Tuen Mun Hospital is a public hospital, with a 24-hour accident and emergency department, in Tuen Mun, New Territories, Hong Kong. Its construction began in 1979, and it was inaugurated on 8 March 1990. It is governed by the Hospital Authority, and is designated under New Territories West Cluster..
Copeptin is an emerging biomarker for polyuria-polydipsia syndrome. Postoperative copeptin levels may predict acquired arginine vasopressin deficiency (AVP-D). This prospective study evaluated the diagnostic performance of serum copeptin for predicting postoperative AVP-D after transsphenoidal surgery (TSS). Copeptin was measured preoperatively, immediately after surgery (periextubation, T0), upon first ward arrival (T1), daily until discharge, and at week 2. Delta copeptin was calculated as the percentage change from T0 to T1. Of 53 patients, 23 (43.4
Background Surgical outcomes monitoring has evolved from periodic retrospective audits to risk-adjusted benchmarking systems that support governance, quality improvement (QI) and research. The Surgical Outcomes Monitoring & Improvement Programme (SOMIP), launched in 2008 across all public hospitals under the Hospital Authority in Hong Kong, provides annual risk-adjusted outcome benchmarking and an infrastructure for local improvement initiatives.Methods This meeting report synthesizes the content of three presentations delivered at the RCSEd/CSHK Conjoint Scientific Congress session on 30 November 2025. Source materials comprised the speakers' slide sets and the session video-recording (excluding the Q&A session).Results Speakers reviewed the professional and historical foundations of outcomes monitoring from Codman's 'end result' philosophy to contemporary risk-adjusted surgical report cards, emphasizing the Donabedian structure-process-outcome framework. SOMIP was described as a risk-adjusted benchmarking programme adapted from the ACS NSQIP model, providing department-level signals to trigger system diagnosis and QI. Potential unwanted effects-league table thinking, morale harm, risk aversion and gaming-were highlighted, with the session advocating that outcome monitoring becomes an ally when embedded in a just culture and paired with actionable process improvement. A cluster-level case study from the New Territories West Cluster (NTWC) illustrated how early 'poor outlier' signals in 30-day mortality catalysed multi-layered interventions, including strengthened senior presence, structured mortality review, multidisciplinary quality circles, ICU liaison pathways, sepsis control and pneumonia prevention workstreams, and workflow integration of a risk calculator to support perioperative triage and optimization.Conclusions The session positioned SOMIP as a mature surgical outcome research and audit platform that can strengthen surgical governance and drive improvement where data credibility, fair risk adjustment and supportive implementation are prioritized. Future opportunities include deeper integration into clinical management systems and the development of surgical data science-enabled decision support, coupled with safeguards to mitigate unintended consequences.
Background: Most of the public hospitals in Hong Kong provide a regular colorectal endoscopic submucosal dissection (ESD) service. The current retrospective study aims to review the long- and short-term outcomes of these services, so as to identify areas for improvement. Method and Results: From January 2017 to March 2020, 634 lesions in 623 patients were removed by an ESD technique in seven endoscopic units. The mean lesion size was 31 mm (SD 13 mm, range 10–95 mm), and the mean procedure time was 121 min (SD 67 min). En bloc resection and R0 resection could be achieved in 91.3% and 79.3% of the lesions, respectively. The intra-procedure perforation rate was 12.3%. The delayed bleeding rate was 2.1%, and the delayed perforation rate was 0.8%. Only 0.9% (6/634) of the procedures needed emergency surgical salvage due to complications. Most of the lesions were adenomas (564/634), and 55 of them were adenocarcinomas. The cumulative local recurrence rate was 4.0% at a mean follow-up of 34 months. In multivariate analysis, longer procedure time, submucosal fibrosis, hybrid ESD and piecemeal removal were associated with intra-procedure perforation. Risk factors for failed en bloc resection included non-granular and polypoid morphology, colonic location, longer procedure time and low centre volume. Malignant pathology without salvage surgery was the only independent risk factor for local recurrence. Conclusions: Colorectal ESD has been carried out in Hong Kong with acceptable short-and long-term outcomes despite the technique still being in the learning phase in some centres. Potential areas for improvement should include targeted training to speed up the procedure and enable better handling of difficult cases, aiming to decrease the perforation rate and local recurrence.
Background The Omicron variant of SARS-CoV-2 underwent several mutations since it was first identified in November 2021, with a large outbreak in Hong Kong in early 2022. Yet, local cases of Omicron infections persist, even though the COVID-19 pandemic ended in May 2023. Objective This study aims to describe the changes in demographic and clinical characteristics of patients infected with COVID-19 across different Omicron waves in Hong Kong and determine whether the changes continued into the postpandemic period. Methods This retrospective repeated cross-sectional study collected data on patients infected with COVID-19 admitted to public hospitals in Hong Kong between May 1, 2022, and May 31, 2024. These data were later categorized into 3 periods based on the Omicron strain. A subsequent age-stratified descriptive analysis was conducted on each characteristic to identify any significant differences across the periods. Results First, the case fatality ratio significantly lowered among those older than 85 years (1.5% proportion decrease, period 1: 11.6%, period 2: 10.1%, effect size: 0.02; P<.001). Second, most patients were Chinese (≥68.7% per age group and period), and females were predominantly infected for those aged older than 85 years (≥56.9% per period). Third, the Charlson Comorbidity Index scores in most age groups showed a predominant proportion of infected individuals with 0 scores (more than 70% per period). Fourth, most cases were from slightly disadvantaged populations in Hong Kong (≥30.5% per age group per period). Fifth, clinical management of Omicron hospitalizations showed lowered length of hospital stays among adults and older individuals (≥1 d decrease between periods 1 and 3, per age group), as well as increased administration of bronchodilators. Conclusions Despite the decreasing incidence of Omicron cases admitted to public hospitals in Hong Kong, the increasing case fatality ratio with age suggests that long-term surveillance of COVID-19 should be maintained to prepare for potential mutations and outbreaks.
