高频全血捐献及其对死亡率的影响:来自澳大利亚数据链接研究的证据
Md Morshadur Rahman1,2,3, Surendra Karki1,2,4, Andrew Hayen1
1School of Public Health, University of Technology Sydney, Sydney, New South Wales, Australia.
Transfusion
|November 4, 2024
概括
定期高频献血不会增加死亡风险. 考虑到健康献血者效应的先进统计方法证实,频繁的全血献血与全因死亡率之间没有显著的关联.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 生物统计学 生物统计学
背景情况:
- 以前的研究表明,献血者死亡率较低,可能是由于健康捐赠者效应 (HDE).
- 选择偏差的一种形式,HDE,如果在研究献血者健康结果的研究中不适当地解决问题,可能会混结果.
研究的目的:
- 调查定期高频全血 (WB) 献血与所有原因死亡率之间的关联.
- 使用先进的统计技术减轻健康捐赠者效应 (HDE).
主要方法:
- 利用与献血历史相关的45岁及以上研究数据.
- 使用5年暴露窗口将捐赠者分为高频 (≥2次/年) 和低频组.
- 应用反向概率加权 (IPW) 边际结构模型和针对性的基于最小损失的估计器 (TMLE) 使用机器学习进行时间变化分析.
主要成果:
- 分析包括2588名高频和4750名低频献血者.
- 在IPW (RR=0.98,95% CI 0.68-1.28) 使用定期高频WB捐赠和死亡率之间没有发现统计学上显著的关联.
- TMLE和时间变化的TMLE模型证实了这些发现,显示高频献血和全因死亡率之间没有显著的联系 (RR=0.97,95% CI 0.80-1.16和RR=0.98,95% CI 0.74-1.29,分别).
结论:
- 这项研究发现,定期高频献血和全因死亡率之间没有显著的关联.
- 适当的统计方法有效地将健康捐赠者的效应降到最低,从而更清楚地了解捐赠对死亡率的影响.
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