Key result
Implementation of a standard operating procedure safely reduced routine preoperative group and save testing from 98% to 65% in patients undergoing emergency appendicectomy, with no patients requiring perioperative blood transfusion in the post-intervention cohort.
Why the study?
Routine practice often includes preoperative group and save samples for all emergency appendicectomy patients despite a lack of guidance or formalised risk stratification protocols.
Does a standard operating procedure reduce routine group and saves without increasing transfusion-related risks in patients undergoing emergency appendicectomy?
Observational (n=233)
No
Does a standard operating procedure reduce routine group and saves without increasing transfusion-related risks in patients undergoing emergency appendicectomy?
A standard operating procedure safely reduces unnecessary preoperative group and saves for emergency appendicectomies, offering cost and resource savings.
Questions routine group-and-save sampling in appendicectomy; hypothesis-generating and should not yet change practice.
Introduction: acute appendicitis is the most common abdominal surgical emergency. Laparoscopic appendicectomy is the gold standard of care in management (78% in 2010) , and is usually associated with a closed approach to pneumoperitoneum induction. Despite lack of national/international guidance or formalised risk stratification protocols in the literature, routine practice often includes group and save samples to be taken pre-operatively for all patients.
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Khetan et al. (2023) conducted an observational in Acute appendicitis (n=233). Standard operating procedure for preoperative group and save vs. Routine practice (blanket preoperative group and save) was evaluated on Incidence of perioperative blood product transfusion up to 30 days from index admission. Implementation of a standard operating procedure safely reduced routine preoperative group and save testing from 98% to 65% in patients undergoing emergency appendicectomy, with no patients requiring perioperative blood transfusion in the post-intervention cohort.
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