Revised Trauma Score -  (RTS) (Champion 1989)

Physiologic injury severity score

It is scored from the first set of data obtained consists of:

  • Glasgow Coma Scale (GCS)

  • Systolic Blood Pressure (SBP)

  • Respiratory Rate (RR)

The GCS, SBP and RR are given a coded value, the RTS is then calculated by adding together the coded values.
 

Glascow coma scale Systolic blood pressure Respiratory rate Coded value
13- 15 >89 10-29 4
9-12 76-89 >29 3
6-8 50-75 6-9 2
4-5 1-49 1-5 1
3 0 0 0

 

In the field the unweighted score ranges 0-12, a score less than 11 is an indication for transfer to a dedicated trauma centre.

A coded form of the RTS is used for quality assurance and outcome prediction.

RTS = 0.9368 GCS + 0.7326 SBP + 0.2908 RR

Values for the codedRTS range 0 to 7.8408. (0 = dead 7.8408 = normal)

The RTS is heavily weighted towards the Glasgow Coma Scale to compensate for major head injury without multisystem injury or major physiological changes. A threshold of RTS < 4 has been proposed to identify those patients who should be treated in a trauma centre, although this value may be somewhat low.

Limitations of RTS:

  • Calculating coded form in field not practical

  • Problems with GCS in intubated patients

  • Influence of alcohol and drugs

  • Changing physiological parameters with resuscitationtion of of physiological derangement not accounted for

Champion HR, Sacco WJ, Copes WS, et al: A revision of the trauma score. J Trauma 1989; 29: 623–629

Trauma.org scoring systems

Last updated 11/09/2015