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| Item Type: | Article |
|---|---|
| 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 |
| Creators Name: | Britsch, Markward, Becher, Tobias, Lindner, Simon, Hahn, Leonie, Schneider-Lindner, Verena, Helbing, Thomas, Langer, Harald F., Mohr, David, Krebs, Joerg, Duerschmied, Daniel and Britsch, Simone |
| Abstract: | OBJECTIVE: 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. METHODS: 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. RESULTS: Among 5,327 patients (median age 66 years, 38.9% female, mortality 28.3%), median MCV variation was 1.86% (IQR 1.15–2.74%). Patients with high variation (CV >2.5%) showed higher mortality rates (34.7% vs. 20.1%, p<0.0001). In a baseline-adjusted model, this association remained significant (OR 1.65, 95% CI 1.46–1.87, p<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 0.98–1.06, p=0.31). Determinants of high variation (>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: 0.84–1.59). CONCLUSIONS: 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. |
| Keywords: | MCV, Mean Corpuscular Volume, Variation, Intensive Care Medicine, Prediction |
| Source: | Science Progress |
| ISSN: | 0036-8504 |
| Publisher: | Sage Publications |
| Volume: | 109 |
| Number: | 2 |
| Page Range: | 1-14 |
| Date: | June 2026 |
| Official Publication: | https://doi.org/10.1177/00368504261438557 |
| PubMed: | View item in PubMed |
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