Revised Trauma Score (RTS)

The Revised Trauma Score (RTS) is one of the most widely used physiological scoring systems for the initial assessment of trauma patients. Developed by Champion et al. in 1989, the RTS evaluates three critical physiological parameters: the Glasgow Coma Scale (GCS) for neurological function, systolic blood pressure (SBP) for circulatory status, and respiratory rate (RR) for ventilatory function.

The RTS exists in two forms serving different clinical purposes. The Triage RTS (T-RTS) is a simple sum of coded values (range 0-12) used for field triage decisions. The weighted RTS applies regression coefficients derived from the Major Trauma Outcome Study to each parameter, yielding a score that correlates more precisely with survival probability and is used in outcomes research.

The weighted RTS formula is: RTS = 0.9368 x GCS code + 0.7326 x SBP code + 0.2908 x RR code. The coefficients reflect each parameter's relative importance in predicting survival, with neurological status having the greatest weight. The weighted RTS ranges from 0 to 7.8408, with higher scores indicating better physiological status.

Each parameter is converted to a coded value (0-4). For GCS: 13-15=4, 9-12=3, 6-8=2, 4-5=1, 3=0. For SBP: >89=4, 76-89=3, 50-75=2, 1-49=1, 0=0. For RR: 10-29=4, >29=3, 6-9=2, 1-5=1, 0=0.

In the prehospital setting, T-RTS of 11 or less generally triggers transport to a designated trauma center. The RTS has demonstrated strong predictive validity across multiple validation studies. When combined with the Injury Severity Score (ISS) in the TRISS methodology, the RTS provides robust outcome prediction forming the foundation of trauma system quality assessment worldwide.

While the RTS is valuable for its simplicity and rapid assessment capability, it has limitations. It does not account for interventions that may mask physiological derangement (intubation, vasopressors), and may underestimate injury severity in young patients who maintain normal vital signs until late decompensation. Despite these limitations, the RTS remains a cornerstone of trauma assessment and triage.

The RTS was developed as a revision of the original Trauma Score (1981), simplifying it from five to three parameters while maintaining equivalent or superior predictive accuracy. Its integration into the TRISS methodology alongside the ISS allows comprehensive outcome prediction incorporating both physiological and anatomical injury data.

This calculator provides both the Triage RTS and the weighted RTS with an estimated survival probability category based on the weighted score, suitable for field triage, clinical assessment, and outcomes documentation.