Mise en œuvre des recommandations formalisées d'experts de la Sfar pour la réalisation des examens préinterventionnels appliquées aux examens immunohématologiques

We present a retrospective observational study from 2009 to 2013 aiming to streamline the prescription of preoperative type and screen blood test in accordance with the recommendations of the SFAR Experts. Recommendations to prescribe type and screen blood test preoperative according to transfusion rate for 13 interventions were broadcast: not to prescribe preoperative when the transfusion rate was less than 1% and to prescribe preoperative type and screen blood test when it was over 5%. The data (transfusion rate and rate of patients who received at least one preoperative type and screen blood test) were compared before and after the dissemination of recommendations. Before recommendations, 4897 patients were included for interventions without EIH, and 1418 for interventions with EIH. After recommendations, 7088 patients were included for interventions without EIH and 3488 for interventions with EIH. Transfusion rate did not differ significantly. The decrease in the number of patients who received at least one preoperative type and screen blood test was significant for interventions in which they were not recommended, except for knee arthroscopy and laparoscopic or vaginally hysterectomies. For interventions in which they were recommended, we found that the practice of preoperative type and screen blood test was not systematic. This approach to the relevance of preoperative laboratory tests, based on intervention transfusion rates, is effective to reduce the number of preoperative type and screen blood test, no delay transfusion or emergent transfusion were reported.