{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T05:19:22Z","timestamp":1783055962153,"version":"3.54.6"},"reference-count":23,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T00:00:00Z","timestamp":1782950400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T00:00:00Z","timestamp":1782950400000},"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":["Transfusion Medicine"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Restrictive transfusion strategies and patient blood management programs increasingly recommend administration of single\u2010unit red blood cell (RBC) transfusions followed by reassessment. However, clinicians often lack objective indicators to determine whether additional transfusion may subsequently be administered after the initial unit. Early haemoglobin response may provide clinically useful information regarding post\u2010transfusion haematologic response and the likelihood of repeat transfusion.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n We conducted a prospective observational cohort study including 518 hospitalized adults who received single\u2010unit\n RBC<\/jats:styled-content>\n transfusion. Haemoglobin concentrations for the primary analysis were measured at baseline and 24 h following transfusion. The primary predictor variable was the 24\u2010h haemoglobin increment (\n \u0394Hb24<\/jats:styled-content>\n ). The primary outcome was repeat\n RBC<\/jats:styled-content>\n transfusion within 48 h. A multivariable logistic regression model incorporating haemoglobin response and clinical variables was developed. Model performance was evaluated using receiver operating characteristic analysis, calibration assessment, and decision curve analysis.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Among the 518 patients included in the study, 42 (8.1%) received repeat transfusion within 48 h. Patients who received additional transfusion demonstrated significantly smaller haemoglobin increments compared with those who did not. In multivariable analysis,\n \u0394Hb24<\/jats:styled-content>\n emerged as the strongest independent predictor of repeat transfusion, with increasing haemoglobin increments associated with lower risk. The prediction model demonstrated moderate discrimination (\n AUC<\/jats:styled-content>\n 0.74) and acceptable calibration. Risk stratification showed that patients with\n \u0394Hb24<\/jats:styled-content>\n <1 g\/\n dL<\/jats:styled-content>\n had substantially higher probability of repeat transfusion, whereas those with\n \u0394Hb24<\/jats:styled-content>\n >1.5 g\/\n dL<\/jats:styled-content>\n had low risk. Decision curve analysis demonstrated positive clinical net benefit across clinically relevant threshold probabilities.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n Early haemoglobin response may provide clinically useful prognostic information regarding repeat transfusion risk following single\u2010unit\n RBC<\/jats:styled-content>\n transfusion. These findings support structured reassessment following single\u2010unit transfusion and demonstrate that early haemoglobin response may assist in identifying patients more likely to receive repeat transfusion.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/tme.70099","type":"journal-article","created":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T04:46:05Z","timestamp":1783053965000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Early Haemoglobin response after single\u2010unit red blood cell transfusion predicts repeat transfusion in hospitalised adults: A prospective cohort study and clinical prediction model"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9921-7186","authenticated-orcid":false,"given":"Rudraksh","family":"Kesharwani","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine District Hospital Bilaspur 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":"Shubhangi","family":"Nagpal","sequence":"additional","affiliation":[{"name":"Vascular and Upper Gastrointestinal Surgery University College London Hospital London UK"}],"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":"Rehan","family":"Ali","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Community Health Centre Pendra 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"}]},{"given":"Angel Parul","family":"Luka","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine District Hospital Raipur Chhattisgarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,2]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.20121"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.2450\/2012.0195\u201012"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199902113400601"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1012452"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.9185"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1211801"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1406617"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpa.2013.01.001"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/msj.21290"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e318254d1a3"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccc.2003.12.002"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(13)60650\u20109"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.165.8.845"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccc.2016.12.011"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2019000773"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20100043\u20101763503"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/vox.12130"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.g7594"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.7326\/M14\u20100698"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X06295361"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1541\u20100420.2010.01431.x"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehu207"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.12914"}],"container-title":["Transfusion 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