Revised Trauma Score (RTS)
Physiological severity of injury (weighted RTS, 0–7.84)
Sources last checked: 2026-10-13
Revised Trauma Score (RTS)
Physiological severity of injury (weighted RTS, 0–7.84)
The weighted RTS is meant for outcome evaluation (it feeds TRISS together with ISS and age), not for bedside triage. Intubated or sedated patients cannot be scored validly on GCS and respiratory rate.
What is the Revised Trauma Score (RTS)?
The Revised Trauma Score combines coded values of the Glasgow Coma Scale, systolic blood pressure and respiratory rate into a weighted physiological severity index from 0 to 7.8408. Champion and colleagues published it in 1989 using data from the US Major Trauma Outcome Study. It is the physiological component of the TRISS survival model.
When to use it
- Trauma registries and audit, together with ISS and age (TRISS)
- Describing physiological injury severity at first assessment in research
- Teaching the link between physiology and trauma outcome
When not to use it
- Field triage decisions on their own — use local triage tools and mechanism criteria
- Intubated, sedated or paralysed patients, in whom GCS and respiratory rate are not valid
How it is calculated
Each variable is coded 0–4. RTS = 0.9368 × GCS code + 0.7326 × SBP code + 0.2908 × RR code (range 0–7.8408).
Clinical pearls and limitations
- The weighted RTS is meant for outcome evaluation (it feeds TRISS together with ISS and age), not for bedside triage. Intubated or sedated patients cannot be scored validly on GCS and respiratory rate.
- GCS carries the largest weight (0.9368), so head injury dominates the score.
- A lower RTS means worse physiology; the maximum 7.8408 is normal physiology.
- The unweighted T-RTS (sum of codes, 0–12) was proposed for triage, the weighted RTS for outcome evaluation.
Frequently asked questions
What is a normal Revised Trauma Score?
7.8408 — all three variables in their normal range (coded 4).
What is the difference between RTS and T-RTS?
T-RTS is the simple sum of the three codes (0–12) for triage; RTS weights the codes (0.9368, 0.7326, 0.2908) for outcome prediction.
Is RTS part of TRISS?
Yes. TRISS combines RTS, ISS, age and blunt or penetrating mechanism to estimate survival probability.
Evidence and guidelines
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