301 Blood Grouping and Save in Day Case Laparoscopic Surgery – Potential for Resource Savings?

Abstract

Abstract Introduction Currently, patients listed for Laparoscopic cholecystectomy and Laparoscopic Appendicectomy undergo routine Blood Grouping and Saving (G&S) pre-operatively. Blood transfusion administration in this context is a rare occurrence. Processing of G&S samples takes approximately 45 minutes and costs £31 per sample. This excludes the phlebotomy and junior doctor resources for sample collection, which incurs additional costs. We retrospectively assessed the blood transfusion requirements in those patients who underwent either a laparoscopic appendicectomy or cholecystectomy in the last 18 months at a busy District General Hospital (Milton Keynes Hospital) to determine if there were any potential costs and resource savings that could have been made. Method Retrospective case notes analysis of patients who had laparoscopic cholecystectomy and laparoscopic appendicectomy from January 2019 to June 2020 focusing on timing of G&S, preoperative and postoperative haemoglobin, the timing of blood transfusion and the number of units transfused. Results Of a total of 613 patients, 323 patients had laparoscopic cholecystectomy. 256 (78.8%) of these had 1 G&S sample and 96 (29.7%) had 2 samples. 290 patients had laparoscopic appendicectomy. 190 (65.5%) of these laparoscopic appendicectomy patients had 1 G&S sample and 89 (30.6%) had two G&S samples. None of the 613 patients was transfused. The total cost of G&S was £22,196. Conclusions Our study illustrates that in this group there was no requirement for blood transfusion. Routine group and save samples result in a significant waste of resources and finances. Targeted groups and save samples should be reserved for high-risk groups only.