402 Cutting Costs and Carbon: Rethinking Routine Group and Save Testing for Appendicectomies Article Swipe
A. Nayak
,
O Amoako-Adjei
,
A Defer
,
Bijaya B. Karki
,
Ashley Wilkins
·
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.1093/bjs/znaf128.643
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.1093/bjs/znaf128.643
Aim Routine Group and Save (G&S) testing is frequently performed pre-operatively for appendicectomies, despite the low likelihood of blood transfusion. This study evaluates the clinical utility, financial cost, and environmental impact of pre-operative G&S testing for appendicectomies performed at a high-volume District General Hospital over a 200-day period. Method A retrospective review was conducted on all appendicectomies performed between December 2023 and June 2024. Data collected included patient demographics, pre-op haemoglobin levels, G&S samples sent, sample rejections, associated costs, and carbon emissions. Estimates were extrapolated for 12 months. Results A total of 265 appendicectomies were performed, with 261 completed laparoscopically and 4 converted to open surgery. A total of 520 G&S samples were sent, of which 15% were rejected, due to the presence of valid previous samples and labelling errors. No intra-operative transfusions were required. The estimated costs and CO₂ emissions were £5,400 and 306 kg CO₂, respectively, for the 200 days. (£10,560 and 598.4 kg CO₂ over a year). This amounts to emissions comparable to driving a petrol car from London to Istanbul. Conclusions Pre-operative G&S testing for appendicectomies has minimal clinical utility, incurring significant financial and environmental costs. Many trusts across the UK do not routinely perform pre-operative G&S testing for appendicectomies. Although national NICE guidelines exist for pre-operative testing in elective surgeries, no guidelines exist for common emergency surgeries like appendicectomies and abscesses. Reducing unnecessary testing could enhance sustainability, reduce costs and workload without compromising patient safety.
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All OpenAlex metadata
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https://doi.org/10.1093/bjs/znaf128.643Digital Object Identifier
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402 Cutting Costs and Carbon: Rethinking Routine Group and Save Testing for AppendicectomiesWork title
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articleOpenAlex work type
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enPrimary language
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2025Year of publication
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2025-06-01Full publication date if available
- Authors
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A. Nayak, O Amoako-Adjei, A Defer, Bijaya B. Karki, Ashley WilkinsList of authors in order
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https://doi.org/10.1093/bjs/znaf128.643Publisher landing page
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https://academic.oup.com/bjs/article-pdf/112/Supplement_10/znaf128.643/63505879/znaf128.643.pdfDirect link to full text PDF
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YesWhether a free full text is available
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bronzeOpen access status per OpenAlex
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https://academic.oup.com/bjs/article-pdf/112/Supplement_10/znaf128.643/63505879/znaf128.643.pdfDirect OA link when available
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Medicine, Group (periodic table), Carbon fibers, Algorithm, Chemistry, Organic chemistry, Composite number, Computer scienceTop concepts (fields/topics) attached by OpenAlex
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0Total citation count in OpenAlex
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| abstract_inverted_index.Although | 205 |
| abstract_inverted_index.December | 60 |
| abstract_inverted_index.District | 42 |
| abstract_inverted_index.Hospital | 44 |
| abstract_inverted_index.Reducing | 227 |
| abstract_inverted_index.clinical | 25, 183 |
| abstract_inverted_index.elective | 214 |
| abstract_inverted_index.included | 67 |
| abstract_inverted_index.national | 206 |
| abstract_inverted_index.presence | 123 |
| abstract_inverted_index.previous | 126 |
| abstract_inverted_index.surgery. | 106 |
| abstract_inverted_index.utility, | 26, 184 |
| abstract_inverted_index.workload | 236 |
| abstract_inverted_index.(G&S) | 6 |
| abstract_inverted_index.(£10,560 | 153 |
| abstract_inverted_index.Estimates | 83 |
| abstract_inverted_index.Istanbul. | 174 |
| abstract_inverted_index.collected | 66 |
| abstract_inverted_index.completed | 99 |
| abstract_inverted_index.conducted | 54 |
| abstract_inverted_index.converted | 103 |
| abstract_inverted_index.emergency | 221 |
| abstract_inverted_index.emissions | 141, 164 |
| abstract_inverted_index.estimated | 137 |
| abstract_inverted_index.evaluates | 23 |
| abstract_inverted_index.financial | 27, 187 |
| abstract_inverted_index.incurring | 185 |
| abstract_inverted_index.labelling | 129 |
| abstract_inverted_index.performed | 10, 38, 58 |
| abstract_inverted_index.rejected, | 119 |
| abstract_inverted_index.required. | 135 |
| abstract_inverted_index.routinely | 198 |
| abstract_inverted_index.surgeries | 222 |
| abstract_inverted_index.abscesses. | 226 |
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| abstract_inverted_index.comparable | 165 |
| abstract_inverted_index.emissions. | 82 |
| abstract_inverted_index.frequently | 9 |
| abstract_inverted_index.guidelines | 208, 217 |
| abstract_inverted_index.likelihood | 17 |
| abstract_inverted_index.performed, | 96 |
| abstract_inverted_index.surgeries, | 215 |
| abstract_inverted_index.Conclusions | 175 |
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| abstract_inverted_index.high-volume | 41 |
| abstract_inverted_index.rejections, | 77 |
| abstract_inverted_index.significant | 186 |
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| abstract_inverted_index.compromising | 238 |
| abstract_inverted_index.extrapolated | 85 |
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| abstract_inverted_index.transfusions | 133 |
| abstract_inverted_index.Pre-operative | 176 |
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| abstract_inverted_index.pre-operative | 33, 200, 211 |
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| abstract_inverted_index.sustainability, | 232 |
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| abstract_inverted_index.appendicectomies, | 13 |
| abstract_inverted_index.appendicectomies. | 204 |
| cited_by_percentile_year | |
| countries_distinct_count | 1 |
| institutions_distinct_count | 5 |
| citation_normalized_percentile.value | 0.38824829 |
| citation_normalized_percentile.is_in_top_1_percent | False |
| citation_normalized_percentile.is_in_top_10_percent | False |