Designing a novel program for emergency neurosurgical task-sharing in Indonesia: Evidence base from a meta-analysis of global task-sharing outcomes.
J Clin NeurosciJun 24, 2026 (epub)
Bryan Gervais de Liyis, Muhammad Kusdiansah, Aryandhito Widhi Nugroho et al.
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In 30 seconds
This meta-analysis evaluated global outcomes of emergency cranial procedures performed by general surgeons in the absence of on-site neurosurgeons, focusing on their applicability in Indonesia. Analyzing 15 studies with 1,195 patients, the study found a pooled mortality rate of 14% within one month and 17% at last follow-up, suggesting a cautious approach to task-sharing in neurosurgery.
Key findings
- Pooled ≤1-month mortality was 14% (95%CI: 9%-20%) and last follow-up mortality was 17% (95%CI: 12%-24%).
- Reoperation rates were 13% (95%CI: 7%-22%).
- Favorable outcomes occurred in 73% (95%CI: 52%-87%) of cases.
- Subgroup analyses indicated lower mortality in cohorts with prior dedicated training.
Why it matters
The findings highlight the potential for structured emergency neurosurgical task-sharing programs to improve access to critical care in underserved areas, while emphasizing the importance of training and supervision to ensure patient safety.