Mp40-02 Monocyte Distribution Width (Mdw) to Diagnose Urosepsis in Patients With Urinary Stones and to Monitor Their Responses to Therapies in an Emergency Setting

You have accessJournal of UrologyStone Disease: Epidemiology & Evaluation I (MP40)1 May 2024MP40-02 MONOCYTE DISTRIBUTION WIDTH (MDW) TO DIAGNOSE UROSEPSIS IN PATIENTS WITH URINARY STONES AND TO MONITOR THEIR RESPONSES TO THERAPIES IN AN EMERGENCY SETTING Davide Baiamonte, Ignazio Lampasona, Silvia Altomare, Piero Mannone, Nicola Pavan, Gabriele Tulone, Rosa Giaimo, Luisa Agnello, Bruna Lo Sasso, Rosaria Vincenza Giglio, Caterina Maria Gambino, Marcello Ciaccio, and Alchiede Simonato Davide BaiamonteDavide Baiamonte , Ignazio LampasonaIgnazio Lampasona , Silvia AltomareSilvia Altomare , Piero MannonePiero Mannone , Nicola PavanNicola Pavan , Gabriele TuloneGabriele Tulone , Rosa GiaimoRosa Giaimo , Luisa AgnelloLuisa Agnello , Bruna Lo SassoBruna Lo Sasso , Rosaria Vincenza GiglioRosaria Vincenza Giglio , Caterina Maria GambinoCaterina Maria Gambino , Marcello CiaccioMarcello Ciaccio , and Alchiede SimonatoAlchiede Simonato View All Author Informationhttps://doi.org/10.1097/01.JU.0001008788.18007.3f.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Urosepsis secondary to ureteral and kidney stones is responsible of several morbidities and mortalities. White blood cells (WBC), C-reactive protein (CRP) and procalcitonin are the most used blood markers to recognize septic patients and to follow their responses to therapies. Monocyte Distribution Width (MDW) has been used in emergency settings to diagnose sepsis with promising results, without being altered by factors such as surgical stress. The aim of the study was to assess whether MDW could be used to early diagnose sepsis in patients with kidney and ureteral stones in an emergency setting and if it could be a good indicator of patients' responses to therapies. METHODS: All patients treated with urgent ureteral stent (mono J and double J) or nephrostomy placement for ureteral/renal stones from April 2021 to October 2022 were enrolled. They were divided, according to the Sepsis-2 criteria, in septic and not septic. For every patient, clinical data, MDW, CRP and Complete blood count (CBC) values were collected and divided into groups: pre-operative, postoperative and time of discharge. CBC samples were analyzed using the DxH 900 Analyzer (Beckman Coulter Inc., USA). Chi square for nominal variables and t student for continuous variables were used. RESULTS: 107 patients were enrolled, of which 42 (32.3%) were septic. Fever (p=0.01), positive urine cultures (p<0.01) and older age (p<0.01) were more frequent in septic group. Septic group had higher CRP at admission (sepsis 184 mg/L vs no sepsis 67.9 mg/L, p<0.01), but there were no differences at discharge between the two groups (sepsis 82.23 mg/L vs no sepsis 53.87 mg/L, p=0.06). There was no difference in total monocytes (no sepsis 1.08 10^3/µL±1.36 vs. sepsis 0.82 10^3/µL±0.49; p=0.26). Preoperative MDW was significantly higher in septic patients (sepsis MDW 31±9.58 vs. no sepsis MDW 22.3±5.82; p<0.01), with a MDW cut off value≥23 strongly associated with sepsis (p<0.01). Evaluating MDW as a marker of therapies' response, it decreased significantly postoperatively (pre-op MDW 31±9.58 vs post-op MDW 25.3±6.3, p=0.01) and returned to below the threshold values at discharge (pre-op MDW 31±9.58 vs discharge MDW 22.2±5.6, p<0.01). CONCLUSIONS: Monocyte Distribution Width (MDW) was able to diagnose urosepsis in patients with urolithiasis in an emergency setting. Its kinetics resulted useful to understand patients' responses to therapies, both surgical and/or pharmaceutical. Considering that MDW is a hemocromocitometric parameter, it is a fast, effective, economic and easily measurable biomarker to diagnose urosepsis and to follow patients after treatments. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e662 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Davide Baiamonte More articles by this author Ignazio Lampasona More articles by this author Silvia Altomare More articles by this author Piero Mannone More articles by this author Nicola Pavan More articles by this author Gabriele Tulone More articles by this author Rosa Giaimo More articles by this author Luisa Agnello More articles by this author Bruna Lo Sasso More articles by this author Rosaria Vincenza Giglio More articles by this author Caterina Maria Gambino More articles by this author Marcello Ciaccio More articles by this author Alchiede Simonato More articles by this author Expand All Advertisement PDF downloadLoading ...