Onsite vasovagal reactions with and without loss of consciousness are distinct outcomes with different risk factors.

IF 1.6 4区医学 Q3 HEMATOLOGY

Vox Sanguinis Pub Date : 2025-09-01 Epub Date: 2025-08-07 DOI:10.1111/vox.70072

Christina Mikkelsen, Betina Samuelsen Sørensen, Bitten Aagaard, Sys Hasslund, Mie Topholm Bruun, Rune Larsen, Louise Ørnskov Drechsler, Maria Didriksen, Michael Schwinn, Joseph Dowsett, Erik Sørensen, Christian Erikstrup, Ole B Pedersen, Niels Grarup, Kari Stefansson, Morten Bagge Hansen, Torben Hansen, Sisse Rye Ostrowski

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引用次数: 0

Abstract

Background and objectives: Vasovagal reactions (VVRs) are some of the most common adverse reactions (ARs) in blood donors. While researchers have tried to develop precise risk prediction tools, these studies have all combined onsite and offsite reactions as well as reactions with and without the loss of consciousness. This study aimed to investigate potential differences in risk phenotypes in onsite VVRs, here defined as syncope and near-fainting.

Materials and methods: We included 40,543 participants from the Danish Blood Donor Study (136 syncope and 1453 near-fainting cases). Data on lifestyle and health were available from questionnaires. Data on donation type, time of day and ARs were available from the blood bank it-system. The risk of VVRs was assessed in a logistic mixed-effects model which included 345,751 donations. For genotyped participants (N = 21,102), polygenic scores were calculated for syncope, anxiety, neuroticism and cardiometabolic disease.

Results: Risk of both types of VVR was found to increase during warmer season and apheresis donation and reduce by donating late in the day. In addition, less donation experience and lower height increased the risk for near-fainting. In contrast, no donor-specific characteristics appeared to mediate the risk of syncope. Genetic predisposition of various traits had no effect on the risk of onsite VVRs.

Conclusion: This study indicates that onsite syncope and near-fainting are distinct conditions with different risk profiles. Our findings emphasize the importance of a more detailed analysis of VVRs, suggesting that the common practice of combining VVR subtypes may reduce the accuracy of risk prediction.

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伴有和不伴有意识丧失的现场血管迷走神经反应具有不同的危险因素。

背景和目的：血管迷走神经反应（VVRs）是献血者中最常见的不良反应（ARs）。虽然研究人员试图开发精确的风险预测工具，但这些研究都结合了现场和场外的反应，以及有和没有失去意识的反应。本研究旨在调查现场vvr的潜在风险表型差异，这里定义为晕厥和近昏厥。材料和方法：我们纳入了来自丹麦献血者研究的40,543名参与者（136例晕厥和1453例接近昏厥）。生活方式和健康方面的数据可从调查问卷中获得。从血库信息系统可获得有关献血类型、时间和ar的数据。在包括345,751例捐献的logistic混合效应模型中评估vvr的风险。对于基因分型的参与者（N = 21,102），计算晕厥、焦虑、神经质和心脏代谢疾病的多基因评分。结果：两种类型的VVR风险均在温暖季节和单采献血时增加，在晚些时候献血时降低。此外，较少的捐赠经验和较低的身高增加了几乎晕厥的风险。相比之下，似乎没有供体特异性特征介导晕厥的风险。各种性状的遗传易感性对现场vvr的风险没有影响。结论：本研究表明，现场晕厥和近昏厥是不同的情况，具有不同的风险概况。我们的研究结果强调了对VVR进行更详细分析的重要性，表明结合VVR亚型的常见做法可能会降低风险预测的准确性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Vox Sanguinis 医学-血液学

CiteScore

4.40

自引率

11.10%

发文量

156

审稿时长

6-12 weeks

期刊介绍： Vox Sanguinis reports on important, novel developments in transfusion medicine. Original papers, reviews and international fora are published on all aspects of blood transfusion and tissue transplantation, comprising five main sections: 1) Transfusion - Transmitted Disease and its Prevention: Identification and epidemiology of infectious agents transmissible by blood; Bacterial contamination of blood components; Donor recruitment and selection methods; Pathogen inactivation. 2) Blood Component Collection and Production: Blood collection methods and devices (including apheresis); Plasma fractionation techniques and plasma derivatives; Preparation of labile blood components; Inventory management; Hematopoietic progenitor cell collection and storage; Collection and storage of tissues; Quality management and good manufacturing practice; Automation and information technology. 3) Transfusion Medicine and New Therapies: Transfusion thresholds and audits; Haemovigilance; Clinical trials regarding appropriate haemotherapy; Non-infectious adverse affects of transfusion; Therapeutic apheresis; Support of transplant patients; Gene therapy and immunotherapy. 4) Immunohaematology and Immunogenetics: Autoimmunity in haematology; Alloimmunity of blood; Pre-transfusion testing; Immunodiagnostics; Immunobiology; Complement in immunohaematology; Blood typing reagents; Genetic markers of blood cells and serum proteins: polymorphisms and function; Genetic markers and disease; Parentage testing and forensic immunohaematology. 5) Cellular Therapy: Cell-based therapies; Stem cell sources; Stem cell processing and storage; Stem cell products; Stem cell plasticity; Regenerative medicine with cells; Cellular immunotherapy; Molecular therapy; Gene therapy.