Analysis of the Positivity Rate of Sector-based Whole-body CT Scans in Grade C Trauma Patients in Essonne - NCT07929168

Background: Grade C trauma patients show no obvious severe injury at first assessment, but the mechanism or circumstances of the accident make serious lesions possible. Guidelines recommend a whole-body CT scan as first-line imaging1. The organization of the French trauma system varies between regions2. Île-de-France distinguishes level 1 trauma centers, which are authorized to manage the most severe patients, from level 2 hospitals, which can perform a full injury assessment3. Essonne has no level 1 trauma center, and most are located in Paris. Emergency dispatch physicians must therefore choose between performing the scan at the local hospital or transporting the patient directly to a trauma center. When a local scan is abnormal, specialist consultation, image transfer and secondary transport take time (median of about 6 hours4) and may worsen the prognosis. Objective: To assess whether the proportion of abnormal whole-body CT scans in grade C trauma patients justifies systematic transport to a trauma center rather than local imaging. Methods: Retrospective, multicenter cohort study of about 100 adult grade C trauma patients managed by an Essonne mobile emergency team (SMUR) in 2025 who underwent a whole-body CT scan. We will determine the proportion of abnormal scans, whether the lesions could be managed locally or required a level 1 or 2 trauma center, the secondary transfer rate, and the time to final destination. Hypothesis: The proportion of abnormal scans, particularly those requiring specific medical care, is high enough to support performing the first whole-body CT scan at a trauma center.