The Bandung neurosurgery patient outcomes project, Indonesia (Part I): Methods, participant characteristics, and pre-discharge outcomes

Abstract

Introduction: Little is known about neurosurgery patient outcomes in Indonesia. Our study sought to describe patient characteristics, health care pathways, health-related quality of life, and health/rehabilitation care needs of patients admitted to, and discharged from, a major neurosurgery department.

Methods: Eligible patients were aged ≥18 years admitted to the Neurosurgery Department in a regional referral hospital in Bandung, Indonesia. Baseline data was collected on admission. An in-person interview (in the Indonesian language) was held 1 to 2 days pre-discharge. Sociodemographic along with clinical characteristics, Glasgow Coma Scale (GCS), and EQ-5D-5L data were collected.

Results: A total of 217 patients were admitted, 37 died before discharge, and a pre-discharge interview was undertaken by 178 (82%). Almost half (48%) were admitted because of injury, 38% brain tumour, 10% acute illness, and 4% other conditions. The mean age was 41 years. On admission, 63% had a mild Glasgow Coma Scale, 31% moderate, and 3% severe. The average hospital stay was 8 days for injury and 24 days for illness patients. Prior to discharge, one-third, or less, of the 178 patients interviewed reported "no problems" in the EQ-5D dimensions of mobility (32%), self-care (27%), usual activities (16%), and pain/discomfort (32%), whereas 70% reported "no problems" with anxiety/depression.

Conclusion: A large proportion of patients are being discharged with considerable levels of difficulty in four of the five EQ-5D dimensions. This stresses the importance of providing good follow-up and support of patients and their families.

Keywords: EQ-5D-5L; Indonesia; neurosurgery; quality of life.