Prise en charge actuelle du traumatisé grave en France: Premier bilan de l'étude FIRST (French Intensive care Recorded in Severe Trauma)

Translated title of the contribution: Current support for severe blunt trauma patients in France: Initial assessment of the FIRST study (French Intensive care Recorded in Severe Trauma)

J. M. Yeguiayan, D. Garrigue, C. Binquet, C. Jacquot, J. Duranteau, C. Martin, F. Rayeh, Bruno Riou, C. Bonithon-Kopp, M. Freysz

Research output: Contribution to journalArticleResearchpeer-review

7 Citations (Scopus)

Abstract

Aim: The FIRST study (French Intensive care Recorded in Severe Trauma) was designed in order to describe the French management of severe blunt trauma in collaboration with 14 University hospitals. Procedure: Epidemiological, clinical data of pre- and in-hospital evolution were prospectively recorded for 3090 patients admitted in ICU within 72 hours after trauma and/or managed by a prehospital medical team of a participant center. Results: The mean age is 42 years old (SD 18), 61% of patients are road traffic victims, 30% are miscellaneous accidents victims (domestic, sports...)and 7% are involved in work accident and 2% in other type of accident. More than 50% of patients are intubated during prehospital care. Median Coma Glasgow Score is 12; IQR [6; 15]. After prehospital management, mean arterial pressure evolves from 89 mmHg (SD 29) to 84 mmHg (SD 23). Mean prehospital fluid loading is 788 ± 862 ml and 16% of patients receive prehospital continuous catecholamine infusion. Nearly 25% of patients are initially admitted in a general hospital before University hospital transfer. Such strategy increases delay admission to University hospital (1,9 hours, IQR [1,3-2,5 hours] to 6,4 hours, IQR [5,0-8,4 hours], p <0,001. Many patients were not managed by a medical prehospital team (7%) and whole-body CT on admission is not systematically performed. The injury severity score (median ISS: 25; IQR [18; 34]) may explain the time stay in intensive care unit (7 days), IQR [2-19 days] where 57% of patients have sepsis complications, and the global mortality of 23% at the 30 th day. Conclusion: This study shows that all recommendations are well followed and promotes the installation of formalized regional care systems.

Translated title of the contributionCurrent support for severe blunt trauma patients in France: Initial assessment of the FIRST study (French Intensive care Recorded in Severe Trauma)
Original languageFrench
Pages (from-to)156-163
Number of pages8
JournalAnnales Francaises de Medecine d'Urgence
Volume2
Issue number3
DOIs
Publication statusPublished - May 2012
Externally publishedYes

Keywords

  • Emergency medicine
  • Epidemiological study
  • Intensive care
  • Medical prehospital management
  • Mobile Intensive Care Unit
  • Severe Blunt trauma

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