793 Environmental Impacts of Excess Perioperative Testing: A Carbon Footprint Analysis of the Group and Save and Characterisation of Transfusion Rates in Common Surgical Procedures

Aim To determine perioperative transfusion rates of different surgical procedures at a single Trust and to calculate the carbon footprint of the group and save (G&S) blood tests. Method All operations within the Trust over a six-month period and all packed red cell requests made within the same timeframe were retrospectively analysed. Patients were categorised by operation and cross-referenced with transfusion data to determine the transfusion rate of each procedure. The carbon footprint (kg CO2e) of a single G&S was calculated using a bottom-up approach. Results 15,293 operations and 637 red cell requests were included for analysis. The ten most performed elective operations had a collective transfusion rate of 1.15%, compared to 5.67% for the ten most common emergency operations. Most transfusions across all operation types occurred after the operation day; only 36 elective cases (0.24%) required intraoperative transfusions. The carbon footprint of the G&S was calculated at 0.43kg CO2e for an inpatient sample, and 7kg CO2e for an outpatient sample. A mean of 2.41 G&S tests were performed per patient. In the transfused patients alone, this was an excess of 401 G&S tests, representing a carbon footprint of 172kg CO2e. Eliminating the G&S in elective procedures with transfusion rates of <1% could save our Trust the equivalent emissions of a petrol engine car circling Earth twice over a six-month period. Conclusions Transfusion requirements vary significantly for different operation types. Guidelines surrounding perioperative G&S testing should reflect this, which could save avoidable carbon emissions, cost, and resources.