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开发和验证一种列线图,用于预测献血后血管迷走性反应的风险。

Development and validation of a nomogram for predicting the risk of vasovagal reactions after plasma donation.

机构信息

Department of Blood Transfusion, Taiyuan Blood Center, Taiyuan, Shanxi Province, People's Republic of China.

Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, Chengdu, Sichuan Province, People's Republic of China.

出版信息

J Clin Apher. 2023 Oct;38(5):622-631. doi: 10.1002/jca.22074. Epub 2023 Jul 19.

Abstract

BACKGROUND AND OBJECTIVES

Vasovagal reactions (VVRs) are the most common adverse reactions and are frequently associated with serious donor adverse events. Even mild VVRs can lead to a significant reduction in the likelihood of subsequent donations. The purpose of this study is to explore the factors related to the occurrence of VVRs after plasma donation and to construct a nomogram to identify individuals at risk for VVRs to improve the safety of plasma donors.

MATERIALS AND METHODS

We collected the donation data from July 2019 to June 2020 from a plasma center in Sichuan, China, to explore the independent risk factors for vasovagal reactions. From these data, we constructed and validated a predictive model for vasovagal reactions.

RESULTS

VVRs after plasma donation occurred 737 times in 120 448 plasma donations (0.66%). Gender, season, donor status, weight, pulse, duration of donation, and cycle were independent risk factors for VVRs (P< 0.05). The concordance index (C-index) of a logistic model in the derivation cohort was 0.916, with a Hosmer-Lemeshow goodness-of-fit probability of 0.795. The C-index of a logistic model in the validation cohort was 0.916, with a Hosmer-Lemeshow goodness-of-fit probability of 0.224. The calibration curve showed that the predicted results were in good agreement with the actual observed results.

CONCLUSION

This study preliminarily constructed and verified a prediction model for VVRs after plasma donation. The model nomogram is practical and can identify high-risk donors.

摘要

背景与目的

血管迷走性反应(VVR)是最常见的不良反应,常与严重的供者不良事件相关。即使是轻度的 VVR 也会显著降低后续捐献的可能性。本研究旨在探讨与血浆捐献后 VVR 发生相关的因素,并构建列线图以识别 VVR 风险个体,从而提高血浆供者的安全性。

材料与方法

我们收集了 2019 年 7 月至 2020 年 6 月期间中国四川某血浆中心的捐献数据,以探讨 VVR 的独立危险因素。基于这些数据,我们构建并验证了 VVR 的预测模型。

结果

在 120448 次血浆捐献中,共有 737 次(0.66%)发生了血浆捐献后 VVR。性别、季节、供者状态、体重、脉搏、捐献时间和周期是 VVR 的独立危险因素(P<0.05)。在推导队列中,逻辑模型的一致性指数(C 指数)为 0.916,Hosmer-Lemeshow 拟合优度概率为 0.795。验证队列中逻辑模型的 C 指数为 0.916,Hosmer-Lemeshow 拟合优度概率为 0.224。校准曲线表明,预测结果与实际观察结果吻合良好。

结论

本研究初步构建并验证了血浆捐献后 VVR 的预测模型。该模型列线图实用,可识别高风险供者。

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