Agnello et al used the ratio of the monocyte distribution width to the mean monocyte volume to identify patients who may have sepsis. This was named the Sepsis Index. The authors are from the University of Palermo.
Patient selected: Emergency Department
Parameters:
(1) monocyte distribution width (MDW; reference interval 16.5 to 22.7), units unclear (Beckman uses IU)
(2) mean monocyte volume (MMV), units not stated but may be femtoliters (normal around 174)
sepsis index =
= MDW / MMV
Interpretation:
• The MDW is elevated (>= 23) in patients with sepsis.
• A septic index >= 1 is associated with sepsis.
NOTE:
(1) Since the MMV has a much higher value than MDW, it is difficult for the ratio as shown to be achieved.
(2) If the standard deviation of MMV (SDMV) septic is used, then the ratio makes more sense. This has a range of 18.05 to 20.61 in controls)
(3) In Table 2, page 1603 (Agnello, 2021) the AUC for the standard deviation of the mean monocyte volume (SDMV) is 0.956, which is better than the MMV.
Performance:
• The authors reported an area under the ROC curve os 0.96.
