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Open Access 09-05-2024 | Chronic Obstructive Lung Disease | IM - ORIGINAL

Monocyte distribution width (MDW) and DECAF: two simple tools to determine the prognosis of severe COPD exacerbation

Authors: Carlos A. Amado, Cristina Ghadban, Adriana Manrique, Joy Selene Osorio, Milagros Ruiz de Infante, Rodrigo Perea, Laura Gónzalez-Ramos, Sergio García-Martín, Lucia Huidobro, Javier Zuazaga, Patricia Druet, Pedro Argos, Claudia Poo, Ma Josefa Muruzábal, Helena España, Guido Andretta

Published in: Internal and Emergency Medicine

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Abstract

Monocyte distribution width (MDW) has been associated with inflammation and poor prognosis in various acute diseases. Chronic obstructive pulmonary disease (COPD) exacerbations (ECOPD) are associated with mortality. The objective of this study was to evaluate the utility of the MDW as a predictor of ECOPD prognosis. This retrospective study included patient admissions for ECOPD. Demographic, clinical and biochemical information; intensive care unit (ICU) admissions; and mortality during admission were recorded. A total of 474 admissions were included. MDW was positively correlated with the DECAF score (r = 0.184, p < 0.001) and C-reactive protein (mg/dL) (r = 0.571, p < 0.001), and positively associated with C-RP (OR 1.115 95% CI 1.076–1.155, p < 0.001), death (OR 9.831 95% CI 2.981– 32.417, p < 0.001) and ICU admission (OR 11.204 95% CI 3.173–39.562, p < 0.001). High MDW values were independent risk factors for mortality (HR 3.647, CI 95% 1.313–10.136, p = 0.013), ICU admission (HR 2.550, CI 95% 1.131–5.753, p = 0.024), or either mortality or ICU admission (HR 3.084, CI 95% 1.624–5.858, p = 0.001). In ROC analysis, a combined MDW–DECAF score had better diagnostic power (AUC 0.777 95% IC 0.708–0.845, p < 0.001) than DECAF (p = 0.023), MDW (p = 0.026) or C-RP (p = 0.002) alone. MDW is associated with ECOPD severity and predicts mortality and ICU admission with a diagnostic accuracy similar to that of DECAF and C-RP. The MDW– DECAF score has better diagnostic accuracy than MDW or DECAF alone in identifying mortality or ICU admission.
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Metadata
Title
Monocyte distribution width (MDW) and DECAF: two simple tools to determine the prognosis of severe COPD exacerbation
Authors
Carlos A. Amado
Cristina Ghadban
Adriana Manrique
Joy Selene Osorio
Milagros Ruiz de Infante
Rodrigo Perea
Laura Gónzalez-Ramos
Sergio García-Martín
Lucia Huidobro
Javier Zuazaga
Patricia Druet
Pedro Argos
Claudia Poo
Ma Josefa Muruzábal
Helena España
Guido Andretta
Publication date
09-05-2024
Publisher
Springer International Publishing
Published in
Internal and Emergency Medicine
Print ISSN: 1828-0447
Electronic ISSN: 1970-9366
DOI
https://doi.org/10.1007/s11739-024-03632-5
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