Beschreibung:
Abstract Background One group and hold sample costs approximately £18 to process whilst it costs £170 to prepare and administer 1 unit of cross matched blood. We aimed to quantify the amount of blood cross-matched for elective oesophagectomy and gastrectomy cases and compare this to the number of units transfused in the peri-operative setting (within 24 hours of surgery). Current unit guidance required all patients to be cross matched for 2 units of blood pre-operatively. Methods Baseline data was collected retrospectively over a 10 week period (08/07/19-16/09/19). A new blood ordering protocol, made in agreement with oesophago-gastric and anaesthetic consultants was produced. Blood was only to be requested if: antibodies on group and hold, pre-op Hb < 120g/l, operative team concerns or previous radiotherapy. Data was recollected using the same parameters post -intervention over a 10 week period (23/12/19-08/03/20). Results Before implementation of the protocol 24 patients were included, mean age 67 (range 40-84). All patients were cross matched between 2 and 4 units, with a total of 52 units requested and only 1 transfused. After implementation of the protocol 27 patients were included, mean age 69 (range 51-87). 36 units were ordered for 15 patients and 3 units were transfused. The new protocol was correctly implemented in 19 patients (70%). If implemented correctly in all patients in this group a saving of approximately £6120 could have been made. This could equate to a saving of as much as £20,400 per year based on 90 OG operative cases. Conclusions Patients were cross-matched far in excess of their transfusion needs. There was significant reduction in the number of patients being cross-matched post intervention. Rationalising this is important to reduce waste, reduce cost and cut down on delays to maximise theatre time.