An observational study in Multiple Trauma/Injuries and Wounds and Injuries, sponsored by Centre Hospitalier Sud Francilien. Not yet recruiting at 1 site in France. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-11-10.
Sponsored by Centre Hospitalier Sud Francilien · Observational
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.
Grade C trauma patients are a diagnostic and logistical challenge: their initial presentation is reassuring, yet the mechanism of injury may conceal severe lesions, which is why whole-body CT is recommended as first-line imaging6. The destination chosen at the pre-hospital stage therefore determines both the speed of diagnosis and the speed of access to specialized care. In Essonne, where no level 1 trauma center exists, this choice is made by the SAMU dispatch physician, case by case, without local data on how often a scan performed at the sector hospital reveals lesions requiring specialized management. The delays reported after an abnormal local scan are the main argument for direct transfer, while the unnecessary mobilization of resources and the transport of patients who turn out to have normal scans are the main argument against.
This is a retrospective, multicenter, observational cohort study. It covers hospitals of the Essonne department that received grade C trauma patients managed by an Essonne SMUR team in 2025 and who received a whole-body CT. Cases will be identified from SMUR and SAMU activity records, then linked to the receiving hospitals' medical files. No intervention will be performed and no change to patient care is planned.
Data will be extracted from SAMU dispatch records, emergency department files and radiology reports. Variables will include:
Data will be recorded in a pseudonymized, secure database. Descriptive statistics will be used for the whole cohort. The proportion of abnormal whole-body CT scans will be reported with its 95% confidence interval.
139 studies on the registry are indexed under Multiple Trauma; 32 are open to participants now.
This study's planned enrollment of 100 is below the median of 200 across 84 observational studies indexed under Multiple Trauma.
Browse Multiple Trauma studies →Centre Hospitalier Sud Francilien is the lead sponsor of 58 studies on the registry; 13 are open to participants now.
Counted across the registry records on this site, refreshed daily.
Adult grade C trauma patients attended on scene by a mobile emergency and resuscitation team (SMUR) of Essonne between 01/01/2024 and 31/12/2025, who underwent a whole-body CT scan at the sector hospital. Grade C patients are stable at first assessment, with no obvious severe injury, but their mechanism of injury and/or medical background make severe lesions possible. Patients are identified from the Essonne SAMU dispatch software and from the medical records of the emergency departments of the participating hospitals.
Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.
Exclusion Criteria:
Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
A line of therapy is one course of treatment, which may combine several drugs. First-line is the first course given; second-line follows when that stops working or is not tolerated.
“Two prior lines” means two courses that count separately under the study’s rules — not simply two drugs. Ask the study team if you are unsure how yours are counted.
Line of therapy
A line of therapy is one course of treatment, which may combine several drugs. First-line is the first course given; second-line follows when that stops working or is not tolerated.
“Two prior lines” means two courses that count separately under the study’s rules — not simply two drugs. Ask the study team if you are unsure how yours are counted.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Adult (\>18 years) grade C trauma patients attended on scene by an Essonne SMUR team between 01/01/2025 and 31/12/2025, who underwent a whole-body CT scan at the sector hospital. A grade C patient is stable (no hemodynamic disorder) and meets no grade A or B criterion, but has a high-risk mechanism of injury (fall of more than 6 m, ejected, crushed, thrown or blasted victim, death of a passenger in the same vehicle, proximal open limb fracture or closed fracture of at least 2 long bones) and/or an at-risk medical background.
Diagnostic Test: Whole-body CT scan at the sector hospital
Whole-body computed tomography performed as first-line imaging in the radiology department of the sector hospital covering the accident site, as part of routine care. Its results (trauma-related lesions, level of care required, secondary transfer to a trauma center) are analysed retrospectively.
Proportion of pathological whole-body CT scans
A whole-body CT scan is considered pathological if it shows trauma-related lesions on imaging, whatever their severity. Lesions discovered incidentally or present before the accident are not counted. Data are collected from the Essonne SAMU dispatch software and, for missing data, by calling the receiving emergency departments of the sector hospitals.
Time frame: at day 0
Rate of secondary transfers to a trauma center
Final orientation of patients with a pathological whole-body CT scan, analysed qualitatively: proportion of patients secondarily transferred to a level 1 trauma center or an intensive care unit, and distribution between patients who can be managed at the sector hospital and those requiring care in a level 1 or level 2 trauma center.
Time frame: at day 0
Total time from initial SMUR care to arrival at the final destination
Total duration between the initial SMUR care and the arrival of the patient at the final destination, used to evaluate the impact of under-triage of grade C trauma patients by comparison of delays (Wilcoxon test). Delays are described as medians with interquartile ranges.
Time frame: at day 0
Proportion of pathological whole-body CT scans according to the collected variables
Descriptive analysis of the cohort of grade C trauma patients: proportion of pathological scans according to age, sex, medical background, type of accident and the criterion defining grade C.
Time frame: at day 0
Plan to share: No
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Start is estimated for Nov 2026; primary completion for Nov 2027, 12 months later.
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Centre Hospitalier Sud Francilien