783 Routine Pre-Operative Group and Save Testing: Is It Necessary for Laparoscopic Appendicectomy?

Aim Pre-surgical group and save tests are routine but can result in unnecessary expense and theatre delays. The aim of this study is to examine the necessity of group and save testing prior to appendicectomy and evaluate the cost implications. Method This retrospective study analysed the records of 200 patients with appendicitis who underwent emergency appendicectomies in a busy general surgery department between March 2021 to August 2022. The study adhered to local clinical governance unit protocol. Patients who had elective appendicectomies or other emergency procedures were excluded. Data was collected on age, gender, number of samples, and requirement for peri-operative transfusion. Comparisons were drawn between patients who underwent laparoscopic, open, or converted emergency appendicectomies. Results Of the sample population, (median age 32, 55.5% male), 93.5% had valid pre-operative group and save tests. None required peri-operative blood transfusions. 26% of the patients only required one sample for a valid group and save due to having previous samples in the lab. 55% required two samples. 7% needed a third sample because one initial sample was rejected and 5.5% required 4 samples because the initial 2 samples were rejected. The total cost of these samples was estimated to be £3500.14. Conclusions Emergency appendicectomy poses minimal risk of resulting in the need for blood transfusions. Re-evaluating the need for routine pre-operative group and save testing and adopting a risk-benefit analysis approach could have a financial benefit for the NHS.