Revised Trauma Score Calculator — Trauma Triage and Survival Prediction

How to Use This Calculator

1. Enter GCS (3–15), systolic blood pressure, and respiratory rate.
2. T-RTS, Weighted RTS, and estimated survival probability display instantly.
3. Use the Weighted RTS tab with ISS and age to calculate TRISS probability of survival.
4. Use the Triage RTS tab for mass casualty triage category assignment.

Formula

Example

Frequently Asked Questions

• What is the Revised Trauma Score? ▼
  The Revised Trauma Score (RTS) is a physiological trauma scoring system developed by Champion et al. in 1989 to replace the earlier Trauma Score. It uses three clinical parameters — Glasgow Coma Scale (GCS), systolic blood pressure (SBP), and respiratory rate (RR) — each coded on a 0–4 scale based on physiological ranges. The Triage RTS (T-RTS) is the simple sum of the three coded values (0–12) and is used for rapid field triage, with scores of 11–12 classified as minor (green), 1–10 as serious (yellow or red), and 0 as expectant (black). The Weighted RTS uses regression coefficients (0.9368 for GCS, 0.7326 for SBP, and 0.2908 for RR) and is used in the TRISS methodology to calculate probability of survival when combined with the Injury Severity Score and patient age.
• How are the RTS coded values determined? ▼
  Each of the three RTS parameters is converted to a coded value of 0–4 based on physiological ranges. For GCS: 13–15 = 4, 9–12 = 3, 6–8 = 2, 4–5 = 1, 3 = 0. For systolic blood pressure: above 89 mmHg = 4, 76–89 = 3, 50–75 = 2, 1–49 = 1, 0 = 0. For respiratory rate: 10–29 breaths/min = 4, 6–9 = 3, 1–5 = 2, above 29 = 4 (tachypnoea coded same as normal), 0 = 0. Note that respiratory rates above 29 are scored the same as 10–29 (both 4) in the T-RTS, but the Weighted RTS coefficients slightly differentiate their prognostic impact. The worst pre-hospital or initial hospital value is typically used for scoring.
• What is TRISS and how does the Weighted RTS fit in? ▼
  TRISS (Trauma and Injury Severity Score) is a methodology for estimating the probability of survival (Ps) in trauma patients. It combines the Weighted RTS (physiological component), the Injury Severity Score (ISS, anatomical component), and patient age (coded as 0 if below 55 or 1 if 55 or above) using logistic regression coefficients derived from the Major Trauma Outcome Study (MTOS). Separate coefficients are used for blunt and penetrating injuries. The formula is: Ps = 1 / (1 + e^-b), where b = b0 + b1(RTS) + b2(ISS) + b3(age) with blunt coefficients b0=−1.2470, b1=0.9544, b2=−0.0768, b3=−1.9052. TRISS Ps allows outcome benchmarking — comparing observed mortality to predicted mortality for trauma centres.
• What are the limitations of the RTS? ▼
  The RTS has several important limitations. First, it relies on accurate GCS assessment, which can be confounded by intubation, sedation, alcohol, or pre-existing neurological conditions. Second, the respiratory rate variable has the weakest predictive weight, and its dichotomous coding (above 29 scored same as 10–29) reduces sensitivity. Third, the regression coefficients were derived from the 1980s MTOS dataset and may not reflect modern resuscitation outcomes. Fourth, RTS does not capture anatomical injury severity — a patient with an isolated GCS 13 from a severe traumatic brain injury may have an RTS of 11 suggesting minor injury, while having a life-threatening intracranial haemorrhage. Fifth, prehospital measurement of RR is notoriously unreliable. Despite these limitations, RTS remains a standard in trauma triage and international trauma registry benchmarking.
• How is the RTS used in mass casualty triage? ▼
  The Triage RTS (T-RTS) is used in mass casualty incident (MCI) triage systems including START (Simple Triage and Rapid Treatment) as a physiological assessment component. T-RTS is calculated rapidly: score 12 corresponds to Green (minor/walking wounded), 11 to Yellow (delayed), 1–10 to Red (immediate life-threatening), and 0 to Black (expectant/unsalvageable). The SALT (Sort, Assess, Lifesaving Interventions, Treatment/Transport) protocol uses similar physiological assessments. In field triage, where speed is paramount, T-RTS provides a quick objective physiological summary. However, MCI triage protocols also include limb-moving assessment, breathing check, and pulse/perfusion assessment before RTS calculation in the most acute patients. Pure T-RTS triage without clinical context risks undertriage of injured patients with compensated physiology.

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