Trauma Score - Revised (RTS)

The Trauma Score Revised (RTS) with raw vital sign input is a comprehensive physiological scoring tool that accepts actual clinical values and automatically converts them into the coded values used in the standard Revised Trauma Score. Unlike the standard RTS calculator requiring pre-coded inputs, this version accepts the raw Glasgow Coma Scale score (3-15), systolic blood pressure in mmHg, and respiratory rate in breaths per minute.

This approach eliminates manual coding table lookups, reducing coding errors and speeding assessment in time-critical trauma situations. The underlying methodology is identical to the standard RTS developed by Champion et al. in 1989, using the same coded value ranges and MTOS regression coefficients.

The Glasgow Coma Scale (GCS) is the most heavily weighted RTS component (coefficient 0.9368), reflecting the paramount importance of neurological function in trauma outcomes. GCS assesses eye opening (1-4), verbal response (1-5), and motor response (1-6), totaling 3-15. The RTS codes GCS as: 13-15=4, 9-12=3, 6-8=2, 4-5=1, 3=0.

Systolic blood pressure reflects circulatory adequacy. Hypotension in trauma typically indicates hemorrhage, cardiac tamponade, or tension pneumothorax. SBP coding: >89=4, 76-89=3, 50-75=2, 1-49=1, 0=0. Respiratory rate reflects ventilatory function, compromised by chest injuries, pneumothorax, spinal cord injury, or CNS depression. RR coding: 10-29=4, >29=3, 6-9=2, 1-5=1, 0=0.

The weighted RTS = 0.9368 x GCS code + 0.7326 x SBP code + 0.2908 x RR code (maximum 7.8408). The Triage RTS is the simple sum of coded values (0-12), with scores of 11 or less triggering trauma center transport. This calculator displays individual coded values alongside final scores for comprehensive documentation.

The weighted RTS integrates into the TRISS methodology combining physiological (RTS) and anatomical (ISS) data with patient age and injury mechanism for the most accurate trauma outcome prediction available. Serial RTS calculations can track physiological trajectory, unlike anatomical scores that remain fixed.

Clinical limitations include the inability to account for therapeutic interventions (intubation normalizing RR, vasopressors affecting BP) and the potential for young patients to maintain normal vital signs until catastrophic decompensation. These limitations underscore the importance of clinical judgment alongside objective scoring.

This calculator provides both intermediate coded values and final scores with survival probability estimates, making it a comprehensive tool for trauma assessment, field triage documentation, and outcomes research data collection.