Authors (including presenting author) :
KF Wong* (1), YK Lam (1), Max Chung (1), HL Yiu (1), Henry Chan (2), HW Yip (2), WM Tang (2), Gerund Cheung (3), Carmen Lam (3), Benny CP Cheng (3), Carmen Chan (4), LM Hau (4) *corresponding author, e-mail: wkf442@ha.org.hk
Affiliation :
(1)Department of Surgery, Tuen Mun Hospital (2)Department of ICU, Tuen Mun Hospital (3)Department of A&OT, Tuen Mun Hospital (4)Department of Q&S, Tuen Mun Hospital
Keyword 1: :
SOMIP emergency operation risk calculator
Introduction :
The SOMIP emergency operation risk calculator (calculator) was validated and launched by the HAHO SOMIP team in 2018’ in order to predict emergency operations (EOT) mortality risk. In NTWC, this calculator has been used routinely for emergency operations since 10/2023, aimed to improve SOMIP results and reduce postoperative mortality. If the calculated mortality risk is >=10%, ICU liaison system will be triggered for conjoint cases discussion, risk assessment and patient management (among surgeon, intensivist and anaesthetist) before EOT. This is the first time of this calculator being used routinely in Hong Kong.
Objectives :
To investigate the impact on clinical outcome in NTWC after this calculator was routinely used since 10/2023.
Methodology :
Patients received major or ultra-major EOT within 10/2023 - 30/6/2025 (calculator group) in NTWC, under the Department of Surgery, were recruited and compared with those patients received major or ultra-major EOT within 1/2022 – 9/2023 (non-calculator group). Data, such as patient’s demographic, number of EOT performed, % of major/ ultra-major operations, 30-day operative mortality, was collected and analysed.
Result & Outcome :
Total 3245 major or ultra-major EOT were performed (1660 EOT in 1/2022 – 9/2023, non-calculated group, vs 1585 EOT in 10/2023 – 6/2025, calculator group). There is no significant difference between groups in terms of mean estimated postoperative 30-day mortality risk (4.65% in non-calculator group vs 4.25% in calculator group. P-value 0.34), while there is significantly more ultra-major EOT in the calculator group with P-value < 0.001 (68.7% major EOT and 31.3% ultra-major EOT in non-calculator group vs 51.0% major EOT and 49.0% ultra-major EOT in calculator group). For postoperative 30-day mortality, there was a statistically significant decrease in the calculator group in terms of (1) 30-day mortality crude number (45 cases vs 71 cases in the non-calculator group), and (2) the 30-day mortality rate (2.92% vs 4.47% in the non-calculator group) with P-value < 0.001. The absolute mortality case reduction rate was 36.6% Conclusion The routine use of the SOMIP emergency operation calculator and ICU liaison system was shown to be effective in reducing postoperative mortality. It gives us the insight on how to improve surgical outcomes, inter-disciplinary communication, integrated risk triage and patients’ optimization.
