Severe trauma is a public health problem because it is the leading cause of death in young people and the third leading cause of death in France for all ages. These injuries will cause anatomical and functional after-effects that are sometimes permanent, and are therefore among the leading causes of acquired disability in France.
The Vittel criteria constitute a decision-making algorithm of 24 criteria for triage of trauma patients. The presence of only one criterion out of the 24 must direct the patient to a trauma referral center. The existence of only one trauma referral center per territory questions the relevance of using the Vittel criteria in the French Antilles and Guiana.
It therefore seems important that the relevance of the different Vittel criteria be reassessed in our territories, where the typology of patients and the urban network is different compared to that of mainland France. are a common cause of severe trauma, followed by assaults or fights, accidents at work, during leisure or at home, falls from a great height, and weapon-related injuries. Special and rapid care is then necessary.
This is why trauma severity criteria and triage scores are used to target these serious patients and direct them to the appropriate healthcare facilities.
The Vittel criteria constitute a decision-making algorithm of 24 criteria for triage of trauma patients. The presence of only one criterion out of the 24 must direct the patient to a trauma referral center. The existence of only one trauma referral center per territory questions the relevance of using the Vittel criteria in the French Antilles and Guiana.
It therefore seems important that the relevance of the different Vittel criteria be reassessed in Martinique, Guadeloupe and french Guiana, french overseas territories, where the typology of patients and the urban network is different compared to that of mainland France.
Minor patients (2-17 years) and adults (≥ 18 years).
Patients treated in the emergency units of the hospitals participating in the study, whether they were brought by a SAMU/SMUR team, by a rescue and victim assistance vehicle or arrived directly.
Patients suspected of severe trauma, defined as trauma likely to have caused multiple injuries and/or threatening the vital or functional prognosis.
Patient if he is able to, or representative of the patient in case of incapacity, having given his agreement for the use of his medical data for this research.
Absence of consent from the patient, or representative to the use of the data for the research.
Patients suspected of severe trauma, treated in the emergency units of the hospitals participating in the study (Martinique, Guadeloupe, Frech Guiana).
Cohort
Prospective
Routine care
Other interventionThe investigator takes care of the patient according to the protocol in force in his department and decides on the final orientation of the patient (transfer to intensive care unit/ICU, hospitalization or home discharge). No recommendations or instructions are given to the investigators. Each investigator is free to decide on his care and the terms of transfer, hospitalization and discharge.
To compare the frequency of each Vittel criterion according to the patient's status within 30 days
Calculation of the proportion of each Vittel criterion in the two groups defined according to the patient's status at day 30 (alive vs. deceased or hospitalized in intensive care).
To compare the discriminatory capacity of the different Vittel criteria to estimate the probability of occurrence of a serious anatomical lesion in severely traumatized patients treated by the SAMU/SMUR of the French Antilles-Guiana
Calculation of the area under the ROC curve of the different Vittel criteria to evaluate a posteriori their performance in predicting, in severely traumatized patients, a serious anatomical lesion defined by an ISS score \> 15.
To compare the discriminatory capacity of the different Vittel criteria to estimate the probability of having to resort to a massive transfusion in severely traumatized patients treated by the SAMU/SMUR of the French Antilles-Guiana
Calculation of the area under the ROC curve of the different Vittel criteria to evaluate a posteriori their performance in predicting a massive transfusion (defined by 5 red blood cell concentrates (RBCs) in 3 hours or 8 RBCs in 6 hours or 10 RBCs in 24 hours).
To assess the feasibility of having firefighters fill out a form to collect among the Vittel criteria those relating to the physical circumstances of the accident
Proportion of files for which the "physical circumstances of the accident" sheet was completed by the firefighters.
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