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Patterns of neurosurgical conditions at a major government hospital in Cambodia
Miri Kim1, Chung Bin Yoo2, Owen Lee-Park3, Sam Nang4, Din Vuthy4, Kee B Park5, Iv Vycheth4
1 Department of Neurosurgery, Loyola University Medical Center, Maywood, IL; Department of Neurosurgery, Preah Kossamak Hospital, Phnom Penh, Cambodia
2 Department of General Medicine, Addenbrooke's Hospital, Cambridge University Hospitals, Cambridge, UK
3 Department of Emergency Medicine, George Washington School of Medicine and Health Sciences, Washington, DC, USA
4 Department of Neurosurgery, Preah Kossamak Hospital, Phnom Penh, Cambodia
5 Department of Neurosurgery, Preah Kossamak Hospital, Phnom Penh, Cambodia; Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
Correspondence Address:
Dr. Miri Kim
Department of Neurological Surgery, Loyola University Medical Center, 2160 S. First Avenue, Maywood, IL 60153, USA
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/ajns.AJNS_213_20
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Background: Low- and middle-income countries (LMICs) have a growing and largely unaddressed neurosurgical burden. Cambodia has been an understudied country regarding the neurosurgical pathologies and case volume. Rapid infrastructure development with noncompliance of safety regulations has led to increased numbers of traumatic injuries. This study examines the neurosurgical caseload and pathologies of a single government institution implementing the first residency program in an effort to understand the neurosurgical needs of this population. Methods: This is a longitudinal descriptive study of all neurosurgical admissions at the Department of Neurosurgery at Preah Kossamak Hospital (PKH), a major government hospital, in Phnom Penh, Cambodia, between September 2013 and June 2018. Results: 5490 patients were admitted to PKH requiring neurosurgical evaluation and care. Most of these admissions were cranial injuries related to road traffic accidents primarily involving young men compared to women by approximately 4:1 ratio. Spinal pathologies were more evenly distributed in age and gender, with younger demographics more commonly presenting with traumatic injuries, while the older with degenerative conditions. Conclusions: Despite increased attention and efforts over the past decade, Cambodia's neurosurgical burden mirrors that of other LMICs, with trauma affecting most patients either on the road or at the workplace. Currently, Cambodia has 34 neurosurgeons to address the growing burden of a country of 15 million with an increasing life expectancy of 69 years of age, stressing the importance of better public health policies and urgency for building capacity for safe and affordable neurosurgical care. |
