{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T20:02:45Z","timestamp":1790452965603,"version":"4.1.0"},"reference-count":24,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,4,19]],"date-time":"2026-04-19T00:00:00Z","timestamp":1776556800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,19]],"date-time":"2026-04-19T00:00:00Z","timestamp":1776556800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European J of Haematology"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Transfusion of one unit of packed red blood cells is traditionally expected to increase hemoglobin concentration by approximately 1\u2009g\/dL in adults. However, substantial variability in hemoglobin response is frequently observed in clinical practice. Smaller\u2010than\u2010expected increments may raise concerns regarding ongoing bleeding, hemodilution, or altered erythrocyte distribution. Understanding predictors of inadequate hemoglobin response may help clinicians interpret post\u2010transfusion laboratory values and avoid unnecessary repeat transfusion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a prospective observational cohort study of 518 hemodynamically stable hospitalized adults receiving a single unit of red blood cell transfusion. Hemoglobin concentrations were measured at baseline and at 12, 24, and 48\u2009h after transfusion. Inadequate hemoglobin response was defined a priori as a 24\u2010h hemoglobin increment (\u0394Hb24) &lt;\u20091\u2009g\/dL. Multivariable logistic regression was used to identify predictors of inadequate response. Model discrimination and calibration were evaluated using receiver operating characteristic analysis and calibration plots. A simplified clinical prediction score and nomogram were derived from the regression model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The mean 24\u2010h hemoglobin increment was 1.41\u2009\u00b1\u20090.37\u2009g\/dL. Inadequate hemoglobin response occurred in 106 patients (20.5%). Patients with inadequate response had higher baseline hemoglobin levels and a greater prevalence of splenomegaly. In multivariable analysis, higher baseline hemoglobin (OR 1.35 per 1\u2009g\/dL increase, 95% CI 1.18\u20131.54) and splenomegaly (OR 1.70, 95% CI 1.10\u20132.65) were independently associated with inadequate hemoglobin response. The prediction model demonstrated moderate discrimination (AUC 0.64; 95% CI 0.58\u20130.70) and acceptable calibration. A simplified clinical score stratified patients into low\u2010, intermediate\u2010, and high\u2010risk categories for inadequate response. Decision curve analysis demonstrated modest clinical utility across a range of threshold probabilities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Inadequate hemoglobin response after single\u2010unit red blood cell transfusion occurs in approximately one fifth of patients and appears to be influenced primarily by recipient physiological factors rather than donor unit characteristics. A simple clinical prediction model may assist clinicians in interpreting post\u2010transfusion hemoglobin changes and reduce unnecessary repeat transfusions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ejh.70196","type":"journal-article","created":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T06:51:14Z","timestamp":1776667874000},"page":"396-408","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A Clinical Prediction Model for Inadequate Hemoglobin Response After Red Blood Cell Transfusion"],"prefix":"10.1111","volume":"117","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9921-7186","authenticated-orcid":false,"given":"Rudraksh","family":"Kesharwani","sequence":"first","affiliation":[{"name":"District Hospital  Bilaspur Chhattisgarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ritika","family":"Agarkar","sequence":"additional","affiliation":[{"name":"Department of Medicine Late Shri Lakhiram Agrawal Memorial Government Medical College  Raigarh Chhattisgarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dhruvin","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of General Surgery GMERS Medical College  Junagadh Gujarat India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheryl Francisca","family":"Godinho","sequence":"additional","affiliation":[{"name":"Department of Surgery South Goa District Hospital  Hospicio Goa India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shubhangi","family":"Nagpal","sequence":"additional","affiliation":[{"name":"Vascular and UGI Surgery University College London Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhimanyu","family":"Vishnoi","sequence":"additional","affiliation":[{"name":"Sri Ramachandra Institute of Higher Education and Research  Chennai India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rehan","family":"Ali","sequence":"additional","affiliation":[{"name":"Community Health Centre  Pendra Chhattisgarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angel Parul","family":"Luka","sequence":"additional","affiliation":[{"name":"District Hospital  Raipur Chhattisgarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amar","family":"Karda","sequence":"additional","affiliation":[{"name":"Department of Medicine Late Shri Lakhiram Agrawal Memorial Government Medical College  Raigarh Chhattisgarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,19]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.9185"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199902113400601"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccc.2016.12.011"},{"key":"e_1_2_11_5_1","article-title":"Transfusion Thresholds and Other Strategies for Guiding Allogeneic Red Blood Cell Transfusion","volume":"4","author":"Carson J. 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