Comparison of the Predictive Performance of Revised Trauma Score, Trauma and Injury Severity Score, and BIG Score in Polytrauma Patients

Hala M.A. El-Shorbagy; Sameh Abdelkhalik Ahmed Ismaiel; Mohammad Hamdy Abo-Ryia; Sabry Mohamed Amin Hamoud; Sherif Shawky Abdelaziz Elabd

Comparison of the Predictive Performance of Revised Trauma Score, Trauma and Injury Severity Score, and BIG Score in Polytrauma Patients

Hala M.A. El-Shorbagy

Sameh Abdelkhalik Ahmed Ismaiel

Mohammad Hamdy Abo-Ryia

Sabry Mohamed Amin Hamoud

Sherif Shawky Abdelaziz Elabd

Abstract

Background: Trauma remains a predominant cause of mortality worldwide, especially among individuals aged 1 to 44 years and in developing nations. To optimize management and improve outcomes, several trauma scoring systems have been developed, including the revised trauma score (RTS), trauma and injury severity score (TRISS), and base deficit, INR, and GCS (BIG) score. This work aimed to evaluate and compare the predictive value of trauma severity scales in polytrauma patients regarding trauma severity outcomes.
Methods: This prospective observational study was carried out on 100 patients aged from 18 to 65 years old, of both sexes, with polytrauma (two or more severe injuries in at least two areas of the body). All three trauma scores were calculated for each polytrauma patient.
Results: RTS and TRISS were significantly lower in the mortality group, whereas the BIG score was significantly higher. Moreover, patients admitted to the ICU and those with hospital stays longer than 9 days had significantly lower RTS and TRISS values and higher BIG scores, indicating that these scores reliably reflect injury severity and help anticipate intensive care needs and length of hospital stay. RTS, TRISS, and BIG showed a significant ability to predict mortality in polytrauma patients, respectively, at cut-offs ≤5.3, <70, and >6 with 86.67%, 86.67%, and 93.7% sensitivity and 77.70%, 80.00%, and 81.2% specificity.
Conclusion: RTS, TRISS, and BIG effectively predicted mortality and ICU requirements in polytrauma patients. BIG showed the highest accuracy, making it the most reliable early mortality predictor. RTS and TRISS also performed well but were slightly less accurate.

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Revised Trauma Score Trauma and Injury Severity Score BIG Score Polytrauma Patients

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El-Shorbagy H, Ismaiel S, Abo-Ryia M, Hamoud SM, Elabd S. Comparison of the Predictive Performance of Revised Trauma Score, Trauma and Injury Severity Score, and BIG Score in Polytrauma Patients. Arch Anesth & Crit Care. 2026;.

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