Evaluating the Necessity of Routine Blood Type and Screen Testing Prior to Appendicectomy

Abstract

Aim
Appendicectomy is one of the most common emergency surgeries and is typically associated with minimal blood loss. Despite this, many institutions require routine preoperative type and screening (T&S) prior to appendicectomy. This study aimed to determine the rate of transfusion in appendicectomy.

Methods
Audit approval was obtained (250907). Data was collected retrospectively from health records of all patients who underwent appendicectomy at Connolly Hospital, Ireland, between January 2023 and December 2024.

Results
In total, 340 patients were included. The median age was 35.0 years [IQR; 22.3, range: 16 – 84], with 46% female (157). The majority of cases were emergency (330, 97%) and laparoscopic (339, 99%). A preoperative T&S was sent in 320 patients (94%) and 10 patients (3%) were crossmatched. The rate of intraoperative transfusion was 0% and only 1 patient (0.3%) required a postoperative blood transfusion. Haemoglobin was significantly lower in the crossmatched group (mean haemoglobin 12.5 g/dL [SD: 0.83], p = 0.007). The estimated cost per T&S was €54.52, equating to a total of approximately €17,446.40 for the study period.

Discussion
The incidence of perioperative transfusion during appendicectomy is extremely low. A selective, risk-based approach – targeting patients with complicated appendicitis or pre-existing anaemia – may safely reduce costs without compromising patient care.