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:
- 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:
- all trauma patients irrespective of age
- patients who fulfil the length of stay criteria
- patients whose isolated injuries meet the injury inclusion criteria
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.
| Body region or specific | Included – in isolation (except where specified) | Excluded – in isolation (except where specified) |
| Head injury | All brain or skull injuries | LOC or injuries to scalp |
| Thorax | All internal injuries | Minor soft tissue injury |
| Abdomen | All internal injuries | Minor soft tissue injury |
| Spine | Cord injury, fracture, dislocation, disc injury or nerve root injury | Spinal strain or sprain |
| Face | Fractures documented as:
Significantly displaced, unstable, Open, compound or comminuted. All Lefort fractures All Panfacial fractures All Orbital Blowout fractures Eye avulsion, traumatic retinal detachment or globe rupture |
Fractures documented as Closed and simple or stable |
| Neck | Any organ injury, injury to the Carotid artery, Vertebral artery or Jugular veins, hyoid fracture | Nerve injuries
Skin injuries |
| Femoral fracture | All Shaft, Distal, Head or Subtrochanteric fractures, regardless of age
Isolated Neck of Femur or Inter/ Greater trochanteric fractures <65 years old Same rules apply to periprosthetic fractures |
Isolated Neck of femur or Inter/Greater trochanteric fractures > 65 years |
| Foot or hand: joint or bone | Crush or amputation only | Any fractures and/or dislocations, even if, Open and/or multiple |
| Finger or toe | None | All injuries to digits, even if Open fractures, amputation or crush and/or multiple injuries |
| Limb – upper (except hands/fingers) | Any Open injury
Any fractures and/or dislocations involving 2 or more limbs |
Any Closed unilateral injury (including multiple closed fractured bones and/or dislocations in the same limb) |
| Limb – below knee (except feet/toes) | Any Open injury
Any fractures and/or dislocations involving 2 or more limbs |
Any Closed unilateral injury (including multiple closed fractured bones and/or dislocations in the same limb) |
| Pelvis | All fractures to Ischium, Sacrum, Coccyx, Ileum, Acetabulum
Multiple Pubic Rami fractures Single Pubic Rami fracture <65 years old Any fracture involving SIJ or Symphysis pubis |
Single Pubic Rami fracture >65 years old |
| Nerve | Any injury to sciatic, facial, femoral, cranial nerve or brachial plexus | All other nerve injuries, single or multiple |
| Vessel | All injuries to femoral, neck, facial, cranial, thoracic or abdominal vessels
Transection or major disruption of any other vessel (excluding vessels in the hands, feet and digits) |
Intimal tear or superficial laceration or perforation to any limb vessel |
| Skin | Laceration or penetrating skin injuries with blood loss >20% (>1000mls)
Major degloving injury (>50% body region) |
Simple skin lacerations or penetrating injuries with blood loss < 20% (<1000mls); single or multiple
Contusions or abrasions: single or multiple Minor degloving injury (<50% body region) |
| Burn | Any full thickness burn or
Partial/superficial burn >10% body surface area NOT referred to a Burns unit |
Partial or superficial burn <10% body surface area
Or any burn referred to a Burns unit |
| Inhalation | All included – if not referred to Burns unit | If referred to Burns unit |
| Frostbite | Severe frostbite | Superficial frostbite |
| Asphyxia | With loss of consciousness | Without a loss of consciousness |
| Drowning | With loss of consciousness | Without a loss of consciousness |
| Explosion | All | None |
| Hypothermia | Accompanied by another NMTR eligible injury | Hypothermia in isolation |
| Electrical | All | None |
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.