Audit of trauma management in Scotland
Scottish Trauma Audit Group

About this release

This PHS release presents information on Scottish Trauma Network (STN) key performance indicator (KPI) compliance, outcomes, injury patterns and care pathways for adults and children who sustained severe injuries.

Main points

The STAG reports on 8,164 adult and 228 paediatric patients who attended hospital in 2025 following a severe injury.

This chart shows case-mix adjusted mortality for Scotland from 2023-2025. Data shows improvement year on year.

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Case-mix adjusted mortality (adult and paediatric) (2023-2025)

Patient outcome

• Case-mix adjusted mortality improved to 0.45 additional survivors per 100 patients in 2025, meaning around 36 more survivors in 2025 than in 2019-2022.
• Among patients employed before injury, return to work increased significantly to 76%, compared with 67% before national STN implementation in August 2021.
• Severe disability at six months reduced from 28% to 26% among patients who required every day help from family or carers.

Injury patterns

• The most common mechanism of injury in adults was a fall (77%, n=6,290), with 74% caused by a fall on the same level (n=4,632).
• Falls and moving vehicle injuries accounted for 44% (n=100) and 37% (n=85) respectively, of all injuries among paediatric patients.
• Among paediatrics who sustained major trauma in moving vehicle incidents, e-bike and e-scooter injuries combined accounted for the same proportion as pedestrian injuries (28%, n=9).

Care pathways and access to specialist services

• 57% of adults with major trauma were taken directly to a major trauma centre (MTC) in 2025 by the Scottish Ambulance Service (SAS).
• 49% of paediatric patients, compared to 18% of adults, self-presented to ED.
• At the first admitting MTC, 61% of adult major trauma patients were admitted under the major trauma service (MTS), with a further 18% admitted under an appropriate surgical specialty.
• In paediatrics, 571 patients were managed by the MTS, but only 228 were recorded in STAG, mainly because shorter lengths of stay meant they did not meet the audit inclusion criteria.
• 73% of patients assessed as frail using the Clinical Frailty Scale (5-8) were reviewed by a specialist in Medicine for the Elderly.

Background

STAG’s aim is to improve the quality of care, patient experience, and outcomes of severely injured patients through measuring compliance with KPIs and promoting use of data to support quality improvement.

Severe injury is categorised using the Injury Severity Score (ISS, Baker et al,1974) into major (ISS>15), moderate (ISS 9-15), or minor (ISS<9). To be included in STAG, an injured patient must stay in hospital for at least three days, be admitted to critical care or die in hospital. There are many more patients with an injury admitted to Scottish hospitals which are reported in the Unintentional injuries report by PHS.

Full details of the KPIs and STAG inclusion criteria can be found on the PHS website.

Further information

The next release of this publication will be 25 August 2027.