A Retrospective Study of Adverse Events in Blood Donors From Navi Mumbai.

Abstract

BACKGROUND:The safety and sufficiency of blood supply is dependent on the altruism of healthy donors, to provide blood. These donors get exposed to potential risk of discomfort, complications, and rarely injury from the collection procedure. All medical procedures including blood donation carry some risk of adverse events (AE). Although blood donation is generally safe, approximately of 2-6 % of donors experience complications, mostly mild, that resolve promptly but are still unpleasant for donors, and blood services have an obligation to minimize them. The aim of this study was to estimate the frequency and severity of AE's occurring in whole blood donors, especially in outdoor camps, and to suggest measures to minimize them. MATERIALS AND METHODS: This is a five year retrospective study on whole blood donors (2008)(2009)(2010)(2011)(2012). Our blood collection is mainly in camps by voluntary blood donors. Donations in camps: voluntary-8992(81.2%). Donations in blood bank: voluntary 831(7.53%), replacement 1211(10.97%). RESULTS: Overall 258 adverse events occurred in a total of 11034 donors, resulting in an adverse event rate of 2.33%. Most common AE was presyncopal or vasovagal reaction (72.86%). Syncopal minor reactions associated with transient loss of consciousness comprised 14.3%. Severe AE's formed a very small fraction accounting for 1.16%. CONCLUSION: AE analysis helps in identifying the donors at risk and adopting environmentally appropriate measures to reduce risk and improve donor satisfaction. KEY WORDS: voluntary blood donation, outdoor camps, adverse events, vasovagal reactions. INTRODUCTION:All medical procedures carry some risk of adverse events (AE) and blood donation is no exception. After proper donor selection as per the laid down criteria, blood donation is a relatively safe procedure. However, occasionally AE's do occur which are usually mild, but can be severe. Donor complications are an important problem not only for the donors, but also for transfusion medicine in general, as some complications may negatively affect donor recruitment and retention 1 . Adverse events have a negative effect on donor health, donor satisfaction and blood donor return rate (BDRR) 2 . AEs result in disrupted work flow at blood donor centres, impact on customer service to other donors, and also result in loss of/wastage of blood products. Various studies have quoted an AE of 2-6% in donors but only 0.08 -0.3% have a syncopal reaction where there is loss of consciousness 3,4,5 . In order to have an adequate and regular supply of blood it is not only important to recruit new donors but also to retain them as repeat donors.

Complications related to blood donation: A multicenter study of the prevalence and influencing factors in voluntary blood donation camps in Karnataka, India

“…In our study, the overall rate of complications was 3.2%. This is in agreement with some studies[ 9 11 ] which reported 2.3-2.5%, higher than some other studies[ 8 10 ] which reported 0.6-0.8% and lesser than several other[ 3 7 17 18 ] studies which reported more than 7% complications. The significant differences in the definitions and the mechanism for identification of the complication may explain the variations.…”

“…The confusion over the definitions and scope of complications is also evident in the various studies that have been done on the subject within the country. [ 9 10 11 ] There appears to be an urgent need for national guidelines on definitions, prevention and management of postdonation complications which would then pave the way for uniform training and skill building.…”

“…Results of other single center studies in India concluded upon the rate of reactions varying between 0.6-2.33%. [ 10 11 ] The present study focuses on voluntary blood donation in outdoor blood donation camps and includes the participation of 16 blood banks in Karnataka.…”

Profile of blood donors who presented adverse reactions to the donation

“…Thus, adverse events were observed more frequently during the afternoons, when the temperature was higher and when there was agglomeration and concentration of donors. As strategies to reduce adverse reactions, the intake of liquids was encouraged half an hour before blood donation (17) .…”

“…A third study presents the incidence of 72.9% mild reactions, 15.3% moderate reactions and 2.5% serious reactions. The discrepancy in the percentage of the study is based on the characterization that 9.3% of total donors suffered some type of phlebotomy accident, distinguishing them from the variable "adverse reaction" (17) .…”