Tehran University of Medical Sciences Journal of Orthopedic and Spine Trauma 2538-2330 12 1 2026 03 06 43 9 Mohammadreza Golbakhsh Associate Professor, Department of Orthopedic Surgery, Orthopedic Subspecialty Research Center (OSRC), Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran Seyed Aref Daneshi Orthopedic Surgeon, Orthopedic Subspecialty Research Center (OSRC), Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran Tina Azimzadeh Bachelor of Nursing, Orthopedic Subspecialty Research Center (OSRC), Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran Amirmohammad Sharafi Medical Student, Orthopedic Subspecialty Research Center (OSRC), Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran Mehrdad Sheikhvatan Assistant Professor, Department of Medical Genetics, Orthopedic Subspecialty Research Center (OSRC), Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran Seyed Hossein Shafiei Assistant Professor, Department of Orthopedic Surgery, Orthopedic Subspecialty Research Center (OSRC), Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran 2025 02 27 2026 01 26 Background: Caring for trauma patients is a paramount international concern. Delays in diagnosing patients in need of intensive care have unredeemable consequences. Identifying predicting factors of ICU admission in trauma patients is not without merit regarding this matter. This study aimed to investigate the underlying factors associated with ICU admission in trauma patients. Methods: A retrospective study was designed based on data from the National Trauma Registry of Iran from 2016 to 2021. ICU admission was considered the primary endpoint. Relationships between demographic variables, injury site, injury mechanism, vital signs, and trauma scores with the outcome were evaluated by univariate analyzes. ICU risk factors and their specific odds ratio were determined by multivariate analysis. Results: Following univariate and multivariate analysis, age> 55 years, widowhood, injuries due to road accidents, falling from a height, penetrating objects, and gunshot, underlying cardiovascular disease, injury to head, thorax, abdomen, spine, and lower extremities, hypotension, hypertension, tachycardia, bradycardia, hyperpnea, low oxygen saturation, high body temperature, GCS≤8, and ISS>15 were introduced as independent risk factors of ICU admission. Nonetheless, transport to the hospital (personal car) and upper extremity injury reduced the outcome incidence. Conclusions: Numerous contextual variables were significantly associated with ICU admission, each with its own matter. When entering the emergency room, paying attention to these factors can help diagnose people in need of ICU care sooner. https://jost.tums.ac.ir/index.php/jost/article/view/661 https://jost.tums.ac.ir/index.php/jost/article/download/661/462