Study of factors affecting the positive strength of direct antiglobulin test by microcolumn gel test

Abstract:

Objective To explore the key factors influencing the positive strength of direct antiglobulin test（DAT）in patients，and to provide guidance for clinical DAT-positive patients during antibiotic administration or red blood cell transfusion.Methods In the retrospective analysis of the data of 27 382 patients who underwent DAT from January 2015 to December 2020，we analyzed the patient's gender，age，clinical diagnosis，antibiotic usage，red blood cell transfusion，and DAT positive strength in statistics.Results A total of 27 382 patients underwent DAT，and 5 745（20.98%） were DAT-positive. Patients with different DAT strength were grouped by male and female，and Mann-Whitney U test was performed on them. The results showed that the DAT⁺ strength was significantly higher in the male than the female（U=2 764 704.5，P<0.001）. The DAT-positive patients were divided into 3 groups according to age（<18 years old group，18-60 years old group，>60 years old group）and the Kruskal-Wallis test results showed that the difference in DAT strength between different age groups was statistically significant（H=200.4，P<0.001）. The DAT positive strength of the <18 and >60 groups were higher than that of the 18–60 group. From the perspective of disease clinical diagnosis，the positive intensity of DAT was significantly different（H=70.82，P<0.001）. Mann-Whitney U analysis showed that the distribution of DAT strength was different between patients with or without usage of antibiotics，indicating that antibiotic usage increased DAT-positive strength（U=1 853 921.5，P<0.001）. DAT strength was higher in patients with red blood cell transfusion than in patients without red blood cell transfusion（U=3 315 953.5，P<0.001），but multiple red blood cell transfusions did not cause changes in DAT strength（U=108 911.5，P=0.68）.Conclusion In DAT-positive patients，the patient's gender，age，clinical diagnosis，antibiotic application，and red blood cell transfusion all affect their DAT strength. Repeated red blood cell transfusions haven't caused changes in DAT⁺ strength. Antibiotics and red blood cell transfusions should be used with caution in high DAT strength patients.