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Cost-effectiveness of routine blood type and screen testing before elective laparoscopy
S B Ransom1, S G McNeeley, R B Hosseini
1Division of Gynecologic Surgery, Hutzel Hospital/Wayne State University School of Medicine, Detroit, Michigan, USA.
Objective:
To evaluate the usefulness and cost-effectiveness of the routine preoperative evaluation of blood type and screen testing before laparoscopy.
Methods:
A retrospective review was conducted in patients transfused with blood during or after laparoscopy over a 3-year period at Hutzel Hospital, Detroit, Michigan; Grace Hospital, Southfield, Michigan; and Bixby Medical Center, Adrian, Michigan.
Results:
Of 7529 women receiving laparoscopic procedures, 57 required blood transfusion at laparoscopy. Medical records of the 57 patients requiring blood transfusion were evaluated as to urgency and indication. All 57 subsequent blood transfusions were found to be the result of previously identifiable problems, including ectopic pregnancy and preoperative anemia. No patient required transfusion for a vascular injury.
Conclusion:
In the absence of preoperative indications, routine preoperative type and screen testing for elective and emergency laparoscopic procedures does not enhance patient care and should be eliminated.