Eder Anne F, Hillyer Christopher D, Dy Beth A, Notari Edward P, Benjamin Richard J
Biomedical Services, Medical Office, National Headquarters, American Red Cross, 2025 E St NW, Washington, DC 20006, USA.
JAMA. 2008 May 21;299(19):2279-86. doi: 10.1001/jama.299.19.2279.
Donations by minors (16- and 17-year-olds) now account for approximately 8% of the whole blood collected by the American Red Cross, but young age and first-time donation status are known to be independent risk factors for donation-related complications.
To evaluate adverse reactions to allogeneic whole blood donation by 16- and 17-year-olds compared with older donors in American Red Cross blood centers.
DESIGN, SETTING, AND PARTICIPANTS: Prospective documentation of adverse events among 16- and 17-year-old donors using standardized collection protocols, definitions, and reporting methods in 2006. Data were from 9 American Red Cross blood centers that routinely collect from 16- and 17-year-olds, a population that provides 80% of its donations at high school blood drives.
Rate of systemic (syncopal-type) and phlebotomy-related donor complications per 10,000 collections.
In 2006, 9 American Red Cross regions collected 145,678 whole blood donations from 16- and 17-year-olds, 113,307 from 18- and 19-year-olds, and 1,517,460 from donors aged 20 years or older. Complications were recorded in 15,632 (10.7%), 9359 (8.3%), and 42,987 (2.8%) donations in each corresponding age group. In a multivariate logistic regression model, young age had the strongest association with complications (odds ratio [OR], 3.05; 95% confidence interval [CI], 2.52-3.69; P < .001), followed by first-time donation status (OR, 2.63; 95% CI, 2.24-3.09; P < .001) and female sex (OR, 1.87; 95% CI, 1.62-2.16; P < .001). Infrequent but medically relevant complications, in particular physical injury from syncope-related falls, were significantly more likely in 16- and 17-year-old donors (86 events; 5.9/10,000 collections) compared with 18- and 19-year-old donors (27 events; 2.4/10,000 collections; OR, 2.48; 95% CI, 1.61-3.82) or adults aged 20 years or older (62 events; 0.4/10,000 collections; OR, 14.46; 95% CI, 10.43 -20.04). Sixteen-year-old donors who experienced even a minor complication were less likely to return to donate within 12 months than 16-year-olds who experienced uncomplicated donations (52% vs 73% return rate; OR, 0.40; 95% CI, 0.36-0.44).
A higher incidence of donation-related complications and injury occurs among 16- and 17-year-old blood donors compared with older donors. The increasing dependence on recruiting and retaining young blood donors requires a committed approach to donor safety, especially at high school blood drives.
未成年人（16岁和17岁）的献血量目前约占美国红十字会采集全血量的8%，但已知年龄小和首次献血状态是与献血相关并发症的独立危险因素。
评估美国红十字会血液中心16岁和17岁的献血者与年龄较大的献血者相比，异体全血献血的不良反应。
设计、地点和参与者：2006年采用标准化采集方案、定义和报告方法对16岁和17岁献血者的不良事件进行前瞻性记录。数据来自9个美国红十字会血液中心，这些中心常规采集16岁和17岁人群的血液，该人群80%的献血是在高中献血活动中进行的。
每10000次采集的全身（晕厥型）和静脉穿刺相关献血者并发症发生率。
2006年，9个美国红十字会地区从16岁和17岁的献血者中采集了145678次全血，从18岁和19岁的献血者中采集了113307次，从20岁及以上的献血者中采集了1517460次。各相应年龄组中，分别有15632次（10.7%）、9359次（8.3%）和42987次（2.8%）献血记录到并发症。在多变量逻辑回归模型中，年龄小与并发症的关联最强（比值比[OR]，3.05；95%置信区间[CI]，2.52 - 3.69；P <.001），其次是首次献血状态（OR，2.63；95% CI，2.24 - 3.09；P <.001）和女性性别（OR，1.87；95% CI，1.62 - 2.16；P <.001）。与18岁和19岁的献血者（27例；2.4/10000次采集）或20岁及以上的成年人（62例；0.4/10000次采集）相比，16岁和17岁的献血者发生罕见但与医学相关的并发症，尤其是与晕厥相关跌倒导致的身体损伤的可能性显著更高（86例；5.9/10000次采集；OR，2.48；95% CI，1.61 - 3.82）。经历过哪怕是轻微并发症的16岁献血者在12个月内再次献血的可能性低于经历无并发症献血的16岁献血者（回访率52%对73%；OR，0.40；95% CI，0.36 - 0.44）。
与年龄较大的献血者相比，16岁和17岁的献血者发生与献血相关并发症和损伤的发生率更高。对招募和留住年轻献血者的依赖日益增加，这需要采取切实措施确保献血者安全，尤其是在高中献血活动中。
