Group And Save Sampling In Emergency Appendicectomy: A Multi-Centre Audit

Abstract

Background
Emergency appendicectomy is one of the most common emergency surgical procedures performed
in Scotland. Despite low reported perioperative transfusion rates, no national guidelines exist
for pre-operative group and save (G&S) sampling. This multi-centre audit examined current G&S
sampling practice, transfusion rates, and the associated financial and environmental impact across
Scotland.
Methods
Data were collected retrospectively from 16 hospitals across 8 Scottish health boards, serving
approximately 3.6 million people. Adult patients undergoing emergency appendicectomy during
a consecutive 12-month period were included.
Results
A total of 1546 patients underwent appendicectomy, of whom 91.2% had a laparoscopic proce-
dure. A total of 2029 G&S samples were taken. Six patients received a blood transfusion within
7 days of surgery, with a transfusion rate of 0.4%, while 12 out of 16 hospitals recorded no
transfusions. The estimated cost of G&S sampling was £28,000-£77,000 with carbon emissions
of 872kg CO2e.
Conclusion
Emergency appendicectomy in Scotland is associated with a very low perioperative transfusion
rate despite widespread use of G&S sampling. These findings support further evaluation of
risk-stratified approaches to pre-operative blood testing.