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Background <p>Monocyte distribution width (MDW) has been proposed as an indicator of sepsis. Because MDW can be measured within approximately 1&#xa0;min as part of routine white blood cell differential analysis, it may serve as a practical tool for rapid assessment of bacterial pneumonia severity. However, established biomarkers such as procalcitonin (PCT) require additional processing time and cost.</p> Methods <p>This retrospective study included 252 patients hospitalised with bacterial pneumonia. Disease severity was assessed using the sequential organ failure assessment (SOFA), age, dehydration, respiration, orientation, and pressure (A-DROP), and pneumonia severity index (PSI) scoring systems. The predictive performance of WBC count, C-reactive protein levels, MDW, and PCT levels was analysed. Correlation analysis between MDW and PCT levels was also performed.</p> Results <p>Both MDW and PCT were independently associated with A-DROP and SOFA scores in multivariable analyses, whereas only PCT was associated with PSI score. A moderate positive correlation was observed between MDW and PCT levels (r = 0.6763, p &lt; 0.001). ROC analysis showed that PCT had the highest discriminatory performance (AUC 0.664), whereas MDW demonstrated modest but clinically informative performance (AUC 0.597).</p> Conclusions <p>PCT remains a robust indicator of bacterial pneumonia severity. MDW may serve as a rapid, cost-effective adjunct biomarker that supports early clinical assessment, particularly in time-sensitive settings such as the emergency department, where immediate decision-making is required.</p>

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Utility of monocyte distribution width as a rapid biomarker for severity assessment in bacterial pneumonia: a retrospective study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月19日

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  • Kentaro Wakamatsu,
  • Zenzo Nagasawa,
  • Kouta Katsuki,
  • Hiroyuki Kumazoe,
  • Tomoki Takeyama,
  • Shigesato Inoue,
  • Katsuyuki Katahira,
  • Mizuko Ose,
  • Naotaka Noda,
  • Kouta Miyamoto,
  • Daigo Kawano,
  • Miyoko Tatsuta,
  • Satoru Fukuyama,
  • Miiru Izumi,
  • Ruriko Kiyotani,
  • Izumi Fukui,
  • Satomi Asai,
  • Nobuhiko Nagata,
  • Masayuki Kawasaki,
  • Hozumi Yamada

摘要

Background

Monocyte distribution width (MDW) has been proposed as an indicator of sepsis. Because MDW can be measured within approximately 1 min as part of routine white blood cell differential analysis, it may serve as a practical tool for rapid assessment of bacterial pneumonia severity. However, established biomarkers such as procalcitonin (PCT) require additional processing time and cost.

Methods

This retrospective study included 252 patients hospitalised with bacterial pneumonia. Disease severity was assessed using the sequential organ failure assessment (SOFA), age, dehydration, respiration, orientation, and pressure (A-DROP), and pneumonia severity index (PSI) scoring systems. The predictive performance of WBC count, C-reactive protein levels, MDW, and PCT levels was analysed. Correlation analysis between MDW and PCT levels was also performed.

Results

Both MDW and PCT were independently associated with A-DROP and SOFA scores in multivariable analyses, whereas only PCT was associated with PSI score. A moderate positive correlation was observed between MDW and PCT levels (r = 0.6763, p < 0.001). ROC analysis showed that PCT had the highest discriminatory performance (AUC 0.664), whereas MDW demonstrated modest but clinically informative performance (AUC 0.597).

Conclusions

PCT remains a robust indicator of bacterial pneumonia severity. MDW may serve as a rapid, cost-effective adjunct biomarker that supports early clinical assessment, particularly in time-sensitive settings such as the emergency department, where immediate decision-making is required.