Evaluating the Necessity of Routine Blood Type and Screen Testing Prior to Appendicectomy.

Abstract

Aim: Appendicectomy is one of the most common emergency surgeries and is typically associated with minimal blood loss. Despite this, many institutions require routine preoperative type and screening (T&S) prior to appendicectomy. This study aimed to determine the rate of transfusion in appendicectomy.

Methods: Audit approval was obtained (250907). Data was collected retrospectively from health records of all patients who underwent appendicectomy at Connolly Hospital, Ireland, between January 2023 and December 2024.

Results: In total, 340 patients were included. The median age was 35.0 years [IQR; 22.3, range: 16 - 84], with 46% female (157). The majority of cases were emergency (330, 97%) and laparoscopic (339, 99%). A preoperative T&S was sent in 320 patients (94%) and 10 patients (3%) were crossmatched. The rate of intraoperative transfusion was 0% and only 1 patient (0.3%) required a postoperative blood transfusion. Haemoglobin was significantly lower in the crossmatched group (mean haemoglobin 12.5 g/dL [SD: 0.83], p = 0.007). The estimated cost per T&S was €54.52, equating to a total of approximately €17,446.40 for the study period.

Discussion: The incidence of perioperative transfusion during appendicectomy is extremely low. A selective, risk-based approach - targeting patients with complicated appendicitis or pre-existing anaemia - may safely reduce costs without compromising patient care.