82 Emergency department bacteremia incidence by age and monocyte distribution width value
Recommended Citation
Jaehne AK, Naiman MI, Cook B, Wilson I, Versyer D, Kelly WG, Ghosh S, Rivers EP. 82 Emergency department bacteremia incidence by age and monocyte distribution width value. Acad Emerg Med 2024; 31(S1):45.
Document Type
Conference Proceeding
Publication Date
5-13-2024
Publication Title
Acad Emerg Med
Abstract
Background and Objectives: Bacteremia is the presence of viable bacteria in the bloodstream recognized by diagnostic blood cultures. Monocyte Distribution Width (MDW) is a pathogen-agnostic marker of immune response and dysregulation, reported as part of a Complete Blood Count (CBC) with differential. MDW is derived from the distribution of peripheral blood monocyte volumes and aids in the identification of severe infections and sepsis in adult Emergency Department (ED) patients. Previous clinical trials found no association between age and MDW value. However, patients without suspected infection were included in these studies. This analysis evaluated the relationship between MDW values and age in a real-world population of patients with suspected infection. Methods: This was a prospective, observational cohort study. All patients aged 18 and older who presented to the ED and received orders for a CBC with differential and blood cultures were included. MDW values were not reported to those involved in direct patient care. We evaluated the incidence of bacteremia by age (in decades) and the associated MDW values as median with minimum and maximum values using SPSS Version25. Results: A total of 5310 ED blood culture and MDW results were matched for this interim analysis. The overall blood culture positivity rate was 14.5%. The blood culture positivity rate increased by decade from 11.2% in patients 18–30?years to 19.3% in patients 80–90?years old. There was a significant difference in median MDW values in patients with bacteremia (25.2, range 14.1–82.8) compared with patients without bacteremia (20.65, range 12.8–102.1). There was no significant difference in MDW values within bacteremia status across age groups. Conclusion: There is an incremental increase in bacteremia by age in decades. This analysis reproduced previous observations that MDW elevation is consistent among adults. It is unlikely that MDW value interpretation will require age adjustment, but further research is needed to integrate MDW assessments into ED diagnostic workups.
Volume
31
Issue
S1
First Page
45
