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VOLUME 13 , ISSUE 3 ( September-December, 2020 ) > List of Articles
Ian S Farrell, James Hall, James Hill
Keywords : Appendicectomy, Laparoscopy, Transfusion
Citation Information : Farrell IS, Hall J, Hill J. Cost Analysis of Blood Group and Antibody Screening for Emergency Appendicectomy: Should We Stop?. World J Lap Surg 2020; 13 (3):128-129.
License: CC BY-NC 4.0
Published Online: 28-12-2020
Copyright Statement: Copyright © 2020; Jaypee Brothers Medical Publishers (P) Ltd.
Introduction: The rate of transfusion associated with emergency laparoscopic general surgery has been shown to be 0.36%. A significant number of patients undergo group and antibody screening due to perceived risk of hemorrhage. All NHS hospitals have massive transfusion policies with immediate availability of O-negative blood. Blood group and antibody screening carries a cost of £35. The aim of this study was to determine the cost-effectiveness of group and antibody screening vs crossmatching where required. Materials and methods: All patients undergoing emergency appendicectomy over a 3-year period were retrospectively identified. The transfusion service then identified whether blood had been issued. Results: A total of 645 emergency appendicectomies were identified: 603 were laparoscopic and 42 open. One (0.2%) patient received a transfusion of 2 units. Discussion: Our study has shown a rate of transfusion of 0.2%. If patients were crossmatched as required rather than group and screening, this would give a cost saving of £35 per patient or £22345 across our trust. There are 50,000 appendicectomies per year in the United Kingdom. If this saving were extrapolated, it would generate a saving of £1.1M. Conclusion: Our recommendation would be to crossmatch where required. The cost saving to the NHS could be up to £1.1M with little impact on the demand for O-negative blood.
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