C. C. Cothren, E. E. Moore, H. B. Hedegaard, and K. Meng, Epidemiology of urban trauma deaths:comprehensive reassessment 10 years later, World J Surg, vol.31, issue.7, pp.1507-1518, 2007.

D. S. Kauvar, R. Lefering, and C. E. Wade, Impact of hemorrhage on trauma outcome: an overview of epidemiology, clinical presentations, and therapeutic considerations, J Trauma, vol.60, issue.6, pp.3-11, 2006.

, Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study, The Lancet, 2013.

S. P. Baker, B. Haddon, W. J. Long, and W. B. , The Injury Severity Score: A method for describing patients with multiple injuries and evaluationg emergency care, Journal of Trauma and Acute Care Surgery, vol.14, issue.3, p.187, 1974.

S. Hagiwara, K. Oshima, M. Murata, M. Kaneko, M. Aoki et al., Model for predicting the injury severity score, Acute Med Surg, vol.2, issue.3, pp.158-62, 2014.

J. C. Janak, J. A. Sosnov, J. M. Bares, Z. T. Stockinger, H. R. Montgomery et al., Comparison of Military and Civilian Methods for Determining Potentially Preventable Deaths: A Systematic Review, JAMA Surg, vol.153, issue.4, pp.367-75, 2018.

B. Tieu, J. B. Holcomb, and M. Schreiber, Coagulopathy: Its pathophysiology and treatment in the injured patient, Journal of Surgery, vol.31, issue.5, pp.1055-64, 2007.

P. M. Cantle and B. A. Cotton, Prediction of Massive Transfusion in Trauma, Crit Care Clin, vol.33, issue.1, pp.71-84, 2017.

R. Rossaint, B. Bouillon, V. Cerny, T. J. Coats, J. Duranteau et al., The European guideline on management of major bleeding and coagulopathy following trauma: fourth edition, Crit Care, vol.20, p.100, 2016.

A. Meißner and P. Schlenke, Massive Bleeding and Massive Transfusion, Transfus Med Hemother, vol.39, issue.2, pp.73-84, 2012.

W. G. Baxt, G. Jones, and D. Fortlage, The trauma triage rule: a new, resource-based approach to the prehospital identification of major trauma victims, Ann Emerg Med, vol.19, issue.12, pp.1401-1407, 1990.

A. El-menyar, A. Mekkodathil, H. Abdelrahman, R. Latifi, S. Galwankar et al., Review of Existing Scoring Systems For Massive Blood Transfusion in Trauma Patients: Where Do We Stand?

J. Duranteau, K. Asehnoune, S. Pierre, Y. Ozier, M. Leone et al., Recommandations, vol.29

, sur la réanimation du choc hémorragique, Anesthésie & Réanimation, vol.1, issue.1, pp.62-74, 2015.

B. G. Eick and N. J. Denke, Resuscitative Strategies in the Trauma Patient: The Past, the Present, and the Future, J Trauma Nurs, vol.25, issue.4, pp.254-63, 2018.

T. Vernon, M. Morgan, and C. Morrison, Bad blood: A coagulopathy associated with trauma and massive transfusion review, Acute Med Surg, 2019.

J. N. Bogert, J. A. Harvin, and B. A. Cotton, Damage Control Resuscitation, J Intensive Care Med, vol.31, issue.3, pp.177-86, 2016.

D. N. Naumann, M. A. Khan, J. E. Smith, R. Rickard, and T. Woolley, Future strategies for remote damage control resuscitation after traumatic hemorrhage, J Trauma Acute Care Surg, vol.86, issue.1, pp.163-169, 2019.

D. H. Jenkins, J. F. Rappold, J. F. Badloe, O. Berséus, L. Blackbourne et al., THOR Position Paper on Remote Damage Control Resuscitation: Definitions, Current Practice and Knowledge Gaps, Shock, vol.41, issue.1, pp.3-12, 2014.

S. Leo-kodeli, Hémorragie massive : Harmonisation des pratiques transfusionnelles, p.27

H. Recommandations, ANSM Choc hémorragique et situations à risque de transfusion massive

, Massive Hemorrhage and Emergency transfusion, Clinical Guide to Transfusion.Chapter, vol.11

A. Endo, A. Shiraishi, K. Fushimi, K. Murata, and Y. Otomo, Outcomes of patients receiving a massive transfusion for major trauma, Br J Surg, vol.105, issue.11, pp.1426-1460, 2018.

C. S. Zhu, D. Cobb, R. B. Jonas, D. Pokorny, M. Rani et al., Shock Index and Pulse Pressure as Triggers for Massive Transfusion, Journal of Trauma and Acute Care

J. David, E. Imhoff, M. Durand, P. Gibault, L. Augey et al., Transfusion massive et coagulopathie, p.10

J. B. Holcomb, B. C. Tilley, S. Baraniuk, E. E. Fox, C. E. Wade et al., Transfusion of plasma, platelets, and red blood cells in a 1:1:1 vs a 1:1:2 ratio and mortality in patients with severe trauma: the PROPPR randomized clinical trial, JAMA, vol.313, issue.5, pp.471-82, 2015.

, Scores de gravité en Réanimation . Conférences d'actualisation SFAR, 2019.

J. Schaal and M. Raux, Triage et scores de gravité, p.12

D. Sartorius, L. Manach, Y. David, J. Rancurel, E. Smail et al., glasgow coma scale, age, and arterial pressure (MGAP): a new simple prehospital triage score to predict mortality in trauma patients, Crit Care Med, vol.38, issue.3, pp.831-838, 2010.

S. Figueiredo, C. Taconet, A. Harrois, S. Hamada, T. Gauss et al., How useful are hemoglobin concentration and its variations to predict significant hemorrhage in the early phase of trauma? A multicentric cohort study, Ann Intensive Care, vol.8, issue.1, p.76, 2018.

Y. Nakamura, H. Ishikura, S. Kushimoto, F. Kiyomi, H. Kato et al., Fibrinogen level on admission is a predictor for massive transfusion in patients with severe blunt trauma: Analyses of a retrospective multicentre observational study, Injury. mars, vol.48, issue.3, pp.674-683, 2017.

M. A. Schreiber, J. Perkins, L. Kiraly, S. Underwood, C. Wade et al., Early predictors of massive transfusion in combat casualties, J Am Coll Surg, vol.205, issue.4, pp.541-546, 2007.

A. El-menyar, A. Mekkodathil, H. Abdelrahman, R. Latifi, S. Galwankar et al., Review of Existing Scoring Systems For Massive Blood Transfusion in Trauma Patients: Where Do We Stand, 2019.

D. De-prost, L. Salomon, and P. Verpillat, Utilisation en pratique des marqueurs biologiques de la coagulation et de la fibrinolyse, p.10

F. Fourrier, Fibrinolyse et fibrinogénolyse en réanimation

L. Weinmann, Le dosage des monomères de fibrine: étude in vitro, et intérêt en traumatologie, p.115

J. W. Weisel and R. I. Litvinov, Mechanisms of fibrin polymerization and clinical implications, Blood, vol.121, issue.10, pp.1712-1721, 2013.

M. A. Refaai, P. Riley, T. Mardovina, and P. D. Bell, The Clinical Significance of Fibrin Monomers, Thromb Haemost, vol.118, issue.11, pp.1856-66, 2018.

A. Zhmurov, A. D. Protopopova, R. I. Litvinov, P. Zhukov, J. W. Weisel et al., Atomic Structural Models of Fibrin Oligomers, Structure, vol.26, issue.6, pp.857-868, 2018.

E. M. Haselager and J. Vreeken, Clinical significance of « circulating fibrin monomers, J Clin Pathol, vol.34, issue.5, pp.468-72, 1981.

N. Lerolle, D. Borgel, and J. Diehl, Approche critique des critères diagnostiques de coagulation intravasculaire disséminée, Réanimation, vol.17, issue.4, pp.348-54, 2008.

J. Bollaert, D. Annane, A. H. Bedos, J. Cariou, A. Ducheyron et al., Coagulations intravasculaires disséminées (CIVD) en réanimation : définition, classification et traitement (à l'exception des cancers et hémopathies malignes), Réanimation, vol.11, issue.8, pp.567-74, 2002.

K. Park, E. Kwon, H. Kim, and S. Kim, Evaluation of the diagnostic performance of fibrin monomer in disseminated intravascular coagulation, Korean J Lab Med, vol.31, issue.3, pp.143-150, 2011.

N. Singh, H. P. Pati, S. Tyagi, A. D. Upadhyay, and R. Saxena, Evaluation of the Diagnostic Performance of Fibrin Monomer in Comparison to d-Dimer in Patients With Overt and Nonovert Disseminated Intravascular Coagulation, Clin Appl Thromb Hemost, vol.23, issue.5, pp.460-465, 2017.

J. Gris, E. Cochery-nouvellon, S. Bouvier, S. Jaber, J. Albanese et al., Clinical value of automated fibrin generation markers in patients with septic shock: a SepsiCoag ancillary study, Br J Haematol, vol.183, issue.4, pp.636-683, 2018.
URL : https://hal.archives-ouvertes.fr/hal-01872785

M. Kochi, M. Shimomura, T. Hinoi, H. Egi, K. Tanabe et al., possible role of soluble fibrin monomer complex after gastroenterological surgery, World J Gastroenterol, vol.23, issue.12, pp.2209-2225, 2017.

T. Gauss, E. Gayat, A. Harrois, M. Raux, A. Follin et al., Effect of early use of noradrenaline on in-hospital mortality in haemorrhagic shock after major trauma: a propensity-score analysis, Br J Anaesth, vol.120, issue.6, pp.1237-1281, 2018.

S. Figueiredo and J. Duranteau, Actualités sur la coagulopathie du choc hémorragique traumatique, p.12

S. Kushimoto, D. Kudo, and Y. Kawazoe, Acute traumatic coagulopathy and trauma-induced coagulopathy: an overview, Journal of Intensive Care, vol.5, issue.1, p.6, 2017.

A. Levrat, C. Defournel, D. Savary, and J. S. David, Anomalies de la coagulation et traumatisme grave, p.20, 2010.

D. Frith, J. C. Goslings, C. Gaarder, M. Maegele, M. J. Cohen et al., Definition and drivers of acute traumatic coagulopathy: clinical and experimental investigations, J Thromb Haemost, vol.8, issue.9, pp.1919-1944, 2010.

M. Hayakawa, Pathophysiology of trauma-induced coagulopathy: disseminated intravascular coagulation with the fibrinolytic phenotype, Journal of Intensive Care, vol.5, issue.1, p.14, 2017.

D. L. Malone, J. R. Hess, and A. Fingerhut, Massive transfusion practices around the globe and a suggestion for a common massive transfusion protocol, J Trauma, vol.60, issue.6, 2006.

A. Wafaisade, R. Lefering, T. Tjardes, S. Wutzler, C. Simanski et al., Acute coagulopathy in isolated blunt traumatic brain injury, Neurocrit Care, vol.12, issue.2, pp.211-220, 2010.

A. Meissner and P. Schkenke, Massive bleeding and Massive transfusion, Transfus Med Hemother, vol.39, issue.2, pp.73-84, 2012.

C. Paugam-burtz, T. Petroviv, and J. E. De-la-coussaye, Traumatismes abdominopelviens.Journées thématiques de la Sfmu de, 2010.

A. Ricard-hibon, S. Hamada, and T. Gauss, Le patient polytraumatisé : les défis de l'accueil hospitalier, p.11

R. L. Simmons, J. A. Collins, C. A. Heisterkamp, . Iii, D. E. Mills et al., Coagulation disorders in combat casualties. I: acute changes after wounding, Ann Surg, vol.169, issue.4, pp.455-462, 1969.

K. Brohi, J. Singh, M. Heron, and T. Coats, Acute traumatic coagulopathy, J Trauma, vol.54, issue.6, pp.1127-1130, 2003.

S. E. Niles, D. F. Mclaughlin, and J. G. Perkins, Increased mortality associated with the early coagulopathy of trauma in combat casualties, J Trauma, vol.64, issue.6, pp.1459-1465, 2008.

A. Hosaka, T. Miyata, and H. Aramoto, Clinical implication of plasma level of soluble fibrin monomer-fibrinogen complex in patients with abdominal aortic aneurysm, J Vasc Surg, vol.42, issue.2, pp.200-205, 2005.

H. P. Pham and B. H. Shaz, Update on massive transfusion, Br J Anaesth, issue.111, pp.71-82, 2013.

A. Tripodi, V. Chantarangkul, and P. M. Mannucci, Acquired coagulation disorders: revisited using global coagulation/anticoagulation testing, Br J Haematol, vol.147, pp.77-82, 2009.

K. G. Mann, S. Butenas, and K. Brummel, The dynamics of thrombin formation, Arterioscler Thromb Vasc Biol, vol.23, pp.17-25, 2003.

J. R. Hess, A. L. Lindell, L. G. Stansbury, R. P. Dutton, and T. M. Scalea, The prevalence of abnormal results of conventional coagulation tests on admission to a trauma center, Transfusion, vol.49, pp.34-39, 2009.

M. Leod, J. B. Lynn, M. Mckenney, M. G. Cohn, S. M. Murtha et al., Early coagulopathy predicts mortality in trauma, J Trauma, vol.55, pp.39-44, 2003.

J. B. Holcomb, C. E. Wade, and C. E. Michalek, Increased plasma and platelet to red blood cell ratios improves outcome in 466 massively transfused civilian trauma patients, Ann Surg, vol.248, issue.3, pp.447-58, 2008.

A. Verma and T. Kole, International normalized ratio as a predictor of mortality in trauma patients in India, World J Emerg Med, vol.5, issue.3, pp.192-197, 2014.

. Committee-on-trauma, Advanced Trauma Life Support Manual. Chicago:American College of Surgeons, pp.103-112, 1997.

M. Cecconi, D. Backer, D. Antonelli, and M. , Consensus on circulatory shock and hemodynamic monitoring. Task force of the European Society of Intensive Care Medicine, Intensive Care Med, vol.40, issue.12, pp.1795-815, 2014.

N. Yücel, R. Lefering, and M. Maegele, Trauma Associated Severe Hemorrhage (TASH)-Score: probability of mass transfusion as surrogate for life threatening 33 hemorrhage after multiple trauma, J Trauma, vol.60, issue.6, pp.1228-1264, 2006.

M. Maegele, R. Lefering, and A. Wafaisade, Revalidation and update of TASH-Score: a scoring system to predict the probability for massive transfusion as a surrogate for lifethreatening haemorrhage after severe injury, Vox Sang, vol.100, issue.2, pp.231-239, 2011.

R. P. Dutton, L. G. Stansbury, S. Leone, E. Kramer, J. R. Hess et al., Trauma mortality in mature trauma systems: are we doing better? An analysis of trauma mortality patterns, J Trauma, vol.69, issue.3, pp.620-626, 1997.

R. Pfeifer, M. Teuben, H. Andruszkow, B. M. Barkatali, and H. C. Pape, Mortality Patterns in Patients with Multiple Trauma: A Systematic Review of Autopsic Studies, PLoS One, vol.11, issue.2, p.148844, 2016.

J. Sobrino and S. Shafi, Timing and causes of death after injuries, Proc (Bayl Univ Med Cent), vol.26, issue.2, pp.120-123, 2013.

F. Kontny, C. E. Dempfle, and U. Abildgaard, Fibrin monomer antigen: a novel marker of mortality in acute myocardial infraction, Eur Heart J, vol.20, issue.11, pp.808-812, 1999.

J. M. Rivera-caravaca, V. Roldàn, and M. Romera, Soluble fibrin monomer complex and prediction of cardiovascular events in atrial fibrillation: the observationnal Murcia Atrial Fibrillation Project, J Gen Intern Med, vol.33, issue.06, pp.847-854, 2018.

R. Peralta, A. Vijay, and A. El-menyar, Trauma resuscitation requiring massive transfusion: a descriptive analysis of the role of ratio and time, World J Emerg Surg, vol.10, p.36, 2015.

M. Maegele, H. Schöchl, and T. Menovsky, Coagulopathy and haemorrhagic progression in traumatic brain injury: advances in mechanisms, diagnosis, and management, Lancet Neurol, vol.16, pp.630-677, 2017.

R. Chang, J. Cardenas, C. Wade, and J. Holcomb, Advances in the understanding of traumainduced coagulopathy, Blood, vol.128, issue.8, pp.1043-1049, 2016.

M. Nekludov, F. Mobarrez, D. Gryth, B. M. Bellander, and H. Wallen, Formation of microparticles in the injured brain of patients with severe isolated traumatic brain injury, J Neurotrauma, vol.31, issue.23, pp.1927-1933, 2014.

N. Morel, O. Morel, and L. Petit, Generation of procoagiulant microparticles in cerebrospinal fluid and peripheral blood after traumatic brain injury, J Trauma, vol.64, issue.3, pp.698-704, 2008.

Y. Tian, B. Salsbery, and M. Wang, Brain-derived microparticles induce systemic coagulation in a murine model of traumatic brain injury, Blood, vol.125, issue.13, pp.2151-2159, 2015.

A. L. De-oliveira-manoel, A. C. Neto, P. V. Veigas, and S. Rizoli, Traumatic brain injury 34 associated coagulopathy, Neurocrit Care, vol.22, issue.1, pp.34-44, 2015.

R. F. Reiss, Hemostatic defects in massive transfusion: rapid diagnosis and management, Am J Crit Care, vol.9, pp.158-165, 2000.

, En traumatologie, la première cause de mortalité évitable est l'hémorragie

, Ainsi, la détection précoce des patients à risque d'hémorragie grave permet de mettre en oeuvre rapidement et de manière adaptée ce type de protocole. Cependant le nombre de facteurs de risque déjà décrit dans la littérature est globalement limité. Les monomères de fibrine (MF) reflètent directement l'action de la thrombine et sont donc des marqueurs précoces de l'activation de la coagulation, de nombreuses mesures diagnostiques et thérapeutiques comme l'adoption de protocole de transfusion massive ont permis de réduire la mortalité par exsanguination

. Matériel, Analyse rétrospective d'un registre prospectif monocentrique, réalisée de janvier 2012 à décembre 2017. L'étude a été approuvée par le comité d'éthique de la SRLF, p.19

, Les critères d'exclusion étaient : traitement par anticoagulant ou antiagrégant, traumatisme crânien grave associé, absence de dosage de MF à l'admission et grossesse. Les caractéristiques des patients, le résultat du bilan biologique à l'admission, les scores ISS/IGS2/TASH, le volume et type des produits sanguins labiles et l'évolution des patients étaient recueillis prospectivement. Une hémorragie grave était définie comme la, Tous les patients présentant un traumatisme sévère, défini par un score ISS > 15, ont été inclus

, Une analyse univariée puis multivariée par régression logistique a été réalisée afin de déterminer l'association entre MF et hémorragie grave ou recours à la transfusion massive. Un modèle de Cox ajusté a été utilisé pour montrer l'association entre MF et mortalité à J28

. Résultats, Durant la période d'étude, 299 patients ont été analysés. La prévalence des hémorragies graves était de 15

, Les MF étaient significativement plus élevées chez les patients présentant une hémorragie grave (151 [128,4 -151] µg/ml vs, vol.107, pp.3-151

, Le meilleur seuil de MF pour prédire une hémorragie grave était 92,45 µg/ml. A ce seuil, la sensibilité était de 87% la spécificité de 44% et les valeurs prédictives positive et négative respectivement de 22% et 95%. Après analyse multivariée, les MF n'étaient ni associés à une hémorragie grave

, Notre étude ne montre pas d'association significative entre le taux de MF à l'admission et la survenue d'une hémorragie grave ou le recours à une transfusion massive après un traumatisme sévère. Cependant, les MF semblent être associés à la mortalité à J28

, Mots clés. hémorragie grave, monomères de fibrine, transfusion massive