About data collection

The purpose of this page is to outline how providers may submit data to the National Major Trauma Registry (NMTR) and to define the scope of the submission. The collection applies to all trauma receiving hospitals, including clinical audit/effectiveness departments, emergency departments and all other departments and specialties involved with the management of major trauma patients.

To submit trauma data  you will need to register for an account with the Outcome Registries Platform.  This page provides information about:

  • identifying patients using ICD10 codes inclusion criteria
  • patient identification
  • inclusion criteria
  • information governance

Identifying patients using ICD10 codes

Most trauma units use their trust coding system (ICD10) to identify trauma registry patients.

An ICD10 code is given to every patient seen at a hospital and there are 2 sections that refer to trauma: S OR T codes.

Only admitted patients are assigned an ICD10 code and will exclude:

  • transfers out from emergency departments
  • deaths in emergency departments

The trauma registry can supply a SQL script that each trust can run every week or month that will identify ‘potential’ cases where patients:

  • stayed for more than3 overnight stays
  • died (if attended to in hospital)
  • transferred out
  • transferred in
  • admitted to critical care

The spreadsheet will include:

  • discharge destination
  • ICD10 code/s
  • name
  • age or date of birth
  • admission date
  • discharge date or date of death
  • length of stay
  • NMTR inclusion category

Clarifying inclusion

Injuries should be checked using an imaging report or case notes to ensure they meet the inclusion criteria:

  • if they do: complete a treatment
  • if they do not: do not complete a treatment regardless of length of stay or outcome

Inclusion criteria

The decision to include a patient should be based on meeting the following 3 points:

  1. all trauma patients irrespective of age
  2. patients who fulfil the length of stay criteria
  3. patients whose isolated injuries meet the injury inclusion criteria

Inclusion criteria Injury Inclusion Criteria – from 1st January 2026

Include: Patients with at least one AIS3+ injury who meet current NMTR LOS criteria*, which is:

  • admitted for >3 overnight stays or
  • admitted to critical care (for any length of time) or
  • transfers who total LOS >3 overnight stays or are admitted to critical care or
  • died

* With the exception, of Children (under 16 years old) who can be included with an AIS3+ injury and any LOS from 01.01.2026

Consideration of how these patients can be used in reporting, and the Probability of Survival (Ps) model will be undertaken by NMTR.

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PLUS: To reduce audit duplication: Exclude: Patients aged 60+ with Femur fracture (any part of Femur) captured by the National Hip Fracture Database (NHFD) i.e. where the Femur fracture is the primary injury & drives the care.

These patients will be captured by NHFD from Jan 2026 (UK only, not applicable to ROI)

Length of stay criteria

Direct admissions

Direct admissions criteria is determined by one of the following

  • trauma admissions whose length of stay is 3 overnight stays or more

or

  • trauma patients admitted to a High Dependency Area regardless of length of stay

or

  • deaths of trauma patients occurring in the hospital including the Emergency Department (even if the cause of death is medical)

or

  • trauma patients transferred to other hospital for specialist care for ICU/HDU bed or repatriation

Patients transferred

Patient transfer criteria is determined by one of the following:

  • trauma patients transferred into your hospital for specialist care or repatriation whose combined hospital stay at both sites is 3 overnight stays or more

or

  • trauma admissions to an ICU/HDU area regardless of length of stay

or

  • trauma patients who die from their injuries (even if the cause of death is medical)

Patients transferred in for rehabilitation only should not be submitted to NMTR. Military personnel injured on active duty should be excluded from NMTR. Patients with isolated iatrogenic injuries should be excluded.

Injury inclusion criteria

The table below shows injury inclusion criteria according to body region.

All patients must have at least one injury AIS3 or higher (see Appendix A). Modification of a small number of AIS severity scores was agreed over 10 years ago by the TARN Board to better fit UK outcomes. This resulted in a small number (approximately 50 out of 2,000 injury descriptors in the AIS dictionary) of changes to AIS severities. These mainly relate to the head body region, with a small number of other body regions affected (see Appendix B for a full list of modifications).

TARN injury inclusion and exclusion criteria by body region
Body region or anatomical specific Included – in isolation (except where specified) Excluded – in isolation (except where specified)
Head injury
  • All brain injuries
  • Nerve injuries specified in Appendix A**
  • All base of skull fractures
  • Complex/comminuted/open skull vault fractures
  • Loss of consciousness
  • Injuries to scalp
  • Simple skull vault fractures
  • Minor nerve injuries not specified in Appendix A**
Face
  • Le Fort III fractures
  • All panfacial fractures*
  • Bilateral eye avulsion
  • Bilateral optic nerve avulsion or laceration

* Involve multiple complex/comminuted fractures (resulting from high energy mechanism) of the middle and lower face, or middle and upper face, or upper, middle and lower face.
Lower face = Mandible
Middle face = Maxilla, Zygoma, Nose
Upper face = Supraorbital ridge, Frontal bone
  • All facial fractures except Le Fort III and panfacial fractures
  • All other facial injuries including the eye
Neck
  • Any OIS Grade 3–5 organ injury or vascular injury listed in Appendix A**
  • Bilateral phrenic nerve injury
  • Isolated nerve injuries
  • Hyoid fracture
  • Skin injuries
  • Minor organ or vascular injury not listed in Appendix A** (OIS Grade 1 or 2)
Thorax
  • All OIS Grade 3–5 organ injuries
  • 3 or more rib fractures (flail or simple)
  • Complex/comminuted/open/massively displaced rib fractures
  • Pneumothorax
  • Haemothorax
  • All other thoracic injuries listed in Appendix A**
  • Minor organ injuries (OIS Grade 1 and 2)
  • Minor soft tissue injury
  • 1 or 2 simple rib fractures
  • Sternal fractures
  • Any other injury not listed in Appendix A**
Abdomen
  • OIS Grade III–V injury to any of the following major organs: bladder, colon, duodenum, gallbladder, jejunum-ileum (small bowel), kidney, liver, pancreas, rectum, spleen, ureter, uterus
  • Any injury resulting in retroperitoneal haemorrhage
  • All other abdominal injuries listed in Appendix A**
  • Minor soft tissue injury
  • OIS Grade I–II injury to any of the following major organs: bladder, colon, duodenum, gallbladder, jejunum-ileum (small bowel), kidney, liver, pancreas, rectum, spleen, ureter, uterus
  • Any other injury not listed in Appendix A**
Spine
  • Cord or cauda equina injury
  • C2 odontoid fracture
  • Major compression fracture (>20% loss of height)
  • Bilateral facet dislocations
  • Atlanto-axial dislocation
  • Disc or nerve root injury listed in Appendix A**
  • Spinal strain or sprain
  • Ligament injuries
  • Simple vertebral fractures
  • Unilateral dislocations
  • Atlanto-occipital dislocation
  • Minor disc or nerve injuries not listed in Appendix A**
Foot or hand: joint or bone None All foot or hand injuries, even if multiple
Finger or toe None All injuries to digits, even if multiple
Limb – upper (except hands/fingers)
  • Any open fractures listed in Appendix A
  • Any closed unilateral or bilateral fractures
  • Any dislocations
  • Any open fractures not listed in Appendix A
Limb – below knee (except feet/toes)
  • Open bimalleolar/trimalleolar fractures
  • Any open tibia fracture
  • Any complex/comminuted/segmental tibia fracture (closed or open)

Currently, a closed comminuted tibial fracture (AIS3) would be excluded in isolation, even though this results in an ISS 9 and will require surgical intervention. Under the new inclusion criteria this injury, in isolation, would be included.

The Network Advisory Group (NAG) agreed that a blanket AIS3+ criteria should be applied (without exceptions) to simplify the new inclusion as much as possible for data collectors, therefore all comminuted tibia fractures will be included in isolation going forward.
  • Any closed/simple unilateral or bilateral injury (including multiple closed fractured bones)
  • Any dislocation (closed or open)
Femoral fracture England, Wales and Northern Ireland:

  • Patients aged 60+ with a femur fracture not captured by the NHFD (i.e. patients where femur is not the primary injury and care is not driven by femur fracture). Examples will be provided prior to any change going live.
  • All femur fractures aged under 60

ROI:

  • Patients aged 60+ with a femur fracture not captured by the IHFD
  • All femur fractures aged under 60
 England, Wales and Northern Ireland:

  • Patients aged 60+ with femur fracture captured by the NHFD (any part of femur), i.e. where femur is the primary injury and care is driven by the femur fracture. Examples will be provided prior to any change going live.
  • These patients are already collected by the NHFD.

ROI:

  • Patients aged 60+ captured by the IHFD, i.e. those diagnosed with either a hip fracture or other specified fracture (e.g. intracapsular, intertrochanteric or subtrochanteric) other than periprosthetic fractures.
Pelvis
  • Patients (any age) with any open or partially or totally unstable pelvic ring or open acetabular fracture

NHFD: not yet commissioned as a mandatory national clinical audit for pelvic fracture, although a mechanism exists for local teams to start collecting data. Sites are strongly encouraged to collect data in anticipation that it will become mandatory.

Therefore, please enter any patients with any AIS3+ pelvic or acetabular fracture (as defined) onto NMTR.

Pelvic fracture classifications:
Stable (posterior arch intact) = Type A, AP1
Partially unstable (incomplete disruption of posterior arch) = Type B, AP2, LC1, open book
Totally unstable (complete disruption of posterior arch) = Type C, LC2, LC3, AP3, vertical shear (VS), combined mechanism (CM), Malgaine, lumbopelvic dissociation

Patients can be considered to have pelvic instability if they are either fixed in theatre or have bladder displacement/disruption. However, grades of pelvic ring fractures will be required to determine eligibility.
  • Patients (any age) with any stable pelvic ring or closed acetabular fracture
Nerve
  • Injuries to the sciatic, facial, cranial nerve or brachial plexus listed in Appendix A
  • All other nerve injuries, single or multiple, not listed in Appendix A
Vessel
  • Injuries to femoral, neck, facial, cranial, thoracic or abdominal vessels listed in Appendix A
  • Transection or major disruption of any other named vessel (excluding vessels in the hands, feet and digits)
  • Intimal tear or superficial laceration or perforation to any limb vessel
  • Injuries to unnamed branches
  • Vessel injuries not listed in Appendix A
Skin
  • Laceration or penetrating skin injuries with blood loss >20% (>1,000 mls)
  • Major degloving injury (>50% body region)
  • Simple skin lacerations or penetrating injuries with blood loss <20% (<1,000 mls), single or multiple
  • Contusions or abrasions, single or multiple
  • Minor degloving injury (<50% body region)
Burn
  • 2nd/3rd degree burn 10–19% TBSA in patients under 5 years old
  • 2nd/3rd degree burn >19% TBSA any age
  • Not referred to a burns unit
  • Any burn referred to a burns unit
  • All burns <10% TBSA
  • All burns <20% in patients over 5 years old
Inhalation
  • Inhalation injury with at least one of the following: erythema, bronchorrhoea, carbonaceous deposits, bronchial obstruction, hypoxaemia, mucosal sloughing, necrosis or endoluminal obliteration; OR carboxyhaemoglobin ≥15%
  • If not referred to burns unit
  • All minor inhalation injuries with absence of any features listed in the inclusion column
  • All inhalation injuries referred to burns unit (audited by International Burn Injury Database)
Frostbite
  • Full thickness frostbite across multiple body sites
  • Superficial frostbite
  • Any frostbite affecting a single body site (e.g. toes only)
Asphyxia
  • With loss of consciousness, neurological deficit or cardiac arrest
  • Without a loss of consciousness
Drowning
  • With loss of consciousness, neurological deficit or cardiac arrest
  • Without a loss of consciousness
Explosion
  • Whole body (explosion-type) injury affecting >25% TBSA skin injuries, multiple fractures and/or organ injuries
  • Minor soft tissue injuries with or without minor fractures
Hypothermia
  • Accompanied by another NMTR eligible injury
  • Hypothermia in isolation
Electrical
  • Electrical injury with muscle necrosis or cardiac arrest
  • Minor electrical injuries without muscle necrosis or cardiac arrest

Information governance

Data submission is mandated for any trauma unit or major trauma centre that is part of a major trauma network.

The National Major Trauma Registry collects data from more than 200 hospitals across England, Wales, Northern Ireland and Ireland. This is used to monitor trauma care and facilitate improvement of trauma services.

The following agreements and information governance procedures are in place to ensure patient data is protected and processed correctly.

Legal Basis

NHS England has a section 254 Direction and section 255 requests under the Health and Social Care Act 2012 to collect and analyse National Major Trauma Registry data.

Training

All registry staff complete regular mandatory data protection and confidentiality training.

Opt-out

The National Data Opt-Out only applies where a patient has received NHS funded healthcare or treatment in England. If an NHS patient treated in England has registered a National Data Opt-Out, their data will still be collected by NHS England because the opt-out does not apply where it is required by law.

However, where NHS England shares NMTR data with other organisations through their Data Access Request Service, the National Data Opt-Out will be applied in accordance with the National Data Opt-Out policy. Patients can find out more about the National Data Opt-Out and register their choice.

Privacy notice

Access NHS England’s NMTR privacy notice.