Blood Donation in the Hospital de S. José. A 11-Year Retrospective Analysis of Deferrals and Exclusions

Background: Approximately 5% of the population donates blood each year in developed countries. Recruiting and maintaining a pool of altruistic and healthy blood donors is a challenging task. Blood donation as a dynamic process must naturally co-exist with the arguably essential deferrals. Aims: To analyse a 11-year cohort of donors and blood donations in order to determine the profile of the average donor and the typical donation. Characterize the donor’s population in terms of gender, age, number of donations, most common causes for deferral and exclusion and the possible relationships between them. Establish the tendency flow of donations per year. Methods: Analysis of 95861 blood donations from 31550 donors collected between 2000 and 2010 (11 years) in the Immunohemotherapy Department of the ‘‘Centro Hospitalar Lisboa Central - Hospital de Sa˜o Jose´’’ (Lisboa, Portugal). Prior to blood donation, donors were required to fill out a form of informed consent, a questionnaire of 21 ‘‘yes or no’’ questions and were submitted to a clinical assessment and physical examination including: measurement of weight, blood pressure, pulse and capillary hemoglobin levels. Post-donation, the collected blood was tested for ALT elevation and blood-borne viral agents (HBV, HCV, HIV 1 and 2 and HTLV 1 and 2) and other infections (Treponema pallidum). Blood donors and donations were registered in a database and statistically studied in terms of: gender and age distribution, number of donations, most common causes for deferral and exclusion. The frequency of blood donations throughout the period of observation was analyzed and statistically significant relationships between the collected variables were investigated. Results: From the population of 31550 donors 61% were male and a mean age of 41.5 years (± 12.5 years) was found. From the total of 95682 blood donations collected 78% were successful while the most common causes for deferral were: donation incompatible hemoglobin levels (5% of the blood donations and 22% of deferrals), ALT elevation (3% and 14%), positive blood screening test for Treponema pallidum (1% and 6%), medication (1% and 4%), positive serological blood markers for HBV (1% and 4%), endoscopy in the previous 12 months (1% and 3%), arterial hypertension (1% and 3%), infectious conditions (1% and 3%), influenza or influenza-like symptoms (1% and 2%) and positive serological blood markers for HCV (1% and 2%). Summary/Conclusions: Several factors may have contributed to a limited number of new regular donors in the population, namely: ageing population, the alienation of the individual from the community induced by modern lifestyles and job precariousness. It is of the utmost importance to refine our blood donation campaigns according to the existing population of donors. The optimization of the blood donation potential of a population of donors must be achieved through the development of reliable and consistent screening methods. In order to appeal to new donors it is important to promote blood donations considering the profile of the regular and healthy blood donor of the existing population.

Health-Related Quality of Life Impact of a Triple Combination of Olmesartan Medoxomil, Amlodipine Besylate and Hydrochlorotiazide in Subjects with Hypertension

BACKGROUND: A post-hoc analysis was performed on the data from a 54 weeks phase III study (ClinicalTrials.gov identifier: NCT00923091) to measure changes in the health-related quality of life (HRQoL) of 2,690 patients aged ≥18 with moderate-to-severe hypertension who received one of six doses of olmesartan/amlodipine/hydrochlorothiazide (OLM/AML/HCTZ), using the MINICHAL and EQ-5D instruments. METHODS: Descriptive statistics were used to assess blood pressure and HRQoL scores over the study period. Analysis of covariance (ANCOVA) was used to identify those factors that could possibly have influenced HRQoL. Linear regression was used to assess the relationship between changes in blood pressure and HRQoL scores. RESULTS: Patients' baseline MINICHAL mood and somatic domains scores were 5.5 and 2.6. Over the study period HRQoL improved as both MINICHAL scores decreased by 31-33%. Patients' baseline EQ-5D index and VAS scores were 0.9 and 73.4 respectively, increasing by 6% and 12% over the study period. Patients' QALY gain over the 54 weeks study period was estimated to be 0.029 QALYs. The ANCOVA showed that changes in patients' HRQoL was likely to have been influenced by patients' achievement of blood pressure control, the amount of concomitant medication and patients' last used dosage strength of antihypertensive. Linear regression showed that blood pressure improvement may have been associated with improved HRQoL. CONCLUSIONS: This study showed that OLM/AML/HCTZ reduced blood pressure and significantly increased blood pressure control whilst improving patients' HRQoL. Achieving blood pressure control, amount of concomitant medication and dosage strength of antihypertensive impacted on patients' HRQoL.