Japanese Red Cross Tokyo Metropolitan Blood Center, Tokyo, Japan.
Vox Sang. 2021 Jan;116(1):36-41. doi: 10.1111/vox.12981. Epub 2020 Jul 23.
Delayed syncopal-type complications are infrequent among blood donors, but sometimes have critical consequences, such as severe injury. We retrospectively investigated the characteristics of donors with delayed syncopal-type complications or falls.
We defined a delayed reaction (DR) as syncopal-type complications occurring >20 min after needle removal. Subjects were stratified by sex, age, estimated blood volume (EBV), body mass index (BMI) and frequency of donation. Multiple logistic regression analysis and propensity score weighted M estimation were performed to evaluate the covariate-adjusted risk of syncopal DRs among donors giving 400 ml of whole blood (WB). The DR rate was calculated as the number of DRs divided by the number of all syncopal-type reactions after needle removal. The risk of falls was assessed similarly. Donors who discontinued before completing phlebotomy (donation of 400 ml) were excluded.
Among 3818 syncopal-type reactions after needle removal, there were 359 DRs and 93 falls. Elderly donors and female donors with syncopal-type reactions had a significantly higher risk of DRs (P for trend < 0·001). Elderly donors with syncopal-type reactions also had a higher risk of falls (P for trend < 0·001). Among all donors with syncopal-type reactions, the risk of DRs or falls was not correlated with EBV, BMI or donation frequency.
In female donors and elderly donors (donating 400 ml of WB), syncopal-type reactions tended to be delayed. Elderly donors with syncopal-type reactions had a significantly higher risk of falls.
献血者中迟发性晕厥样并发症并不常见，但有时会产生严重后果，如严重受伤。我们回顾性调查了有迟发性晕厥样并发症或跌倒的献血者的特征。
我们将延迟反应（DR）定义为在拔针后>20 分钟出现晕厥样并发症。根据性别、年龄、估计血容量（EBV）、体重指数（BMI）和献血频率对受试者进行分层。采用多因素逻辑回归分析和倾向评分加权 M 估计，评估 400ml 全血（WB）献血者中 DRs 的协变量调整风险。DR 发生率为 DR 例数除以拔针后所有晕厥样反应例数。跌倒风险评估类似。在完成采血（400ml 捐献）之前停止捐献的献血者被排除在外。
在 3818 例拔针后晕厥样反应中，有 359 例 DR 和 93 例跌倒。老年献血者和有晕厥样反应的女性献血者发生 DR 的风险显著增加（趋势 P<0·001）。有晕厥样反应的老年献血者跌倒的风险也更高（趋势 P<0·001）。在所有有晕厥样反应的献血者中，DR 或跌倒的风险与 EBV、BMI 或献血频率无关。
在女性献血者和老年献血者（捐献 400ml WB）中，晕厥样反应往往会延迟。有晕厥样反应的老年献血者跌倒的风险显著增加。
