{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T20:47:11Z","timestamp":1782852431051,"version":"3.54.5"},"reference-count":26,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Science Progress"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate whether early variability in mean corpuscular volume (MCV) during the first five days of intensive care unit stay is associated with in-hospital mortality in critically ill patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively studied all adult patients treated on intensive care units (ICU) at the University Medical Center Mannheim between 2018 and 2022 with more than one MCV measurement within the first five days, including at least one on the day of admission. The primary endpoint was in-hospital mortality. MCV variation, expressed as the coefficient of variation (CV), was analyzed using generalized additive models, multivariable logistic and Cox regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 5,327 patients (median age 66 years, 38.9% female, mortality 28.3%), median MCV variation was 1.86% (IQR 1.15\u20132.74%). Patients with high variation (CV &gt;2.5%) showed higher mortality rates (34.7% vs. 20.1%, p&lt;0.0001). In a baseline-adjusted model, this association remained significant (OR 1.65, 95% CI 1.46\u20131.87, p&lt;0.001). By contrast, baseline MCV at admission showed a univariat association with mortality but was not independently associated with mortality after multivariate adjustment (OR 1.02, 95% CI 0.98\u20131.06, p=0.31). Determinants of high variation (&gt;2.5%) included elevated CRP, transfusion volume, respiratory disease, and fluid balance disturbances. In a second, severity-adjusted model including lactate, mean arterial pressure, and fluid balance, the previously observed association between high MCV variation and mortality was no longer significant (adjusted OR 1.16, p = 0.57, CI: 0.84\u20131.59).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Early variation in MCV during the initial five days after ICU admission is associated with in-hospital mortality in unadjusted analyses. However, this relationship is not independent of established clinical severity markers, suggesting that MCV variability reflects disease severity. Nonetheless, MCV variation may serve as a readily accessible adjunctive marker of physiological instability in critically ill patients, meriting further investigation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00368504261438557","type":"journal-article","created":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T09:30:20Z","timestamp":1778319020000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Dynamic changes in mean corpuscular volume could be integrated into longitudinal prediction frameworks for individualized risk assessment in the ICU setting: A retrospective study"],"prefix":"10.1177","volume":"109","author":[{"given":"Markward","family":"Britsch","sequence":"first","affiliation":[{"name":"University Medical Centre Mannheim"},{"name":"Medical Faculty Mannheim, Heidelberg University"},{"name":"Heidelberg University"},{"name":"Heidelberg University"},{"name":"Heidelberg University"},{"name":"Heidelberg University"},{"name":"HMS Analytical Software GmbH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"Becher","sequence":"additional","affiliation":[{"name":"University Medical Centre Mannheim"},{"name":"Medical Faculty Mannheim, Heidelberg University"},{"name":"Heidelberg University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Lindner","sequence":"additional","affiliation":[{"name":"University Medical Centre Mannheim"},{"name":"Medical Faculty Mannheim, Heidelberg University"},{"name":"Heidelberg University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonie","family":"Hahn","sequence":"additional","affiliation":[{"name":"University Medical Centre Mannheim"},{"name":"Medical Faculty Mannheim, Heidelberg University"},{"name":"Heidelberg University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Verena","family":"Schneider-Lindner","sequence":"additional","affiliation":[{"name":"University Medical Center Mannheim"},{"name":"Medical Faculty Mannheim, of the University of Heidelberg"},{"name":"Heidelberg University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-9210-9559","authenticated-orcid":false,"given":"Thomas","family":"Helbing","sequence":"additional","affiliation":[{"name":"University Medical Centre Mannheim"},{"name":"Medical Faculty Mannheim, Heidelberg University"},{"name":"Heidelberg University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harald F.","family":"Langer","sequence":"additional","affiliation":[{"name":"University Medical Centre Mannheim"},{"name":"Medical Faculty Mannheim, Heidelberg University"},{"name":"Heidelberg University"},{"name":"University of Heidelberg"},{"name":"Helmholtz-Institute for Translational AngioCardioScience (HI-TAC) of the Max Delbr\u00fcck Center for Molecular Medicine in the Helmholtz Association (MDC) at Heidelberg University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Mohr","sequence":"additional","affiliation":[{"name":"University Medical Center Mannheim"},{"name":"Medical Faculty Mannheim, of the University of Heidelberg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joerg","family":"Krebs","sequence":"additional","affiliation":[{"name":"University Medical Center Mannheim"},{"name":"Medical Faculty Mannheim, of the University of Heidelberg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Duerschmied","sequence":"additional","affiliation":[{"name":"University Medical Centre Mannheim"},{"name":"Medical Faculty Mannheim, Heidelberg University"},{"name":"Heidelberg University"},{"name":"Helmholtz-Institute for Translational AngioCardioScience (HI-TAC) of the Max Delbr\u00fcck Center for Molecular Medicine in the Helmholtz Association (MDC) at Heidelberg University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-2212-4114","authenticated-orcid":false,"given":"Simone","family":"Britsch","sequence":"additional","affiliation":[{"name":"University Medical Centre Mannheim"},{"name":"Medical Faculty Mannheim, Heidelberg University"},{"name":"Heidelberg University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,5,9]]},"reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/08850666231166349"},{"key":"e_1_3_6_3_2","volume-title":"Mean Corpuscular Volume","author":"Maner BS","year":"2025","unstructured":"Maner BS, Killeen RB, Moosavi L. Mean Corpuscular Volume. StatPearls, 2025."},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics15161993"},{"key":"e_1_3_6_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000031415"},{"key":"e_1_3_6_6_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0229135"},{"key":"e_1_3_6_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/hsr2.70441"},{"key":"e_1_3_6_8_2","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2022.972659"},{"key":"e_1_3_6_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000239116.01855.61"},{"key":"e_1_3_6_10_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0321213"},{"key":"e_1_3_6_11_2","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.00970116"},{"key":"e_1_3_6_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00392-019-01549-0"},{"key":"e_1_3_6_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e31821b85c6"},{"key":"e_1_3_6_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiochem.2015.07.011"},{"key":"e_1_3_6_15_2","doi-asserted-by":"publisher","DOI":"10.1177\/0885066617741873"},{"key":"e_1_3_6_16_2","doi-asserted-by":"publisher","DOI":"10.1111\/trf.14759"},{"key":"e_1_3_6_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61602-X"},{"key":"e_1_3_6_18_2","volume-title":"R: A language and environment for statistical computing","author":"R Core Team","year":"2023","unstructured":"R Core Team. R: A language and environment for statistical computing. R Foundation for Statistical Computing, 2023."},{"key":"e_1_3_6_19_2","first-page":"1","article-title":"Biological variation of hematology tests based on the 1999-2002 National Health and Nutrition Examination Survey","volume":"54","author":"Lacher DA","year":"2012","unstructured":"Lacher DA, Barletta J, Hughes JP. Biological variation of hematology tests based on the 1999-2002 National Health and Nutrition Examination Survey. Natl Health Stat Report 2012; 54: 1\u201310.","journal-title":"Natl Health Stat Report"},{"key":"e_1_3_6_20_2","doi-asserted-by":"publisher","DOI":"10.5858\/arpa.2012-0377-OA"},{"key":"e_1_3_6_21_2","doi-asserted-by":"publisher","DOI":"10.5858\/arpa.2013-0685-LE"},{"key":"e_1_3_6_22_2","doi-asserted-by":"publisher","DOI":"10.1177\/0885066614523536"},{"key":"e_1_3_6_23_2","doi-asserted-by":"publisher","DOI":"10.1186\/cc13851"},{"key":"e_1_3_6_24_2","doi-asserted-by":"publisher","DOI":"10.1177\/193229680900300609"},{"key":"e_1_3_6_25_2","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2021.655393"},{"key":"e_1_3_6_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cll.2014.10.002"},{"key":"e_1_3_6_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.exphem.2020.07.011"}],"container-title":["Science Progress"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00368504261438557","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00368504261438557","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00368504261438557","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T19:47:10Z","timestamp":1782848830000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00368504261438557"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4]]},"references-count":26,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1177\/00368504261438557"],"URL":"https:\/\/doi.org\/10.1177\/00368504261438557","relation":{},"ISSN":["0036-8504","2047-7163"],"issn-type":[{"value":"0036-8504","type":"print"},{"value":"2047-7163","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4]]},"article-number":"00368504261438557"}}