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Value of monocyte distribution width for predicting severe cholecystitis: a retrospective cohort study

  • Chih-Hao Kao , Yen-Hung Liu , Wei-Kung Chen , Fen-Wei Huang , Tai-Yi Hsu , Han-Tsung Cheng , Po-Ren Hsueh , Chiung-Tzu Hsiao , Shih-Yun Wu and Hong-Mo Shih ORCID logo EMAIL logo
Published/Copyright: April 21, 2023
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Clinical Chemistry and Laboratory Medicine (CCLM)
From the journal Clinical Chemistry and Laboratory Medicine (CCLM) Volume 61 Issue 10

Abstract

Objectives

Acute cholecystitis is a gallbladder inflammation, and the Tokyo Guidelines 2018 (TG18) can be used to predict its presence and severity with high sensitivity and specificity. However, TG18 grading require the collection of excessive parameters. Monocyte distribution width (MDW) is a parameter used to detect sepsis early. Therefore, we investigated the correlation between MDW and cholecystitis severity.

Methods

We conducted a retrospective study of patients with cholecystitis admitted to our hospital from November 1, 2020, to August 31, 2021. The primary outcome was severe cholecystitis analyzed as a composite of intensive care unit (ICU) admission and mortality. The secondary outcomes were length of hospital stay, ICU stay, and TG18 grade.

Results

A total of 331 patients with cholecystitis were enrolled in this study. The average MDWs for TG18 grades 1, 2, and 3 were 20.21 ± 3.99, 20.34 ± 3.68, and 25.77 ± 6.61, respectively. For patients with severe cholecystitis, the average MDW was 25.42 ± 6.83. Using the Youden J statistic, we set a cutoff MDW of 21.6. Multivariate logistic regression revealed that patients with an MDW≥21.6 had a higher risk of severe cholecystitis (odds ratio=4.94; 95 % CI, 1.71–14.21; p=0.003). The Cox model revealed that patients with an MDW≥21.6 were more likely to have a prolonged hospital stay.

Conclusions

MDW is a reliable indicator of severe cholecystitis and prolonged length of stay. Additional MDW testing and a complete blood count may provide simple information for predicting severe cholecystitis early.

Keywords: cholecystitis; inflammatory biomarker; monocyte distribution width; sepsis
Corresponding author: Hong-Mo Shih, MD, Department of Emergency Medicine, China Medical University Hospital, Taichung, Taiwan; School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan; and Department of Public Health, China Medical University, No. 91, Xueshi Road, North District, Taichung, Taiwan, E-mail:
Chih-Hao Kao and Yen-Hung Liu contributed equally to this work.

Funding source: China Medical University Hospital

Award Identifier / Grant number: DMR-112-165

Acknowledgments

This manuscript was edited by Wallace Academic Editing. We thank their efforts in revising and improving the manuscript.

  1. Research funding: This work was supported, in part, by China Medical University Hospital under grant (DMR-112-165). The funding agencies had no role in the design and conduct of the study; collection, management, analysis, and interpretation of data; preparation, review, approval of manuscript; or decision to submit manuscript for publication.

  2. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: Authors state no conflict of interest.

  4. Informed consent: Not applicable.

  5. Ethical approval: This study was approved by the research Ethics Committee of China Medical University and Hospital (referencing number: CMUH110-REC3-106).

  6. Data availability: The datasets generated and analyzed in this study are not publicly available due to the nondisclosure agreement of the Institutional Review Board. The datasets are available from the corresponding author upon reasonable request.

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Received: 2023-02-24
Accepted: 2023-04-09
Published Online: 2023-04-21
Published in Print: 2023-09-26

© 2023 Walter de Gruyter GmbH, Berlin/Boston

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https://doi.org/10.1515/cclm-2023-0195
Keywords for this article
cholecystitis; inflammatory biomarker; monocyte distribution width; sepsis

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. Laboratory Medicine: from just testing to saving lives
  4. Reviews
  5. Serum biomarkers of remodeling in severe asthma with fixed airway obstruction and the potential role of KL-6
  6. Safety monitoring of drug-induced muscle injury and rhabdomyolysis: a biomarker-guided approach for clinical practice and drug trials
  7. Mini Review
  8. Concise review on the combined use of immunocapture, mass spectrometry and liquid chromatography for clinical applications
  9. Opinion Paper
  10. Recommendation for the design of stability studies on clinical specimens
  11. General Clinical Chemistry and Laboratory Medicine
  12. Assessment of WHO 07/202 reference material and human serum pools for commutability and for the potential to reduce variability among soluble transferrin receptor assays
  13. veRification: an R Shiny application for laboratory method verification and validation
  14. Impact of storage temperature and time before analysis on electrolytes (Na+, K+, Ca2+), lactate, glucose, blood gases (pH, pO2, pCO2), tHb, O2Hb, COHb and MetHb results
  15. The stability of blood gases and CO-oximetry under slushed ice and room temperature conditions
  16. Elevated levels of renal function tests conferred increased risks of developing various pregnancy complications and adverse perinatal outcomes: insights from a population-based cohort study
  17. Poor comparability of plasma renin activity measurement in determining patient samples: the status quo and recommendations for harmonization
  18. Salivary cortisol and cortisone in diagnosis of Cushing’s syndrome – a comparison of six different analytical methods
  19. Improved diagnostics of purine and pyrimidine metabolism disorders using LC-MS/MS and its clinical application
  20. Analytical evaluation of a GAD65 antibodies chemiluminescence immunoassay for CSF in neurological syndromes
  21. Reference Values and Biological Variations
  22. Evaluation of low-density lipoprotein cholesterol equations by cross-platform assessment of accuracy-based EQA data against SI-traceable reference value
  23. Highly sensitive tandem mass spectrometric measurement of serum estradiol without derivatization and pediatric reference intervals in children and adolescents
  24. Cancer Diagnostics
  25. Practical delta check limits for tumour markers in different clinical settings
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  27. Hematology and Coagulation
  28. Value of monocyte distribution width for predicting severe cholecystitis: a retrospective cohort study
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  30. Validation of non-invasive point of care blood content analysis using the TensorTip™ MTX device: a method comparison study
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  32. Kinetics and ability of binding antibody and surrogate virus neutralization tests to predict neutralizing antibodies against the SARS-CoV-2 Omicron variant following BNT162b2 booster administration
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  41. Misdiagnosis of Hb Bart’s disease: prenatal screening and diagnosis of thalassemia in special population
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