Excessive use of preoperative blood type and antibody screening: A retrospective observational study conducted in a hospital in Norway

Author:

Morberg Pål Christian Wold1ORCID,Ringdal Kjetil Gorseth12,Espinosa Aurora3,Lindholm Espen1ORCID

Affiliation:

1. Department of Anesthesiology Vestfold Hospital Trust Tønsberg Norway

2. Division of Prehospital Care Vestfold Hospital Trust Tønsberg Norway

3. Department of Immunology and Transfusion Medicine Oslo University Hospital Oslo Norway

Abstract

AbstractIntroductionThis study aimed to identify the blood transfusion rates for several surgical procedures in a single district general hospital and assess the value of preoperative blood type and antibody screen across all relevant surgical procedures. We hypothesized that there was an overuse of blood type and antibody screen in our general surgical population.MethodsA database containing transfusions of patients who underwent elective‐ or emergency surgery from January 2015 to September 2020 was matched to a database of preoperative type‐and‐screen performed in the same period. Registered procedures where the incidence of transfusion is deemed low were excluded. The included procedures were assessed for the intraoperative usefulness of type‐ and‐screen testing.ResultsIn the included 68.892 surgeries, 36.134 (52.0%) blood samples were preoperatively tested for the blood type and screened for antibodies according to the hospital's routine. Overall 3.517 (5.1%) of surgeries had patients that received a transfusion in the perioperative period and 1.2% (n = 850) during the surgery.ConclusionMost surgeries had a very low incidence of transfusion. Despite this, type‐and‐screen tests were widely used. This suggests the need for a more focused pre‐surgery type‐and‐screen approach, and a more data driven approach to local guidelines in collaboration with surgical specialties.

Funder

Helse Sør-Øst RHF

Publisher

Wiley

Reference22 articles.

1. Norwegian Directorate of Health.(Guidelines for the Transfusion Service in Norway Edition 7.3 2017 (IS‐1414)) Veileder for transfusjonstjenesten i Norge Utgave 7.3 2017(IS‐1414) Oslo: Helsedirektoratet (in Norwegian).2017.

2. Cost‐effectiveness of routine blood group and screen testing for cesarean section;Ransom SB;J Reprod Med,1999

3. The cost‐effectiveness of routine group and screen admission testing for expected vaginal delivery;Ransom SB;Obstet Gynecol,1998

4. Cost‐effectiveness of routine blood group and screen testing before elective laparoscopy;Ransom SB;Obstet Gynecol,1995

5. A cost-effectiveness evaluation of preoperative type-and-screen testing for vaginal hysterectomy

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