Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Sep;19(6):1567-1575.
doi: 10.1007/s11739-024-03632-5. Epub 2024 May 9.

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

Carlos A Amado  1   2   3 , Cristina Ghadban  4   5 , Adriana Manrique  6 , Joy Selene Osorio  6 , Milagros Ruiz de Infante  7 , Rodrigo Perea  8 , Laura Gónzalez-Ramos  6 , Sergio García-Martín  6 , Lucia Huidobro  6 , Javier Zuazaga  6 , Patricia Druet  6 , Pedro Argos  6 , Claudia Poo  6 , Ma Josefa Muruzábal  9 , Helena España  10 , Guido Andretta  6
Affiliations

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

Carlos A Amado et al. Intern Emerg Med. 2024 Sep.

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.

Keywords: COPD; DECAF; Exacerbation; MDW; Prognosis.

PubMed Disclaimer

Conflict of interest statement

Carlos Amado has received speaker or consulting fees from Boehringer Ingelheim, Pfizer, AstraZeneca, Novartis, Chiesi, Faes Farma, Esteve and GSK. Guido Andretta has received speaker fees from AstraZeneca. Javier Zuazaga has received speaker fees from Boehringer Ingelheim. The rest of the authors do not have any conflict of interest.

Figures

Fig. 1
Fig. 1
Flowchart for patient selection
Fig. 2
Fig. 2
High MDW (> 21.5 units) as a predictor of A ICU admission, B mortality and C ICU admission or mortality. MDW monocyte distribution width
Fig. 3
Fig. 3
Receiver operator characteristic curve showing the discrimination ability of MDW, C-reactive protein, neutrophil to lymphocyte ratio, the DECAF score and the MDW–DECAF score for in-hospital mortality or ICU admission. MDW monocyte distribution width, DECAF dyspnea, eosinopenia, consolidation, acidemia and atrial fibrillation score
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. GBD Chronic Respiratory Disease Collaborators (2020) Prevalence and attributable health burden of chronic respiratory diseases, 1990–2017: a systematic analysis for the global burden of disease study 2017. Lancet Respir Med 8:585–596 10.1016/S2213-2600(20)30105-3 - DOI - PMC - PubMed
    1. Soler-Cataluña JJ, Martínez-García MA, Román Sánchez P, Salcedo E, Navarro M, Ochando R (2005) Severe acute exacerbations, and mortality in patients with chronic obstructive pulmonary disease. Thorax 60:925–931 10.1136/thx.2005.040527 - DOI - PMC - PubMed
    1. Dransfield MT, Kunisaki KM, Strand MJ, Anzueto A, Bhatt SP, Bowler RP, Criner GJ, Curtis JL, Hanania NA, Nath H, Putcha N, Roark SE, Wan ES, Washko GR, Wells JM, Wendt CH, Make BJ, COPDGene Investigators (2017) Acute exacerbations and lung function loss in smokers with and without chronic obstructive pulmonary disease. Am J Respir Crit Care Med 195:324–330 10.1164/rccm.201605-1014OC - DOI - PMC - PubMed
    1. Spencer S, Jones PW, GLOBE Study Group (2003) Time course of recovery of health status following an infective exacerbation of chronic bronchitis. Thorax 58:589–593 10.1136/thorax.58.7.589 - DOI - PMC - PubMed
    1. Suissa S, Dell’Aniello S, Ernst P (2012) Long-term natural history of chronic obstructive pulmonary disease: severe exacerbations and mortality. Thorax 67:957–963 10.1136/thoraxjnl-2011-201518 - DOI - PMC - PubMed

Substances

Grants and funding