Prehospital Medical Documentation in the Joint Theater Trauma Registry: A Retrospective Study

Background: Prehospital care of combat casualties is a critical phase of emergency medical practice on the battlefield. The Joint Theater Trauma Registry (JTTR) was developed to standardize a system of data collection for combat casualty care; however, the degree of population and granularity of prehospital data were unknown. Methods: This is a retrospective comparative study of all US military personnel who sustained battle injuries in Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF). The JTTR was queried for all US military battle casualties from OIF and OEF entered between January 2002 and July 2009 containing any data entered into the prefacility fields. Data were separated based on origination, OIF, or OEF. A comparative analysis was performed. Results: During the period studied, 13,080 (66%) entries into the JTTR were recorded in the category of "Battle Injury" and met study inclusion criteria; 3,187 (24%) battle injury entries contained prehospital data (n = 3,187). The percentage of casualty records containing prehospital data were 18.6% for OEF and 25.4% for OIF (p < 0.01). Conclusion: Both poor population of data points and poor granularity of prehospital data entered into the JTTR were observed. It appears that the volume and quality of reporting of role-I data were better for OIF than OEF for this study period. Further investigations into the obstacles to free flow of role-I casualty clinical data, and the means to mitigate this situation, are warranted.