. Dans-le-groupe and . Sce-, 115 (77%) scanners n'ont identifié aucune lésion traumatique, 35 (23%) ont identifié une lésion traumatique d'un seul site et aucun n'a identifié de lésion sur plusieurs sites. Les lésions traumatiques observées dans ce groupe étaient des fractures osseuses

. Dans-le-groupe and . Sce+, 29%) scanners ont identifié une lésion traumatique d'un seul site et 106 (71%) ont identifié des lésions sur plusieurs sites. Cent dix-neuf (79%) patients ont bénéficié d'une surveillance en milieu hospitalier >24 h sans traitement spécifique. Vingt-cinq (17%) patients avaient une lésion osseuse traumatique relevant d'une chirurgie en urgence, 4 (3%) présentaient des lésions viscérales ayant nécessité un traitement chirurgical en urgence (2 perforations digestives, 2 splénectomies d'hémostase chez des patients initialement stables sur le plan hémodynamique) et 2 (1%) ont bénéficié d'une artério-embolisation d'hémostase, vol.44

, L'analyse de régression logistique binomiale a identifié les critères suivants comme étant des facteurs prédictifs indépendants de SCE utile : Chute >5m, p.36

, p = 0,027 ), présence de 2 régions corporelles symptomatiques, p.10

, hyperleucocytose à polynucléaires neutrophiles

J. A. Haagsma, N. Graetz, I. Bolliger, M. Naghavi, H. Higashi et al., The global burden of injury: incidence, mortality, disability-adjusted life years and time trends from the Global Burden of Disease study 2013, Inj Prev J Int Soc Child Adolesc Inj Prev, vol.22, issue.1, pp.3-18, 2016.

, Epidemiology of major trauma -Søreide -2009 -BJS -Wiley Online Library, 2019.

E. J. Mackenzie, F. P. Rivara, G. J. Jurkovich, A. B. Nathens, K. P. Frey et al., A National Evaluation of the Effect of Trauma-Center Care on Mortality, N Engl J Med, vol.354, issue.4, pp.366-78, 2006.

S. Huber-wagner, R. Lefering, L. Qvick, M. Körner, M. V. Kay et al., Effect of whole-body CT during trauma resuscitation on survival: a retrospective, multicentre study. The Lancet, vol.373, pp.1455-61, 2009.

J. C. Sierink, K. Treskes, M. Edwards, B. Beuker, D. Den-hartog et al., Immediate total-body CT scanning versus conventional imaging and selective CT scanning in patients with severe trauma (REACT-2): a randomised controlled trial. The Lancet, vol.388, pp.673-83, 2016.

N. Butcher and Z. J. Balogh, The definition of polytrauma: the need for international consensus, Injury, vol.40, pp.12-22, 2009.

B. Riou and C. P. Le, Actualités en réanimation pré-hospitalière, J Sci SAMU Fr, 2002.

J. Babaud, C. Ridereau-zins, G. Bouhours, J. Lebigot, L. Gall et al., Benefit of the Vittel criteria to determine the need for whole body scanning in a severe trauma patient, Diagn Interv Imaging, vol.93, issue.5, pp.371-380, 2012.

S. R. Hamada, T. Gauss, F. Duchateau, J. Truchot, A. Harrois et al., Evaluation of the performance of French physician-staffed emergency medical service in the triage of major trauma patients, J Trauma Acute Care Surg, vol.76, issue.6, p.1476, 2014.

D. Belabbas, M. Auger, M. Lederlin, J. Bonenfant, Y. Gandon et al., Whole-Body CT after Motor Vehicle Crash: No Benefit after High-Energy Impact and with Normal Physical Examination, Radiology, vol.292, issue.1, pp.94-100, 2019.

D. J. Brenner and C. D. Elliston, Estimated Radiation Risks Potentially Associated with Full-Body CT Screening, Radiology, vol.232, issue.3, pp.735-743, 2004.

R. M. Davies, A. B. Scrimshire, L. Sweetman, M. J. Anderton, and E. M. Holt, A decision tool for whole-body CT in major trauma that safely reduces unnecessary scanning and associated radiation risks: An initial exploratory analysis, Injury, vol.47, issue.1, pp.43-52, 2016.

D. Demetriades, M. Karaiskakis, K. Toutouzas, K. Alo, G. Velmahos et al., Pelvic fractures: epidemiology and predictors of associated abdominal injuries and outcomes1 1No competing interests declared, J Am Coll Surg, vol.195, issue.1, pp.1-10, 2002.

G. Parreira, J. Coimbra, R. Rasslan, S. Oliveira, A. Fregoneze et al., The role of associated injuries on outcome of blunt trauma patients sustaining pelvic fractures, Injury, vol.31, issue.9, pp.677-82, 2000.

G. V. Poole, E. F. Ward, F. F. Muakkassa, H. S. Hsu, J. A. Griswold et al., Pelvic fracture from major blunt trauma. Outcome is determined by associated injuries, Ann Surg, vol.213, issue.6, pp.532-541, 1991.

M. W. Hills, A. M. Delprado, and S. A. Deane, Sternal fractures: associated injuries and management, J Trauma, vol.35, issue.1, pp.55-60, 1993.

P. R. Miller, M. A. Croce, T. K. Bee, A. K. Malhotra, and T. C. Fabian, Associated Injuries in Blunt Solid Organ Trauma: Implications for Missed Injury in Nonoperative Management, J Trauma Acute Care Surg, vol.53, issue.2, p.238, 2002.

C. F. Chandler, J. S. Lane, and K. S. Waxman, Seatbelt sign following blunt trauma is associated with increased incidence of abdominal injury, Am Surg, vol.63, issue.10, pp.885-893, 1997.

P. A. Anderson, F. P. Rivara, R. V. Maier, and C. Drake, The epidemiology of seatbeltassociated injuries, J Trauma, vol.31, issue.1, pp.60-67, 1991.

K. Lunsjo, A. Tadros, A. Hauggaard, R. Blomgren, J. Kopke et al., Associated Injuries and Not Fracture Instability Predict Mortality in Pelvic Fractures: A Prospective Study of 100 Patients, J Trauma Acute Care Surg, vol.62, issue.3, p.687, 2007.

V. Leung, A. Sastry, T. D. Woo, and H. R. Jones, Implementation of a split-bolus singlepass CT protocol at a UK major trauma centre to reduce excess radiation dose in trauma pan-CT, Clin Radiol, vol.70, issue.10, pp.1110-1115, 2015.

, Whole body computed tomography in the initial assessment of trauma patients: Is there optimal criteria for patient selection? -Hsiao -2013 -Emergency Medicine Australasia -Wiley Online Library, 2019.


?. K. Çorbac?o?lu and G. Aksel, Whole body computed tomography in multi trauma patients: Review of the current literature, Turk J Emerg Med, vol.18, issue.4, pp.142-149, 2018.

D. C. Chang, E. E. Cornwell, J. Phillips, J. Paradise, and K. Campbell, Early leukocytosis in trauma patients: what difference does it make? Curr Surg, vol.60, pp.632-637, 2003.

D. L. Malone, D. Kuhls, L. M. Napolitano, R. Mccarter, and T. Scalea, Back to basics: validation of the admission systemic inflammatory response syndrome score in predicting outcome in trauma, J Trauma, vol.51, issue.3, pp.458-63, 2001.

M. Keel, O. Trentz, . Pathophysiology, and . Polytrauma, Injury, vol.36, issue.6, pp.691-709, 2005.

C. A. Santucci, T. B. Purcell, and C. Mejia, Leukocytosis as a Predictor of Severe Injury in Blunt Trauma, West J Emerg Med, vol.9, issue.2, pp.81-86, 2008.

S. J. Gluckman and R. R. Macgregor, Effect of acute alcohol intoxication on granulocyte mobilization and kinetics, Blood, vol.52, issue.3, pp.551-560, 1978.

J. Goral, J. Karavitis, and E. J. Kovacs, Exposure-dependent effects of ethanol on the innate immune system, Alcohol, vol.42, issue.4, pp.237-284, 2008.

M. J. Haydel, C. A. Preston, T. J. Mills, S. Luber, E. Blaudeau et al., Indications for Computed Tomography in Patients with Minor Head Injury, N Engl J Med, vol.343, issue.2, pp.100-105, 2000.

J. M. Davis, J. D. Albert, K. J. Tracy, S. E. Calvano, S. F. Lowry et al., Increased neutrophil mobilization and decreased chemotaxis during cortisol and epinephrine infusions, J Trauma, vol.31, issue.6, pp.731-733, 1991.

C. Thobakgale and &. Ndung, Neutrophil counts in persons of African origin, vol.21, 2013.

V. Bhatt and A. Saleem, Drug-Induced Neutropenia -Pathophysiology, Clinical Features, and Management, Ann Clin Lab Sci, vol.34, issue.2, pp.131-138, 2004.

C. Lima, E. V. Paula, T. Takahashi, S. Saad, I. Lorand-metze et al., Causes of incidental neutropenia in adulthood, Ann Hematol, vol.85, issue.10, pp.705-714, 2006.

W. Sigmunda and S. Thomasp, Drug-induced immunological neutropenia. The Lancet, vol.311, pp.1068-72, 1978.