The Neurosurgical Outcomes Monitoring and Improvement Programme (NOMIP) aims to monitor and enhance the outcomes of neurosurgical procedures in public hospitals in Hong Kong. NOMIP utilizes a non-punitive and transparent process to encourage hospitals to improve their performance. The programme focuses on evaluating postoperative mortality and complications within 30 days, taking into account patient risk factors and specific indicators for neurosurgery.
Through NOMIP, this programme aims to monitor risk-adjusted mortality and morbidities within 30 days after neurosurgical operations and assess the stability of a mortality prediction model. Additionally, the feasibility of establishing a neurosurgical risk calculator will be examined.
Data on major and ultra-major neurosurgical operations were retrieved from the Clinical Data Analysis and Reporting System (CDARS). Risk-adjusted models for mortality and morbidities were developed using logistic regression, and model performance was assessed through cross-validation.
Before regularization of NOMIP, during April 2020 to March 2023, risk-adjusted mortality models were built and yielded satisfactory results for each year. A cumulative three-year risk-adjusted model on 30-day mortality even achieved excellent discrimination power. The prediction model for 30-day mortality included significant risk factors and demonstrated fabulous predictive performance.
The next steps involve refining the risk prediction model of mortality and morbidity so as to support clinical decision-making before neurosurgical procedures. This advancement will provide valuable guidance for improving patient outcomes and optimizing the delivery of neurosurgical care.
