Puget Sound Blood Center, Seattle, Washington, USA.
Transfusion. 2011 May;51(5):929-36. doi: 10.1111/j.1537-2995.2010.02919.x. Epub 2010 Oct 26.
Anemia is an early indicator of many diseases, yet blood donors with low hematocrit (Hct) often receive inadequate information about its medical importance. We sought to understand the types of information that are and should be provided to these donors.
Two companion studies were performed. The first investigated blood center practices for care of donors with low Hct including deferral length, information provided, and cutoff values used when referring donors for medical attention. The second was a randomized prospective pilot study comparing behavior of deferred donors receiving an "older" pamphlet providing a list of iron-rich foods or a "newer" pamphlet providing descriptions of common causes of anemia and advice for seeking medical attention.
More than 70% of centers defer donors for 1 day. Only 6% defer donors for more than 2 weeks. Most centers provide written and/or verbal information about low Hct. Only 35% have a cutoff value defining significant anemia that requires additional medical attention. In the study of donors with low Hct, significant disease was identified within 3 months after deferral in 2 of 104 subjects: metastatic lung cancer and acute lymphocytic leukemia. Only donors receiving the newer pamphlet reported that it "definitely improved" their ability to speak with their doctor about anemia.
The diagnosis of anemia in blood donors may be an indicator of significant undiagnosed disease. There are wide variations in how centers care for and educate donors with anemia. Donors with anemia should be provided improved and consistent educational information.
贫血是许多疾病的早期指标,但低血细胞比容(Hct)的献血者通常无法获得关于其医学重要性的充分信息。我们试图了解应向这些献血者提供哪些类型的信息。
进行了两项配套研究。第一项研究调查了血液中心对低 Hct 献血者的护理实践,包括延期时间、提供的信息以及转介献血者接受医疗关注时使用的临界值。第二项是一项随机前瞻性试点研究,比较了接受“较旧”小册子(提供富含铁的食物清单)或“较新”小册子(提供贫血常见原因和寻求医疗建议的描述)的延期献血者的行为。
超过 70%的中心将献血者延期 1 天。只有 6%的中心将献血者延期超过 2 周。大多数中心提供有关低 Hct 的书面和/或口头信息。只有 35%的中心有定义需要进一步医疗关注的显著贫血的临界值。在低 Hct 献血者的研究中,在延期后的 3 个月内,104 名受试者中有 2 名被诊断出患有转移性肺癌和急性淋巴细胞白血病等重大疾病。只有收到较新小册子的献血者报告说,它“肯定提高”了他们与医生讨论贫血的能力。
献血者贫血的诊断可能是未确诊重大疾病的指标。中心如何照顾和教育贫血献血者存在广泛差异。贫血献血者应获得改进和一致的教育信息。