Routine preoperative blood group and save is unnecessary for adult emergency appendicectomies: A retrospective multicentre study.

IF 1.4 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL
Iona Robertson, Jeeva Karuniya Sundarraj, Khurram Shahzad Khan
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引用次数: 0

Abstract

Background and aims: Routine 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.

Methods: A 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.

Results: 1105 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.

Conclusions: The 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.

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来源期刊
Scottish Medical Journal
Scottish Medical Journal 医学-医学:内科
CiteScore
4.80
自引率
3.70%
发文量
42
审稿时长
>12 weeks
期刊介绍: A unique international information source for the latest news and issues concerning the Scottish medical community. Contributions are drawn from Scotland and its medical institutions, through an array of international authors. In addition to original papers, Scottish Medical Journal publishes commissioned educational review articles, case reports, historical articles, and sponsoring society abstracts.This journal is a member of the Committee on Publications Ethics (COPE).
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