MDCalc

Revised Intensity Battle Score (RIBS)

Predicts the likelihood of poor outcome in adult trauma patients with rib fractures.

ribs

Pulmonary contusions

COPD

Chest tube placed/present/anticipated

GCS <15

Result:

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Advice

Use results alongside a thorough evaluation, clinician judgment, and local trauma pathways to guide disposition and management.

Management
  • Higher scores are associated with a higher risk profile; consider:
    • Higher level of care (e.g., ICU, step-down); Buchholz et al. (2023) suggest using a score of 12 as a cutoff for ICU triage.
    • Closer monitoring.
    • Early regional/neuroaxial analgesia.
    • Aggressive pulmonary care (e.g., high-frequency incentive spirometry, respiratory therapy monitoring, early mobilization).
    • Lower threshold for escalation and surgical consultation.
  • Patients with lower scores may be appropriate for standard analgesia, pulmonary hygiene, and medical/surgical ward admission.