Routine preoperative blood group and save is unnecessary for adult emergency appendicectomies: A retrospective multicentre study
Year: 2024
Type: article
Study design: Observational Study
Abstract: Background and AimsRoutine group and save (G&S) is commonly performed before appendicectomy despite limited evidence. This study aims to evaluate the necessity of preoperative G&S by determining perioperative blood transfusion rates.MethodsA multicentre retrospective observational study of adult patients who had emergency appendicectomy across four hospitals between August 2018 and November 2020. Data analysed included demographics, operative details, G&S, crossmatching and perioperative blood transfusion.Results1105 patients were identified, 635 (57.4%) were male. Median age was 37 years (IQR 26-52). 1012 (91.6%) were ASA 1 or 2. Surgical approach: 890 (80.5%) laparoscopic, 79 (7.1%) converted to open, 119 (10.8%) open and 17 (1.5%) laparotomy. Severity of appendicitis: 804 (72.8%) inflamed, 56 (5.1%) gangrenous, 235 (21.3%) perforated and 10 (0.9%) normal. 921 (83.3%) patients had preoperative G&S. 42 (3.8%) patients also had crossmatch. No patients required blood transfusion in 30 days post appendicectomy. The cost of G&S is estimated to be £40,164 in this cohort.ConclusionsThe need for perioperative blood transfusion is rare in patients undergoing appendicectomy. It has a significant cost impact and can cause unnecessary delays. Our study suggests that a routine G&S policy is not necessary, and we suggest a more 'selective' G&S policy.
Source: Scottish Medical Journal
Authors: Iona Robertson, Jeeva Karuniya Sundarraj, Khurram Shahzad Khan
Institutions: Hairmyres Hospital, Glasgow Royal Infirmary, University of Glasgow
Language: English
Subfield: Biochemistry
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
Funder: NHS Health Scotland
OpenAlex ID: W4405511159