment (SOFA) criteria and Sepsis-3 criteria definitions. Institutions Sepsis Code activation in ER, will also be used as an enrolling tool in this study.
A control group will be taken comprising of patients with no evidence of infection like patients presenting to ICU with Cerebrovascular accident (CVA) without aspiration, class I (clean) post-operative care patients, and head trauma patients.
All routine blood investigations will be sent including Complete Blood Count (CBC), MDW, and Procalcitonin (PCT), along with all other tests that could define infection, like imaging.
Blood culture sensitivity (One set of aerobic and anaerobic/ Two sets of aerobic and anaerobic from two different sites if an invasive medical device is present) will be sent in all patients using all standard aseptic precautions. Other cultures will be sent as per the cause of sepsis suspicion.
研究设计
- 研究类型
- Observational
入排标准
- 年龄范围
- 18.00 Year(s) 至 85.00 Year(s)（—）
- 性别
- All
入选标准
- •Admitted in ICU in Ruby Hall clinic with suspicion of sepsis as defined by sepsis 3 criteria
- •Those whose complete blood count, blood culture and other lab tests will be sent within 12hours of admission.
排除标准
- •Patients with an inadequately low monocyte count (less than 100/μl)
- •Patients with a history of onco-haematological disease, immunocompromised, that could affect monocyte size and activation in response to infection.
- •Pregnant women
- •Patients admitted more than once to prevent duplication of data.
结局指标
主要结局
Patients will be grouped into blood culture positive and negative and Monocyte Distribution width, C-reactive protein (CRP), and Procalcitonin (PCT) value will be correlated with the blood culture and other cultures in all the groups.
时间窗: within 2years
次要结局
- Patient with above parameters like MDW, PCT, CRP and Neutrophil: lymphocyte ratio value will be correlated for each group and the significance of MDW in predicting sepsis.(within 2years)
- -MDW efficacy in predicting sepsis in comparison to PCT and its variability in different group of patients.(within 2 years)
- A follow-up of MDW, PCT, and CRP will be performed later in the course of sepsis among survivors and non-survivors to assess the prognostic value.(within 2 years)
- -Using MDW as prognostication marker to see the length of ICU stay.(within 2years)
研究者
Dr Priyanka mohapatra
Ruby Hall Clinic, Pune