Potentially it may result in loss of information of some variables which are supposed to be a part of medical records, as in our experience. In those settings where electronic health records are not available, access to medical records can be difficult. The alternative method of provider based data collection may ensure a higher level of completeness but in high volume facilities this could be challenging and more

expensive. Limitations The study was done in a single tertiary-care academic institution with a electronic health information system, JQ1 in vivo trauma team and round-the-clock availability of computed tomography (CT) and other diagnostic Inhibitors,research,lifescience,medical modalities. This setting may not reflect the reality of all private or public tertiary-care centres Inhibitors,research,lifescience,medical in Pakistan or in other developing countries. Wider, multi centre implementation studies would be needed to improve the data collection system and the implementation process. Conclusion KITR is the first electronic trauma registry in Pakistan developed with local resources. This registry was able to generate surveillance data such as mechanism of injuries, burden of severe injuries and quality indicators such as length of stay in ED, injury to arrival delay, injury severity and survival probability. Inhibitors,research,lifescience,medical To make the data collection process more effective, provider based data collection

or making a standardized data collection tool a part of medical records will be helpful. Competing interests There are no competing interests. Authors’ contributions AM Inhibitors,research,lifescience,medical and JAR conceptualized the pilot of the registry

and developed its study design. AM was involved directly in the development of the registry. SK helped with data collection, data entry and analysis. AM wrote the first draft and all the revisions. JAR, AAH and EJM provided critical Inhibitors,research,lifescience,medical review of the manuscript. All authors read and approved the final manuscript. Pre-publication history The pre-publication history for this paper can be accessed here: http://www.biomedcentral.com/1471-227X/13/4/prepub Acknowledgement This work was partly funded by NIH- Fogarty JHU-AKU grant through International Collaborative Trauma and Injury Research PD184352 (CI-1040) and Training (ICTIRT) program. AM, JAR, EJM and AAH are partly supported by the NIH grant #D43TW007292 (CFDA: 93.989). We acknowledge the contribution of Ms. Saleha Raza and Ms. Nida Mumtaz as the software developers in our project, and Drs. Kiran Ejaz and Mehwish Mehboob during development of Karachi Trauma Registry (KITR).
In the metropolitan area of Florence, 62% of major traumas involve powered two wheeler rider and pillion passengers, 10% cyclists, and 7% pedestrians. The urban and extra-urban areas are the most dangerous for the vulnerable road user. In-depth investigations are needed for assessing detailed information on road accidents. This type of study has been very limited in time frame in Italy, and completely absent in the Tuscan region.