119   Progressive @entity548 After Severe XXXX : Effect of Hemoglobin Transfusion Thresholds.

@entity1 @entity1545 @entity131 @entity548 @entity1410 @entity2981
INTRODUCTION: Our recent study showed that maintaining a higher hemoglobin threshold after severe @entity131 ( @entity131 ) offers no clinical benefit. The present study aimed to determine if a higher transfusion threshold was independently associated with an increased risk of progressive @entity548 (PHI), thereby contributing to higher rates of morbidity and mortality. METHODS: We performed a secondary analysis of data obtained from a recently performed randomized clinical trial studying the effects of erythropoietin and blood transfusions on neurological recovery after severe @entity131 . PHI was defined as the presence of new or enlarging intracranial @entity1410 on computerized tomography up to 24 hours after injury. A severe PHI was defined as an event that required an escalation of medical management or surgical intervention. Clinical imaging parameters and transfusion thresholds (10 g/dL vs 7 g/L) were used in a multivariate Cox regression analysis to identify independent risk factors for PHI. RESULTS: Among 200 @entity1 enrolled in the trial, PHI was detected in 61 @entity1 (30.5%). The majority of @entity1 had a new, delayed @entity2981 (n = 30, 49.2%) or an increase in @entity2981 size (n = 18, 29.5%). Severe PHI events were seen in 40 @entity1 (65.6%). The mean time interval between injury and identification of PHI was 17.2    15.8 hours. Ninety-nine @entity1 had a transfusion threshold of 7 g/dL, and 101 @entity1 had a transfusion threshold of 10 g/dL. The risk of severe PHI was 2.3 times higher for @entity1 with a transfusion trigger of 10 g/dL (95% CI 1.1-4.8, P = .02). Surgery on admission and @entity1545 were associated with lower risk of severe PHI, while higher initial intracranial pressure was linked to an increased incidence of severe PHI. CONCLUSION: Our analysis shows that a higher transfusion threshold of 10 g/dL after severe @entity131 increased the risk of severe PHI events. These results indicate the potential adverse effect of using a higher transfusion threshold after severe @entity131 .
