ArticleAnnals of the Royal College of Surgeons of England2026
The carbon footprint of group and save in elective and emergency surgery.
Article in Annals of the Royal College of Surgeons of England, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
3 citing papers in PubMed.
- Preoperative Group and Save Tests in Elective and Emergency Cholecystectomies: An Economic and Environmental Burden.Cureus · 2025Article
- Reassessing the Necessity of Group and Save Testing in Ambulatory Orthopedic Peripheral Limb Trauma Surgery.Cureus · 2025Article
- Cutting Costs and Carbon: Re-evaluating Routine Group and Save Testing for Appendicectomies.Cureus · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionClimate change is a significant threat to human health, and surgical care is a major contributor to the carbon footprint of hospital medicine. There is wide variation in perioperative group and save (G&S) blood testing that lacks an evidence base. Eliminating low-value clinical investigations in surgical pathways such as the G&S could lead to significant carbon and cost savings.
methodsAll operations within the trust over a 6-month period and all packed red cell requests made within the same timeframe were analysed retrospectively. Patients were categorised by operation and cross-referenced with transfusion data to determine the transfusion rate of each procedure. The carbon footprint (g CO
resultsOverall, 15,293 operations and 637 red cell requests were included for analysis. Most transfusions across all operation types occurred after the operation day, and only 36 elective cases required intraoperative transfusions. The carbon footprint of the G&S was calculated at 0.43kg CO
conclusionsTransfusion requirements vary significantly for different operation types. Guidelines surrounding perioperative G&S testing should reflect this, which could save avoidable carbon emissions, cost and resources.
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Registered trials
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