Blood Systems, Inc, Scottsdale, Arizona 85257, USA.
Transfusion. 2010 Mar;50(3):556-65. doi: 10.1111/j.1537-2995.2009.02397.x. Epub 2009 Oct 5.
Blood donation is safe, but a small proportion of donors have delayed and/or off-site reactions that have the potential to lead to serious injury. This retrospective study sought to identify risk factors for delayed reactions (DRs).
The records of 793,293 allogeneic whole blood and apheresis donations in 2007 were assessed for vasovagal reactions. Donor demographic, biometric, and clinical measurements were captured. Incidents related to needle insertion and mild reactions were excluded. Based on the reaction onset time relative to the procedure end time, reactions were classified as delayed (>15 min) or immediate (<or=15 min). Reactions were analyzed by multivariable logistic regression comparing donors with immediate reactions (IRs) or DRs to donors without reactions and comparing donors with DRs to IRs. The clinical consequences of off-site and on-site reactions are reported.
The prevalence of reactions classified as moderate or severe was 41 in 10,000 donations; 24% of these reactions were delayed and 12% occurred off-site. DRs were associated with female sex (odds ratio [OR], 2.96; 95% confidence interval [CI], 2.21-3.96) and with low estimated blood volume (EBV; OR, 3.91; 96% CI, 2.84-5.51). Off-site reactions, particularly in female donors, were more likely to be associated with a fall, with head trauma, with other injury, and with the use of outside medical care.
Low EBV, youth, and first-time donor status are major risk factors for IRs and DRs. Women are more likely than men to report DRs. Delayed and off-site reactions lead to potentially preventable morbidity. Understanding the physiologic basis of DRs may lead to the development of appropriate interventions to reduce their likelihood.
献血是安全的，但一小部分献血者会出现延迟和/或场外反应，这些反应有可能导致严重伤害。本回顾性研究旨在确定延迟反应（DR）的危险因素。
对 2007 年 793293 例同种异体全血和单采献血的血管迷走反应记录进行评估。采集了供者人口统计学、生物统计学和临床测量数据。排除与针头插入和轻度反应相关的事件。根据反应相对于程序结束时间的发生时间，将反应分为延迟（>15 分钟）或即刻（<=15 分钟）。通过多变量逻辑回归比较即刻反应（IR）或 DR 与无反应的供者以及 DR 与 IR 的供者来分析反应。报告了场外和场内反应的临床后果。
反应分类为中度或重度的发生率为每 10000 次献血 41 次；其中 24%的反应是延迟的，12%发生在场外。DR 与女性（优势比[OR]，2.96；95%置信区间[CI]，2.21-3.96）和低估计血容量（EBV；OR，3.91；96%CI，2.84-5.51）相关。场外反应，特别是女性供者，更有可能与跌倒、头部创伤、其他损伤以及使用外部医疗护理有关。
低 EBV、年轻和首次献血者状态是 IR 和 DR 的主要危险因素。女性比男性更有可能报告 DR。延迟和场外反应会导致潜在可预防的发病率。了解 DR 的生理基础可能会导致开发适当的干预措施来降低其发生的可能性。
