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.
Key-words:
Cambodia - developing countries - epidemiology - global neurosurgery - low- and middle-income
country
