369 Should We Be Group and Save Testing for Laparoscopic General Surgical Procedures? a Retrospective Audit of Transfusion Rates at a District General Hospital

Introduction

The risk of bleeding in surgery makes the requirement for transfusion a pertinent consideration for all clinical staff involved in the care of surgical patients. Group and save testing allow for appropriate blood to be dispensed, but each Group and Save sample costs approximately £20 per sample and 116g of CO2 per test.

Historically the reported transfusion rate for laparoscopic surgery has been low. This audit aimed to ascertain the overall transfusion rate in laparoscopic surgery at a District General Hospital and use the data to inform practice regarding group and save requirements before surgery.

Method

A retrospective audit was undertaken incorporating all elective and emergency laparoscopic procedures undertaken at one trust between January 2020 and October 2021. Colorectal and Gynaecological procedures were excluded. Analysis was then undertaken with records from clinical coding and the hospital blood bank to determine how many patients received transfusion intra-operatively or within 72 hours of their procedure.

Results

1794 laparoscopic procedures were included in the data set. Procedures included were laparoscopic cholecystectomy, laparoscopic appendicectomy, diagnostic laparoscopy, and laparoscopic hernia repair. Of these procedures 93.8% were performed on adults. Following analysis, 2 patients in the data set were found to have received transfusion within 72 hours of their procedure (0.11%).

Conclusions

The low transfusion rate in this study is comparable to other rates reported in the literature. This resulted in a local change in trust policy for elective and emergency laparoscopic surgery, reducing or eliminating the group and save requirement for most procedures.