, Centers for Disease Control and Prevention

A. D. Lopez, C. D. Mathers, and M. Ezzati, Global and regional burden of disease and risk factors, 2001 : systematic analysis of population health data, Lancet, vol.367, issue.9524, pp.1747-57, 2006.

A. M. Minino, E. Arias, and K. D. Kochanek, Deaths : final data for, Natl Vital Stat Rep, vol.50, pp.1-119, 2000.

M. F. Tsan and B. Gao, Endogenous ligand of Toll-like receptors, J Leukoc Biol, vol.76, pp.514-523, 2004.

J. M. Cavaillon, C. Adrie, C. Fitting, and M. Adib-conquy, Reprogramming of circulatory cells in sepsis and SIRS, J Endotoxin Res, vol.11, pp.311-320, 2005.

M. Ditschkowski, HLA-DR expression and soluble HLA-DR levels in septic patients after trauma, Ann Surg, vol.229, pp.246-254, 1999.

D. H. Livingston, S. H. Appel, S. R. Wellhausen, G. Sonnenfeld, and H. C. Polk, Depressed interferon gamma production and monocyte HLA-DR expression after severe injury, Arch Surg, vol.123, pp.1309-1312, 1988.

M. Ploder, Lipopolysaccharide-induced tumor necrosis factor alpha production and not monocyte human leukocyte antigen-DR expression is correlated with survival in septic trauma patients, Shock, vol.25, pp.129-134, 2006.

M. Keel, Different pattern of local and systemic release of proinflammatory and antiinflammatory mediators in severely injured patients with chest trauma, J Trauma, vol.40, pp.907-912, 1996.

W. Ertel, Downregulation of proinflammatory cytokine release in whole blood from septic patients, Blood, vol.85, pp.1341-1347, 1995.

C. Marie, J. Muret, C. Fitting, M. R. Losser, D. Payen et al., Reduced ex vivo interleukin-8 production by neutrophils in septic and nonseptic systemic inflammatory response syndrome, Blood, vol.91, pp.3439-3446, 1998.

M. Majetschak, Regulation of whole blood tumor necrosis factor production upon endotoxin stimulation after severe blunt trauma, J Trauma, vol.43, pp.880-887, 1997.

S. Lendemans, E. Kreuzfelder, C. Waydhas, D. Nast-kolb, and S. Flohé, Clinical course and prognostic significance of immunological and functional parameters after severe trauma, Unfallchirurg, vol.107, pp.203-210, 2004.

H. A. Lindner, Ü. Balaban, T. Sturm, C. Weiß, M. Thiel et al., An Algorithm for Systemic Inflammatory Response Syndrome Criteria-Based Prediction of Sepsis in a Polytrauma Cohort, Crit Care Med, vol.44, issue.12, pp.2199-2207, 2016.

M. Rozanovic, C. Csontos, L. Bogár, L. Szélig, T. Bocskai et al., Can leukocyte antisedimentation rate (LAR) predict septic complications and critical care survival early in polytrauma and burn victims ?, Clin Hemorheol Microcirc, vol.64, issue.4, pp.875-885, 2016.

G. V. Bochicchio, L. M. Napolitano, and M. Joshi, Systemic inflammatory response syndrome score at admission independently predicts infection in blunt trauma patients, J Trauma, vol.50, pp.817-820, 2001.

J. L. Vincent, Nosocomial infections in adult intensive care units, Lancet, vol.361, pp.2068-2077, 2003.

L. J. Mcghan and D. E. Jaroszewski, The role of toll-like receptor-4 in the development of multiorgan failure following traumatic haemorrhagic shock and resuscitation. Injury, Int. J. Care Injured, vol.43, pp.129-136, 2012.

A. Rhodes, L. E. Evans, W. Alhazzani, M. M. Levy, M. Antonelli et al., Guide international pour la prise en charge du sepsis et du choc septique, Campagne « Surviving Sepsis, vol.45, issue.3, pp.486-559, 2016.

S. Tranc?, J. T. Oever, C. Ciuce, M. Netea, A. Slavcovici et al., sTREM-1, sIL-2R?, and IL-6, but not sCD163, might predict sepsis in polytrauma patients : a prospective cohort study, Eur J Trauma Emerg Surg, vol.43, issue.3, pp.363-370, 2017.

A. Ali, M. Mikhael, E. S. Abdelkader, A. Mansour, L. et al.,

, Interleukin-17 as a predictor of sepsis in polytrauma patients : a prospective cohort study

, Eur J Trauma Emerg Surg, vol.44, issue.4, pp.621-626, 2018.

A. B. Dekker, P. Krijnen, and I. B. Schipper, Predictive value of cytokines for developing complications after polytrauma, World J Crit Care Med, vol.5, issue.3, pp.187-200, 2016.

A. K. Shabanov, G. V. Bulava, E. V. Kisluchina, and K. Msh, Criteria of high risk infection pulmonary complications in severe polytrauma patients, Anesteziol Reanimatol, vol.60, issue.2, pp.16-20, 2015.

L. Mica, E. Furrer, M. Keel, and O. Trentz, Predictive ability of the ISS, NISS, and APACHE II score for SIRS and sepsis in polytrauma patients, Eur J Trauma Emerg Surg, vol.38, issue.6, pp.665-71, 2012.

. Traumabase and . Eu,

. Mis-À-jour-en, , 2017.

J. M. Yeguiayan, D. Garrigue, C. Binquet, C. Jacquot, J. Duranteau et al., Prise en charge actuelle du traumatisé grave en France : premier bilan de l'étude FIRST (French Intensive care Recorded in Severe Trauma), Ann Fr Med Urgenc, vol.2, pp.156-163, 2012.

V. Benoît, J. M. Yeguiayan, L. Manach, Y. Bonithon-kopp, C. Mirek et al., The motor component does not convey all the mortaliy prediction capacity of the

, Glasgow Coma Scale in trauma patients, Am J Emerg Med, vol.30, pp.1032-1041, 2012.

D. S. Weinberg, A. S. Narayanan, T. A. Moore, and H. A. Vallier, Prolonged resuscitation of metabolic acidosis after trauma is associated with more complications, J Orthop Surg Res, vol.10, p.153, 2015.

K. Galkova and M. Vrabelova, Normalization of blood lactate as early end-point of polytrauma treatment, Bratisl Lek Listy, vol.114, issue.11, pp.637-641, 2013.

V. Ciriello, S. Gudipati, P. Z. Stavrou, N. K. Kanakaris, M. C. Bellamy et al., Biomarkers predicting sepsis in polytrauma patients : Current evidence, Injury, vol.44, issue.12, pp.1680-1692, 2013.

F. Introduction, Ce phénomène entraîne une immunodépression relative, rendant le patient traumatisé sensible à la survenue d'une complication infectieuse. Or, il est difficile de différencier dans les premiers jours la fièvre issue du SRIS de celle d'une infection réelle. L'objectif de cette étude était de mettre en évidence des facteurs prédictifs d

. Materiels and . Methode, Il s'agissait d'une étude rétrospective monocentrique menée sur trois ans, incluant tous les patients traumatisés graves admis en réanimation chirurgicale, Ont été analysées les données cliniques, biologiques et pronostiques lors des cinq jours suivant le traumatisme initial

, RESULTATS : Deux cent soixante-quatorze patients ont été inclus, cent cinquante-six présentaient une fièvre. Parmi eux, soixante-cinq se sont infectés, les quatre-vingt-onze autres étaient en SRIS. Plusieurs facteurs étaient associés au développement d'une infection mais après régression logistique multivariée

, 0001) étaient prédictifs de la survenue d'une infection. CONCLUSION : Un faible score de Glasgow à la prise en charge et une fièvre marquée persistante à J2 permettraient d'aider à différencier une infection précoce du SRIS chez un traumatisé grave fébrile, p.0

, MOTS CLES : Polytraumatisme -SRIS -Fièvre -Infection -Traumatisme grave EARLY FEVER IN SEVERE POLYTRAUMATISED PATIENTS : HOW TO MAKE DIFFERENCE BETWEEN SIRS AND THE BEGINING OF A SEPSIS? A RETROSPECTIVE STUDY IN AMIENS