Prediction of low haemoglobin levels in whole blood donors

Abstract

Each year, a relevant proportion of whole blood donors is deferred from donation because of low haemoglobin (Hb) levels. Such temporary deferrals are demoralizing, and donors may never return for a donation. Reliable predictions of Hb levels may guide the decision whether donors can be invited for the next donation. In this study, a prediction model was developed for the risk of low Hb levels. Individual data from 5191 whole blood donors were analysed; 143 donors had a low Hb level. Eleven candidate predictors were considered in logistic regression models to predict low Hb levels. The performance of the prediction model was studied with the receiver operating characteristic (ROC) curve. Internal validity was assessed with a bootstrap procedure. Strong predictors were sex, seasonality, Hb level measured at the previous visit, difference in Hb levels between the previous two visits, time since the previous visit, deferral at the previous visit, and the total number of whole blood donations in the past 2 years. Internal validation showed an area under the ROC curve of 0·87. The developed prediction model provides accurate discrimination between donors with low and appropriate Hb levels. The model predictions may be valuable to determine whether donors can be invited for a next donation, or whether some interventions such as postponement of the invitation are warranted. Potentially, this could decrease the number of donor deferrals for low Hb levels.