Résumé
Hemorrhagic shock is a major cause of preventable early death in the severe polytrauma. Delayed diagnostic is a risk factor of poor prognosis. Basic prehospital screening tools have been created in recent years without using the determinant information given by FAST ultrasonography for the severe post-trauma hemorrhage.Our objectif was to study the performance of a combined "FAST-Red Flag" score, integrating FAST into the "Red-Flag" criteria easy to use and previously validated by Hamada et al. in a large cohort. We conducted a retrospective multicentric study based on prehospital registrers from emergency medical services to evaluate the contribution of FAST for predicting severe post-trauma hemorrhage and the relevance of the "FAST-Red Flag" score.We analysed 527 patients including 73 (13,9%) with severe post-trauma hemorrhage. The new predictive performances were: area under the receiver operating caracteristic curve of 0.74 [0.67-0.82], a sensitivity of 59% [45-72] and a specificity of 82% [78-86] for a two points cut-off.Our study supports the relevance of a combined score "FAST-Red-Flag" to predict the onset of severe post-trauma hemorrhage in prehospital settings.