National Neurotrauma Registry Data in Low- and Middle-Income Countries – Current Status and Future Requirements; Comment on “Neurotrauma Surveillance in National Registries of Low- and Middle-Income Countries: A Scoping Review and Comparative Analysis of Data Dictionaries”

Document Type : Commentary


CURE, School of Health and Related Research, University of Sheffield, Sheffield, UK


Since 1990 National Trauma Registries, — taking the form of “not for profit” small and medium enterprises — have been integral to improvementsin major injury case fatality in high-income settings. This is laudable but unsatisfactory as globally most years of life lost to injury occur in low- and middle-income countries (LMICs). International Journal of Health Policy and Management, recently published a scoping review of neurotrauma registries in LMICs by Barthelemy et al; from this the commentary reflects on the state of the art and how these LMIC registries could be taken to “the next level” as meaningful tools for improving major injury patient care.


  1. Haagsma JA, Graetz N, Bolliger I, et al. The global burden of injury: incidence, mortality, disability-adjusted life years and time trends from the Global Burden of Disease study 2013. Inj Prev. 2016;22(1):3-18. doi:1136/injuryprev-2015-041616
  2. Lecky F, Bouamra O, Woodford M. Changing epidemiology of polytrauma. In: Pape HC, Peitzman AB, Rotondo MF, Giannoudis PV, eds. Damage Control Management in the Polytrauma Patient. Cham: Springer; 2017. p. 27-32. doi:1007/978-3-319-52429-0_3
  3. Fuller G, Bouamra O, Woodford M, et al. Temporal trends in head injury outcomes from 2003 to 2009 in England and Wales. Br J Neurosurg. 2011;25(3):414-421. doi:3109/02688697.2011.570882
  4. Moran CG, Lecky F, Bouamra O, et al. Changing the system-major trauma patients and their outcomes in the NHS (England) 2008-17. EClinicalMedicine. 2018;2-3:13-21. doi:1016/j.eclinm.2018.07.001
  5. Barthélemy EJ, Hackenberg AEC, Lepard J, et al. Neurotrauma surveillance in national registries of low-and middle-income countries: a scoping review and comparative analysis of data dictionaries. Int J Health Policy Manag. 2021;11(11):2373-2380. doi:34172/ijhpm.2021.167
  6. Champion HR, Copes WS, Sacco WJ, et al. The Major Trauma Outcome Study: establishing national norms for trauma care. J Trauma. 1990;30(11):1356-1365. doi:1097/00005373-199011000-00008
  7. Yates DW, Woodford M, Hollis S. Preliminary analysis of the care of injured patients in 33 British hospitals: first report of the United Kingdom major trauma outcome study. BMJ. 1992;305(6856):737-740. doi:1136/bmj.305.6856.737
  8. Cameron PA, Finch CF, Gabbe BJ, Collins LJ, Smith KL, McNeil JJ. Developing Australia's first statewide trauma registry: what are the lessons? ANZ J Surg. 2004;74(6):424-428. doi:1111/j.1445-1433.2004.03029.x
  9. National Institute for Health and Care Excellence (NICE). Head Injury: Assessment and Early Management. NICE; 2019.
  10. World Health Organization (WHO). WHO International Registry for Trauma and Emergency Care. WHO; 2020.
  11. Ringdal KG, Coats TJ, Lefering R, et al. The Utstein template for uniform reporting of data following major trauma: a joint revision by SCANTEM, TARN, DGU-TR and RITG. Scand J Trauma Resusc Emerg Med. 2008;16:7. doi:1186/1757-7241-16-7
  12. Lecky FE, Otesile O, Marincowitz C, et al. The burden of traumatic brain injury from low-energy falls among patients from 18 countries in the CENTER-TBI Registry: a comparative cohort study. PLoS Med. 2021;18(9):e1003761. doi:1371/journal.pmed.1003761
  13. MacLeod JBA, Kobusingye O, Frost C, Lett R, Kirya F, Shulman C. A comparison of the Kampala Trauma Score (KTS) with the Revised Trauma Score (RTS), Injury Severity Score (ISS) and the TRISS method in a Ugandan trauma registry. Eur J Trauma. 2003;29(6):392-398. doi:1007/s00068-003-1277-5
  14. Lecky FE, Reynolds T, Otesile O, et al. Harnessing inter-disciplinary collaboration to improve emergency care in low- and middle-income countries (LMICs): results of research prioritisation setting exercise. BMC Emerg Med. 2020;20(1):68. doi:1186/s12873-020-00362-7
  15. Jafar AJN, Fletcher RJ, Lecky F, Redmond AD. A pilot of a UK emergency medical team (EMT) medical record during a deployment training course. Prehosp Disaster Med. 2018;33(4):441-447. doi:1017/s1049023x18000468