Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 0 0 2026 05 24 1563 1563 Hala El-Shorbagy Emergency Medicine and Traumatology Department, Faculty of Medicine, Tanta University, Tanta, Egypt. Sameh Ismaiel Anesthesiology, Surgical Intensive Care and Pain Medicine Department, Faculty of Medicine, Tanta University, Tanta, Egypt. Mohammad Abo-Ryia Anesthesiology, Surgical Intensive Care and Pain Medicine Department, Faculty of Medicine, Tanta University, Tanta, Egypt. Sabry Mohamed Hamoud General Surgery Department, Faculty of Medicine, Tanta University, Tanta, Egypt. Sherif Elabd Emergency Medicine and Traumatology Department, Faculty of Medicine, Tanta University, Tanta, Egypt. 2026 02 02 2026 02 14 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. https://aacc.tums.ac.ir/index.php/aacc/article/view/1563