Adverse reactions and other factors that impact subsequent blood donation visits

Abstract

Background: The importance of adverse reactions in terms of donor safety recently has received significant attention, but their role in subsequent donation behavior has not been thoroughly investigated.

Study design and methods: Six REDS-II blood centers provided data for this analysis. Summary minor and major adverse reaction categories were created. The influence of adverse reactions on donation was examined in two ways: Kaplan-Meier curves were generated to determine the cumulative pattern of first return, and adjusted odds ratios (AORs) for demographic and other factors positively and negatively associated with return were estimated using multivariable logistic regression.

Results: Donors who had major reactions had longer times to return than donors with minor or no reactions. The AOR of returning for donors with major reactions was 0.32 (95% confidence interval [CI], 0.28-0.37) and with minor reactions 0.59 (95% CI, 0.56-0.62) when compared to donors who did not have reactions. Conversely, the most important factors positively associated with return were the number of donations in the previous year and increasing age. Subsequent return, whether a major, minor, or no reaction occurred, varied by blood center. Factors that are associated with the risk of having adverse reactions were not substantial influences on the return after adverse reactions.

Conclusion: Having an adverse reaction leads to significantly lower odds of subsequent donation irrespective of previous donation history. Factors that have been associated with a greater risk of adverse reactions were not important positive or negative predictors of return after a reaction.

Conflict of interest statement

Conflicts of Interest:

Brian Custer: None

Jorge Rios: None

Karen Schlumpf: None

Ram Kakaiya: None

Jerome Gottschall: None

David Wright: None

The authors certify that they have no affiliation with or financial involvement in any organization or entity with a direct financial interest in the subject matter or materials discussed in this manuscript.

© 2011 American Association of Blood Banks.

Figures

Figure 1

Unadjusted Kaplan Meier time to first return curves for each REDS-II blood center (Centers A – F) showing the impact of minor (gray circles) and major reactions (black circles) on the time to return and cumulative number of donors returning compared to donors who did not have reactions. Dashed horizontal line represents the median return time and the dashed horizontal line show return proportions at 400 days following index donation.

Figure 2

Multivariable logistic regression analysis results for minor and major reactions at each REDS-II blood center during the time period of 2007–2009. Donors who did not have reactions are the reference group within each center. Logistic regression model includes gender, race/ethnicity, age, donor status, number of red cell donations in last year, number of non-red cell donations in last year, donation site, successful collection, estimated blood volume and donor blood type as covariates in the model. The horizontal dashed line represents the overall adjusted odds ratio for major reactions (AOR=0.32) across all centers and the horizontal dotted line represents the overall adjusted odds ratio for minor reactions across all centers (AOR=0.59).