Retrospective Assessment of Referral of a Major Trauma Patient

NCT06551350 | Recruiting

• 1 other identifier: CHRD0924
• Study Type: observational
• Target: 461
• Locations: 1 country
• Sites: 1

Brief Summary

The aim of this study is to find out whether major trauma patients from the Val d'Oise are referred to the appropriate trauma centre for their care and to assess the quality of triage within the Val d'Oise department.

Conditions

Trauma Injury

Keywords

Major trauma; Mobile Intensive Care Unit (MCIU)

Outcome Measures

Primary Outcomes (1)

• Triage assessment of a major trauma patient

  The criterion is the evaluation of the referral of the major trauma patient after post-Medics injury assessment into over, normo and under-triage The over-triage patient is referred to a level I trauma centre with an Injury Severity Score (ISS) \<16 The normo-triage patients are either referred to: * a level 1 trauma centre with an ISS \>15 * the local scanner and then to an intensive care unit at the scanner site * in the emergency department and then to a surgical unit * emergency with a return home afterwards The under-triage patient is either referred to: * the local scanner and then to a level 1 trauma centre * initially emergency with hospitalisation in an intensive care or continuing care unit afterwards

  At the end of the study, an average of 9 month

Secondary Outcomes (7)

• Assess if the intervention time is correlated with an under-triage

  At the end of the study, an average of 9 month

• Assess if presumed alcohol intoxication is correlated with a higher rate of under-triage

  At the end of the study, an average of 9 month

• Assess if deliberate toxic poisoning is correlated with a higher rate of under-triage

  At the end of the study, an average of 9 month

• Assess if the TRENAU grade is predictive in pre-hospital of an appropriate referral following an intra-hospital trauma assessment

  At the end of the study, an average of 9 month

• Assess if the positive Shock-Index is predictive of an appropriate pre-hospital referral to a level 1 trauma centre

  At the end of the study, an average of 9 month

Interventions

Data Collection OTHER

Collection of medical data from MICU intervention file and the medical records of patients at the destination hospital

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Patients regulated by SAMU 95 with suspected major trauma between the 1st January 2023 and the 31th December 2023.

You may qualify if:

• Between the 1st January 2023 and the 31th December 2023
• Regulated by SAMU 95 with suspected major trauma
• Sending an MCIU
• At least 1 Vittel criterion\*

You may not qualify if:

• Death on site
• Care by an MICU team outside the 95
• Minor patients and legal protection
• Transport refusals
• Vittel criterion :
• Physiological variables : Glasgow score \< 13 Systolic blood pressure \< 90 mmHg O2 saturation \< 90%
• Elements of kinetics : Ejection from a vehicle Other passenger killed in the same vehicle Fall \> 6 metres Victim thrown or crushed Overall assessment (deformation of the vehicle, estimated speed, absence of helmet, absence of seatbelt) Blast
• Anatomical lesions : Penetrating trauma to the head, neck, thorax, abdomen, pelvis, arm or thigh Flail chest Severe burn, smoke inhalation Pelvic fracture Suspected spinal cord injury Amputation of wrist, ankle or above Acute limb ischaemia
• Pre-hospital resuscitation : Assisted ventilation Filling \> 1000 ml with colloids Catecholamines Inflated shock-proof trousers
• Medical context (to be assessed) : Age \> 65 Cardiac or coronary insufficiency Respiratory insufficiency Pregnancy (2nd and 3rd trimesters) Blood crase disorders

Sponsors & Collaborators

• Hôpital NOVO: lead

Study Sites (1)

Resuscitation Services (SAMU 95/SMUR) - Hôpital NOVO -Pontoise Site

Pontoise, 95300, France

RECRUITING

Related Publications (9)

• MacKenzie EJ, Rivara FP, Jurkovich GJ, Nathens AB, Frey KP, Egleston BL, Salkever DS, Scharfstein DO. A national evaluation of the effect of trauma-center care on mortality. N Engl J Med. 2006 Jan 26;354(4):366-78. doi: 10.1056/NEJMsa052049.

  PMID: 16436768 BACKGROUND

• Haagsma JA, Graetz N, Bolliger I, Naghavi M, Higashi H, Mullany EC, Abera SF, Abraham JP, Adofo K, Alsharif U, Ameh EA, Ammar W, Antonio CA, Barrero LH, Bekele T, Bose D, Brazinova A, Catala-Lopez F, Dandona L, Dandona R, Dargan PI, De Leo D, Degenhardt L, Derrett S, Dharmaratne SD, Driscoll TR, Duan L, Petrovich Ermakov S, Farzadfar F, Feigin VL, Franklin RC, Gabbe B, Gosselin RA, Hafezi-Nejad N, Hamadeh RR, Hijar M, Hu G, Jayaraman SP, Jiang G, Khader YS, Khan EA, Krishnaswami S, Kulkarni C, Lecky FE, Leung R, Lunevicius R, Lyons RA, Majdan M, Mason-Jones AJ, Matzopoulos R, Meaney PA, Mekonnen W, Miller TR, Mock CN, Norman RE, Orozco R, Polinder S, Pourmalek F, Rahimi-Movaghar V, Refaat A, Rojas-Rueda D, Roy N, Schwebel DC, Shaheen A, Shahraz S, Skirbekk V, Soreide K, Soshnikov S, Stein DJ, Sykes BL, Tabb KM, Temesgen AM, Tenkorang EY, Theadom AM, Tran BX, Vasankari TJ, Vavilala MS, Vlassov VV, Woldeyohannes SM, Yip P, Yonemoto N, Younis MZ, Yu C, Murray CJ, Vos T. The global burden of injury: incidence, mortality, disability-adjusted life years and time trends from the Global Burden of Disease study 2013. Inj Prev. 2016 Feb;22(1):3-18. doi: 10.1136/injuryprev-2015-041616. Epub 2015 Dec 3.

  PMID: 26635210 BACKGROUND

• Hirsch M, Carli P, Nizard R, Riou B, Baroudjian B, Baubet T, Chhor V, Chollet-Xemard C, Dantchev N, Fleury N, Fontaine JP, Yordanov Y, Raphael M, Burtz CP, Lafont A; health professionals of Assistance Publique-Hopitaux de Paris (APHP). The medical response to multisite terrorist attacks in Paris. Lancet. 2015 Dec 19;386(10012):2535-8. doi: 10.1016/S0140-6736(15)01063-6. Epub 2015 Nov 28. No abstract available.

  PMID: 26628327 BACKGROUND

• Cotte J, Courjon F, Beaume S, Prunet B, Bordes J, N'Guyen C, Contargyris C, Lacroix G, Montcriol A, Kaiser E, Meaudre E. Vittel criteria for severe trauma triage: Characteristics of over-triage. Anaesth Crit Care Pain Med. 2016 Apr;35(2):87-92. doi: 10.1016/j.accpm.2015.06.013. Epub 2015 Dec 1.

  PMID: 26592159 BACKGROUND

• Sartorius D, Le Manach Y, David JS, Rancurel E, Smail N, Thicoipe M, Wiel E, Ricard-Hibon A, Berthier F, Gueugniaud PY, Riou B. Mechanism, glasgow coma scale, age, and arterial pressure (MGAP): a new simple prehospital triage score to predict mortality in trauma patients. Crit Care Med. 2010 Mar;38(3):831-7. doi: 10.1097/CCM.0b013e3181cc4a67.

  PMID: 20068467 BACKGROUND

• Liao TK, Ho CH, Lin YJ, Cheng LC, Huang HY. Shock index to predict outcomes in patients with trauma following traffic collisions: a retrospective cohort study. Eur J Trauma Emerg Surg. 2024 Oct;50(5):2191-2198. doi: 10.1007/s00068-024-02545-4. Epub 2024 May 31.

  PMID: 38819683 BACKGROUND

• Bouzat P, Ageron FX, Brun J, Levrat A, Berthet M, Rancurel E, Thouret JM, Thony F, Arvieux C, Payen JF; TRENAU group. A regional trauma system to optimize the pre-hospital triage of trauma patients. Crit Care. 2015 Mar 18;19(1):111. doi: 10.1186/s13054-015-0835-7.

  PMID: 25887150 BACKGROUND

• Baker SP, O'Neill B, Haddon W Jr, Long WB. The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care. J Trauma. 1974 Mar;14(3):187-96. No abstract available.

  PMID: 4814394 BACKGROUND

• Rating the severity of tissue damage. I. The abbreviated scale. JAMA. 1971 Jan 11;215(2):277-80. doi: 10.1001/jama.1971.03180150059012. No abstract available.

  PMID: 5107365 BACKGROUND

Related Links

• Insee. Statistiques sur les accidents En France.
• Santé publique France. "Traumatismes non intentionnels." Bulletin épidémiologique hebdomadaire. 2023
• Trauma center Association of America. Best Practices in Trauma Care
• Santé publique France. "Traumatismes et accidents de la vie courante." Publié le 6 mai 2022
• Thèse de Doctorat Université de Rennes 1
• Thèse de Doctorat en santé Publique - Epidémiologie. Université Paris-Saclay
• Thèse de Doctorat Université de Grenoble

MeSH Terms

Conditions

Accidental Injuries

Interventions

Data Collection

Condition Hierarchy (Ancestors)

Wounds and Injuries

Intervention Hierarchy (Ancestors)

Epidemiologic Methods; Investigative Techniques; Health Care Evaluation Mechanisms; Quality of Health Care; Health Care Quality, Access, and Evaluation; Public Health; Environment and Public Health

Study Officials

• Fabrice LOUVET

  Hôpital NOVO

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Maryline DELATTRE

CONTACT

+3333130754131; maryline.delattre@ght-novo.fr

Véronique DA COSTA

CONTACT

+3333130755069; veronique.dacosta@ght-novo.fr

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: August 9, 2024
• First Posted: August 13, 2024
• Study Start: October 18, 2024
• Primary Completion: May 1, 2025
• Study Completion: May 1, 2025
• Last Updated: December 5, 2024

Record last verified: 2024-12

Locations

FR (1)