DOI: 10.5061/dryad.sbcc2frh1
title: A prospective study of preoperative risk factors associated with extended length of stay in patients attending a pre-operative clinic in South Africa

description: Preoperative assessment clinics play a critical role in identifying,
 evaluating, and mitigating perioperative risks. Despite global data
 highlighting the importance of preoperative risk factors on surgical
 outcomes, there remains limited information on their impact on
 postoperative length of stay in South African contexts. This
 study aimed to describe the demographic and clinical profiles of patients
 referred to a preoperative clinic in Johannesburg, South Africa, and to
 examine factors associated with postoperative length of stay
 (LOS). This was a prospective cohort study conducted between 2021
 and 2022 at a private clinic. Patients aged ≥18 years undergoing
 non-cardiac surgery were included. Data on demographics, comorbidities,
 surgical procedures, and clinical outcomes were collected. Statistical
 analysis was performed to assess relationships between preoperative risk
 factors, including ASA grading, Revised Cardiac Risk Index (RCRI), eGFR,
 Diabetes Mellitus, age, obesity, and LOS. A total of 214 patients
 were assessed, of which 75.7% were female, with a median age of 62.5
 years. Common comorbidities included hypertension (59.3%) and obesity
 (55%). The median LOS was 3.5 days, with 47.2% of patients staying more
 than 3 days postoperatively. Knee (33.2%) and hip surgeries (21%) were the
 most common procedures. A significant association was found between longer
 LOS and RCRI score ≥1 (p=0.007), as well as renal dysfunction in knee
 surgery patients (p=0.027) and age in patients undergoing hip surgery
 (p=0.049). There was no significant association between ASA grade,
 presence of diabetes mellitus, eGFR, age, or obesity. Increased RCRI
 scores, renal dysfunction, and age were associated with prolonged hospital
 stays. Findings highlight the need for targeted interventions in
 preoperative care to reduce LOS, particularly for high-risk patients.
 Further research is needed to validate these results across broader
 healthcare settings and to establish appropriate protocols for South
 African patients undergoing pre-operative assessment.
description: Patients attending a pre-operative clinic were asked to consent
 to participate in a pre-operative assessment trial. A questionnaire was
 provided which was completed by the patient attending the clinic after
 consent was obtained. The length of stay was obtained from the hospital
 records of the patient.
description: # A prospective study of preoperative risk factors associated with
 extended length of stay in patients attending a pre-operative clinic in
 South Africa
 [https://doi.org/10.5061/dryad.sbcc2frh1](https://doi.org/10.5061/dryad.sbcc2frh1) ## Description of the data and file structure The data was collected to evaluate the demographics and associated co-morbidities of patients who attended a preoperative clinic in Johannesburg, South Africa. This was a prospectively run study and the outcome of the length of stay in the hospital post-procedure was interrogated. Associated risk factors with prolonged length of stay were noted. ### Files and variables #### File: ERP\_PRe\_op\_PLOS CSV v3.csv **Description:**  ##### Variables * **AGEGROUP**: Age group of the patient in years. * **GENDER**: Gender of the patient classified as 1 or 2 * **HPT**: Hypertension, a condition characterized by high blood pressure. * **Type 2 DM**: Type 2 Diabetes Mellitus, a chronic condition affecting blood sugar regulation. * **IHD**: Ischemic Heart Disease, a condition involving reduced blood supply to the heart muscle. * **Dyslipidaemia**: Abnormal levels of lipids (cholesterol, triglycerides) in the blood. * **Osteoarthritis**: Degeneration of joint cartilage and underlying bone. * **Hypothyroidism**: Underactive thyroid gland leading to low hormone levels. * **Hyperthyroidism:** overactive thyroid gland * **Protein C deficiency:** a deficiency of a blood coagulation factor that helps to prevent abnormal clotting * **ECG**: Electrocardiogram, a test that records the electrical activity of the heart. * **Spiro**: Spirometry, a test measuring lung function and capacity. * **ICA:** Ionised calcium - measured in mol/L * **Hb**: Haemoglobin, a protein in red blood cells carrying oxygen measured in g/dl * **Hct**: Haematocrit, a measure of red blood cells in blood volume described in L/L * **Na**: Sodium levels in the blood measured in mmol/L * **Cl**: Chloride levels in the blood measured in mmol/L * **Urea:** blood value displayed in mmol/L * **Creatinine:** blood value displayed in umol/L * **GFR**: Glomerular Filtration Rate, a measure of kidney function measured in ml/min * **BMI**: Body Mass Index, a measure of body fat based on height and weight described as kg/msq * **BP**: Blood Pressure, a measure of the force of blood against the artery walls described in mmHg * **HGT**: Random capillary glucose measured in mmol/L * **GLUCOSE:** A whole blood glucose reading performed with point of care and measured in mmol/L * **COPD**: Chronic Obstructive Pulmonary Disease, a lung condition that obstructs airflow. * **ASA Grading**: American Society of Anesthesiologists physical status grading system. There are 6 grades in total. * **ICU LOS**: Intensive Care Unit Length of Stay (number of days). * **High Care LOS**: High Care Length of Stay (number of days). * **General LOS**: General Ward Length of Stay (number of days). * **ICD 10 CODES:** International Classification of Diseases, 10th Revision, Clinical Modification - These were the procedure and diagnostic codes captured upon admission of the patient to the hospital. * **30 day FU call**: Follow-up telephone call 30 days post-procedure. * **RCRI POINTS:** Revised Cardiac Risk Index Score  - a validated clinical tool used to estimate the risk of cardiac complications in patients undergoing non-cardiac surgery. Patients can be scored as having 0,1,2 or a maximum of 3 points according to their risk factors. * **PLANNED PROCEDURE:** the procedure that the patient was booked to undergo. * **FIT FOR SURGERY:** Patients that were declared fit by the pre-operative clinic to undergo the planned procedure. * **Post-op Myocardial infarction - ICD I21.9; Post-op Ventricular fibrillation - ICD I49.0; Post-op Primary cardiac arrest - ICD I46.9; Post-op Pulmonary oedema - ICD J81.1; Post-op Heart block ICD I44.3:** possible complications post-surgery that were looked for in particular. * **Cancellation of planned procedure:** If the patient's planned procedure was cancelled by the pre-operative clinic. ## Code/software Microsoft Excel ## Access information NA