Increasing Access to Casualty Care Data in Low-Resource Conflict Settings: A Practical Toolkit.

Background: System-wide trauma registries have played a key role in reducing preventable death among combat casualties of high-resource militaries. Although several efforts exist to introduce trauma registries in low- and lower-middle-income countries, no standardized data collection exists for casualties in low-resource conflict settings (LRCS) encompassing prehospital to operative management.

Methods: We developed a casualty data form (CDF) for LRCS based on a previous analysis of casualty care in Burkina Faso. An initial paper CDF was iteratively refined during data collection and then evaluated against existing tools (e.g., World Health Organization [WHO] and the U.S. Department of Defense Trauma Registry [DoDTR]) to ensure harmonization of variables. The final version of the CDF was then translated into electronic formats (Excel and KoboToolbox) to maximize usability in a range of contexts.

Results: The final toolkit includes (i) a Microsoft Word-based CDF for paper data collection, (ii) an Excel sheet with a coding guide for offline electronic data capture, and (iii) a KoboToolbox form for online or offline data collection. The CDF consists of 29 parent variables that capture patient demographics, prehospital care, injury characteristics, resource utilization, surgical interventions, and early outcomes.

Conclusion: We present an open-access toolkit designed for casualty care data collection in LRCS. By providing standardized data collection instruments in multiple formats compatible with limited connectivity and minimal existing data infrastructure, this toolkit holds the potential to facilitate casualty care documentation in LRCS. An improved evidence base may help data-driven approaches to reducing preventable death and disability among local casualties.