A multicentre, cross-sectional study investigating the prevalence of hypertensive disease in patients presenting for elective surgery in the Western Cape Province, South Africa

Spuy, K. van der; Crowther, Michael J.; Nejthardt, M; Roodt, F; Davids, Jody; Roos, J; Cloete, E; Pretorius, T.; Davies, Gareth; Walt, JE van der; Westhuizen, C. Van der; Flint, M; Swanevelder, Justiaan; Biccard, BM

doi:10.7196/samj.2018.v108i7.13022

Cited by 9 publications

(6 citation statements)

References 17 publications

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“…[10] This figure is considerably lower than ours. When investigating elective surgical patients in the Western Cape, Van der Spuy et al [15] showed a prevalence of self-reported DM of 16%, which is in keeping with our findings. However, neither of these studies evaluated the prevalence of undiagnosed DM at the time of surgery, or the degree of glycaemic control.…”

Section: Researchsupporting

confidence: 92%

A multicentre prospective observational study of the prevalence and glycaemic control of diabetes mellitus in adult non-cardiac elective surgical patients in hospitals in Western Cape Province, South Africa

et al. 2019

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Diabetes mellitus (DM) is a common condition, affecting an estimated 15.5 million people in Africa. Importantly, the prevalence of DM across the continent is expected to double by 2045. [1] Since 2015, this condition has been ranked as the second most common cause of natural death in South Africa (SA), and its impact on healthcare provision is substantial. [2] Accurate assessment of prevalence is difficult owing to the high burden of undiagnosed DM (estimated at 69% in Africa) and the lack of large population studies. [1] In SA, the prevalence of DM is estimated to be between 5.4% and 9.2%. [1,3] There are limited data reporting the prevalence of DM in Western Cape Province, SA, and information with regard to elective surgical patients is minimal. Many studies have shown that DM, especially if poorly controlled, is associated with an increased risk of perioperative complications and mortality. [4-9] In SA, insulin-dependent surgical patients are twice as likely as non-diabetics to die in hospital. [10] Objectives The primary objective of this study was to establish the prevalence of DM in patients presenting for elective surgery over a 1-week period in six Western Cape hospitals. This included patients with a previous diagnosis of DM, and those with a new diagnosis based on screening capillary blood glucose (CBG) testing and a confirmatory elevated glycated haemoglobin (HbA1c) level. The secondary objectives were to assess: (i) the glycaemic control of known diabetics presenting for This open-access article is distributed under Creative Commons licence CC-BY-NC 4.0.

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Section: Researchsupporting

confidence: 92%

A multicentre prospective observational study of the prevalence and glycaemic control of diabetes mellitus in adult non-cardiac elective surgical patients in hospitals in Western Cape Province, South Africa

et al. 2019

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“…). Following assessment, 68 articles, involving 708 032 patients across 71 LMICs, were included in the review ( Tables S1 and S2 , supporting information). Country‐specific patient numbers were reported in 60 studies but were absent from six and two provided total LMIC patient numbers only.…”

Section: Resultsmentioning

confidence: 99%

Systematic review of the use of big data to improve surgery in low- and middle-income countries

Knight

Ots

Maimbo

et al. 2019

British Journal of Surgery

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Background Technological advances have led to the generation of large amounts of data, both in surgical research and practice. Despite this, it is unclear how much originates in low‐ and middle‐income countries (LMICs) and what barriers exist to the use of such data in improving surgical care. The aim of this review was to capture the extent and impact of programmes that use large volumes of patient data on surgical care in LMICs. Methods A PRISMA‐compliant systematic literature review of PubMed, Embase and Google Scholar was performed in August 2018. Prospective studies collecting large volumes of patient‐level data within LMIC settings were included and evaluated qualitatively. Results A total of 68 studies were included from 71 LMICs, involving 708 032 patients. The number of patients in included studies varied widely (from 335 to 428 346), with 25 reporting data on 3000 or more LMIC patients. Patient inclusion in large‐data studies in LMICs has increased dramatically since 2015. Studies predominantly involved Brazil, China, India and Thailand, with low patient numbers from Africa and Latin America. Outcomes after surgery were commonly the focus (33 studies); very few large studies looked at access to surgical care or patient expenditure. The use of large data sets specifically to improve surgical outcomes in LMICs is currently limited. Conclusion Large volumes of data are becoming more common and provide a strong foundation for continuing investigation. Future studies should address questions more specific to surgery.

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“…In a recent study, approximately 50% of patients presenting for non-cardiac elective surgery were identified as having hypertension, of whom 10% were newly diagnosed, and 40% were found to have poorly controlled hypertension. [5] Furthermore, there has been a burgeoning epidemic of other CV risk factors (obesity, dyslipidaemia, and dysglycaemia) that cluster with hypertension.…”

Section: Researchmentioning

confidence: 99%

“…Hypertension is one of the most common comorbidities associated with elective non-cardiac surgery. [5] This, together with additional CV risk factors, significantly increases the perioperative risk of these patients. [6,13] CV risk stratification is fundamental to all hypertension guidelines, since in absolute terms treatment of patients at highest risk will yield the greatest number of events prevented, and those at lowest risk the least.…”

Section: Implications Of the Studymentioning

confidence: 99%

A multicentre cross-sectional descriptive study evaluating the cardiovascular risk profile of preoperatively identified patients with hypertension

et al. 2020

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A multicentre, cross-sectional study investigating the prevalence of hypertensive disease in patients presenting for elective surgery in the Western Cape Province, South Africa

Cited by 9 publications

References 17 publications

A multicentre prospective observational study of the prevalence and glycaemic control of diabetes mellitus in adult non-cardiac elective surgical patients in hospitals in Western Cape Province, South Africa

A multicentre prospective observational study of the prevalence and glycaemic control of diabetes mellitus in adult non-cardiac elective surgical patients in hospitals in Western Cape Province, South Africa

Systematic review of the use of big data to improve surgery in low- and middle-income countries

A multicentre cross-sectional descriptive study evaluating the cardiovascular risk profile of preoperatively identified patients with hypertension

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