Reducing Unnecessary Group and Screen Sampling for Laparoscopic Appendicectomy: A retrospective single centre analysis.

Abstract

Abstract Aims Blood transfusion is rarely required for patients undergoing laparoscopic appendicectomies (LA) however some NHS trusts still require group and screen (G&S) sampling. This study aimed to assess G&S sampling for LA, rate of transfusion and the cost of G&S sampling at our hospital. It re-assessed these parameters after introduction of a guideline specifying that G&S are not needed routinely and should only be considered in case of high-risk patients (including those with deranged clotting, anticoagulation or profound anaemia). Methods A retrospective observational study was conducted in our centre from 01/02/2022-01/06/2022 (cycle one) and 20/04/23- 20/08/2023 (cycle two post, guideline introduction). All patients undergoing emergency LA were included. Laboratory costs of G&S sampling was estimated at £18.37 excluding consumables, CO2 emissions estimated at 116g/ test. Results The first cycle included 48 patients for which 85 G&S samples were sent costing £1561.45. 21 samples were rejected / not required and estimated CO2 emissions were 9.86kg. In second cycle, 32 G&S samples were sent for 52 patients, only 2 samples were rejected. No patients required blood transfusion. £973.61 and an estimated 6.1kg CO2 emissions were saved. Conclusions We established a guideline which negates the need for routine G&S sampling in patients undergoing LA in our hospital. Projected savings are approximately £30,000 per annum excluding theatre delay costs, personnel and other consumables. We recommend other NHS trusts should look to implement similar guidelines in order to reduce cost and CO2 impact of unnecessary testing in EGS.