Deferral for low hemoglobin is not associated with increased risk of infection in Danish blood donors

Sebastian Ranzi Kotze; Ole B Pedersen; Mikkel S Petersen; Erik Sørensen; Khoa Manh Dinh; Kathrine Agergård Kaspersen; Andreas S Rigas; Henrik Hjalgrim; Klaus Rostgaard; Gustaf Edgren; Henrik Ullum; Christian Erikstrup

doi:10.1111/trf.13931

Deferral for low hemoglobin is not associated with increased risk of infection in Danish blood donors

Sebastian Ranzi Kotze, Ole B Pedersen, Mikkel S Petersen, Erik Sørensen, Khoa Manh Dinh, Kathrine Agergård Kaspersen, Andreas S Rigas, Henrik Hjalgrim, Klaus Rostgaard, Gustaf Edgren, Henrik Ullum, Christian Erikstrup

Department of Clinical Medicine

3 Citations (Scopus)

Abstract

BACKGROUND: Low hemoglobin (Hb) is associated with poor general health and adverse outcomes in a wide range of diseases. However, a link between Hb levels and the risk of infection among healthy individuals has yet to be investigated.

STUDY DESIGN AND METHODS: Using data from the Scandinavian Donations and Transfusions database, 497,390 donors were followed after 5,458,499 donations in health registers. With 1,339,362 person-years of follow-up, Andersen-Gill Cox regression was used to study the association of Hb levels below deferral thresholds, very low Hb levels (in the lowest 0.1 percentile), and declining Hb levels with the risk of infection as measured by hospital or outpatient contact for infection and filling of prescription for antimicrobials, respectively, within 3 months of donation. Analyses were stratified by sex, menopausal status, and frequency of donation.

RESULTS: Hb levels below deferral thresholds were not associated with a risk of hospital contact for infection among premenopausal women (hazard ratio [HR], 1.04; 95% confidence interval [CI], 0.95-1.14), postmenopausal women (HR, 0.77; 95% CI, 0.54-1.11), or men (HR, 0.97; 95% CI, 0.81-1.16), nor was there any association with hospital contact for very low Hb levels or patterns of declining Hb levels. However, subthreshold Hb levels were associated with a reduced risk of antimicrobial prescriptions among premenopausal women (HR, 0.92; 95% CI, 0.91-0.93), postmenopausal women (HR, 0.93; 95% CI, 0.89-0.97), and men (HR, 0.91; 95% CI, 0.88-0.94).

CONCLUSIONS: Neither Hb levels below deferral thresholds nor very low or declining Hb levels were associated with an increased risk of infection. This is reassuring, because blood donation can lead to lower Hb levels.

Original language	English
Journal	Transfusion
Volume	57
Issue number	3
Pages (from-to)	571-577
Number of pages	7
ISSN	0041-1132
DOIs	https://doi.org/10.1111/trf.13931
Publication status	Published - 1 Mar 2017

Keywords

Adult
Blood Donors
Denmark
Female
Follow-Up Studies
Hemoglobins
Humans
Infection
Male
Middle Aged
Registries
Risk Factors
Sex Factors
Journal Article

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10.1111/trf.13931

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@article{9f373efcf31748ca87a86a3b798d9a87,

title = "Deferral for low hemoglobin is not associated with increased risk of infection in Danish blood donors",

abstract = "BACKGROUND: Low hemoglobin (Hb) is associated with poor general health and adverse outcomes in a wide range of diseases. However, a link between Hb levels and the risk of infection among healthy individuals has yet to be investigated.STUDY DESIGN AND METHODS: Using data from the Scandinavian Donations and Transfusions database, 497,390 donors were followed after 5,458,499 donations in health registers. With 1,339,362 person-years of follow-up, Andersen-Gill Cox regression was used to study the association of Hb levels below deferral thresholds, very low Hb levels (in the lowest 0.1 percentile), and declining Hb levels with the risk of infection as measured by hospital or outpatient contact for infection and filling of prescription for antimicrobials, respectively, within 3 months of donation. Analyses were stratified by sex, menopausal status, and frequency of donation.RESULTS: Hb levels below deferral thresholds were not associated with a risk of hospital contact for infection among premenopausal women (hazard ratio [HR], 1.04; 95% confidence interval [CI], 0.95-1.14), postmenopausal women (HR, 0.77; 95% CI, 0.54-1.11), or men (HR, 0.97; 95% CI, 0.81-1.16), nor was there any association with hospital contact for very low Hb levels or patterns of declining Hb levels. However, subthreshold Hb levels were associated with a reduced risk of antimicrobial prescriptions among premenopausal women (HR, 0.92; 95% CI, 0.91-0.93), postmenopausal women (HR, 0.93; 95% CI, 0.89-0.97), and men (HR, 0.91; 95% CI, 0.88-0.94).CONCLUSIONS: Neither Hb levels below deferral thresholds nor very low or declining Hb levels were associated with an increased risk of infection. This is reassuring, because blood donation can lead to lower Hb levels.",

keywords = "Adult, Blood Donors, Denmark, Female, Follow-Up Studies, Hemoglobins, Humans, Infection, Male, Middle Aged, Registries, Risk Factors, Sex Factors, Journal Article",

author = "Kotze, {Sebastian Ranzi} and Pedersen, {Ole B} and Petersen, {Mikkel S} and Erik S{\o}rensen and {Manh Dinh}, Khoa and {Agerg{\aa}rd Kaspersen}, Kathrine and Rigas, {Andreas S} and Henrik Hjalgrim and Klaus Rostgaard and Gustaf Edgren and Henrik Ullum and Christian Erikstrup",

note = "{\textcopyright} 2016 AABB.",

year = "2017",

month = mar,

day = "1",

doi = "10.1111/trf.13931",

language = "English",

volume = "57",

pages = "571--577",

journal = "Transfusion",

issn = "0041-1132",

publisher = "Wiley-Blackwell",

number = "3",

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TY - JOUR

T1 - Deferral for low hemoglobin is not associated with increased risk of infection in Danish blood donors

AU - Kotze, Sebastian Ranzi

AU - Pedersen, Ole B

AU - Petersen, Mikkel S

AU - Sørensen, Erik

AU - Manh Dinh, Khoa

AU - Agergård Kaspersen, Kathrine

AU - Rigas, Andreas S

AU - Hjalgrim, Henrik

AU - Rostgaard, Klaus

AU - Edgren, Gustaf

AU - Ullum, Henrik

AU - Erikstrup, Christian

PY - 2017/3/1

Y1 - 2017/3/1

N2 - BACKGROUND: Low hemoglobin (Hb) is associated with poor general health and adverse outcomes in a wide range of diseases. However, a link between Hb levels and the risk of infection among healthy individuals has yet to be investigated.STUDY DESIGN AND METHODS: Using data from the Scandinavian Donations and Transfusions database, 497,390 donors were followed after 5,458,499 donations in health registers. With 1,339,362 person-years of follow-up, Andersen-Gill Cox regression was used to study the association of Hb levels below deferral thresholds, very low Hb levels (in the lowest 0.1 percentile), and declining Hb levels with the risk of infection as measured by hospital or outpatient contact for infection and filling of prescription for antimicrobials, respectively, within 3 months of donation. Analyses were stratified by sex, menopausal status, and frequency of donation.RESULTS: Hb levels below deferral thresholds were not associated with a risk of hospital contact for infection among premenopausal women (hazard ratio [HR], 1.04; 95% confidence interval [CI], 0.95-1.14), postmenopausal women (HR, 0.77; 95% CI, 0.54-1.11), or men (HR, 0.97; 95% CI, 0.81-1.16), nor was there any association with hospital contact for very low Hb levels or patterns of declining Hb levels. However, subthreshold Hb levels were associated with a reduced risk of antimicrobial prescriptions among premenopausal women (HR, 0.92; 95% CI, 0.91-0.93), postmenopausal women (HR, 0.93; 95% CI, 0.89-0.97), and men (HR, 0.91; 95% CI, 0.88-0.94).CONCLUSIONS: Neither Hb levels below deferral thresholds nor very low or declining Hb levels were associated with an increased risk of infection. This is reassuring, because blood donation can lead to lower Hb levels.

AB - BACKGROUND: Low hemoglobin (Hb) is associated with poor general health and adverse outcomes in a wide range of diseases. However, a link between Hb levels and the risk of infection among healthy individuals has yet to be investigated.STUDY DESIGN AND METHODS: Using data from the Scandinavian Donations and Transfusions database, 497,390 donors were followed after 5,458,499 donations in health registers. With 1,339,362 person-years of follow-up, Andersen-Gill Cox regression was used to study the association of Hb levels below deferral thresholds, very low Hb levels (in the lowest 0.1 percentile), and declining Hb levels with the risk of infection as measured by hospital or outpatient contact for infection and filling of prescription for antimicrobials, respectively, within 3 months of donation. Analyses were stratified by sex, menopausal status, and frequency of donation.RESULTS: Hb levels below deferral thresholds were not associated with a risk of hospital contact for infection among premenopausal women (hazard ratio [HR], 1.04; 95% confidence interval [CI], 0.95-1.14), postmenopausal women (HR, 0.77; 95% CI, 0.54-1.11), or men (HR, 0.97; 95% CI, 0.81-1.16), nor was there any association with hospital contact for very low Hb levels or patterns of declining Hb levels. However, subthreshold Hb levels were associated with a reduced risk of antimicrobial prescriptions among premenopausal women (HR, 0.92; 95% CI, 0.91-0.93), postmenopausal women (HR, 0.93; 95% CI, 0.89-0.97), and men (HR, 0.91; 95% CI, 0.88-0.94).CONCLUSIONS: Neither Hb levels below deferral thresholds nor very low or declining Hb levels were associated with an increased risk of infection. This is reassuring, because blood donation can lead to lower Hb levels.

KW - Adult

KW - Blood Donors

KW - Denmark

KW - Female

KW - Follow-Up Studies

KW - Hemoglobins

KW - Humans

KW - Infection

KW - Male

KW - Middle Aged

KW - Registries

KW - Risk Factors

KW - Sex Factors

KW - Journal Article

U2 - 10.1111/trf.13931

DO - 10.1111/trf.13931

M3 - Journal article

C2 - 27900795

SN - 0041-1132

VL - 57

SP - 571

EP - 577

JO - Transfusion

JF - Transfusion

IS - 3

ER -

Deferral for low hemoglobin is not associated with increased risk of infection in Danish blood donors

Abstract

Keywords

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