Christoph Hüser1,2, Matthias Hackl1,2, Victor Suárez1,2, Ingo Gräff3, Michael Bernhard4, Volker Burst1,2, Christoph Adler5,6,7. 1. Klinik II für Innere Medizin: Nephrologie, Rheumatologie, Diabetologie und Allgemeine Innere Medizin, Medizinische Fakultät und Uniklinik Köln, Universität zu Köln, Köln, Deutschland. 2. Zentrale Notaufnahme, Medizinische Fakultät und Uniklinik Köln, Universität zu Köln, Köln, Deutschland. 3. Interdisziplinäres Notfallzentrum, Universitätsklinikum Bonn, Universität Bonn, Bonn, Deutschland. 4. Zentrale Notaufnahme, Universitätsklinikum Düsseldorf, Heinrich-Heine-Universität, Düsseldorf, Deutschland. 5. Klinik für Kardiologie, Angiologie, Pneumologie und internistische Intensivmedizin, Klinik III für Innere Medizin, Herzzentrum, Medizinische Fakultät und Uniklinik Köln, Universität zu Köln, Köln, Deutschland. christoph.adler@uk-koeln.de. 6. Institut für Schutz und Rettung, Berufsfeuerwehr Köln, Köln, Deutschland. christoph.adler@uk-koeln.de. 7. Klinik für Kardiologie, Angiologie, Pneumologie und internistische Intensivmedizin, Uniklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland. christoph.adler@uk-koeln.de.
Abstract
BACKGROUND: Patients discovered recumbent, helpless and incapacitated, awake or unresponsive are referred to as "long lie trauma" (LLT) in the German medical jargon. Yet, a characterization of this cohort is missing. METHODS: We retrospectively analyzed all LLT patients admitted to the emergency department of the University Hospital Cologne from July 2018 to December 2020. RESULTS: A total of 50 LLT patients (median age 76 years, median time on the ground 13.5 h) were identified. The FD was most often attributed to primary cerebral causes in 40% of the cases (20% ischemic stroke, 16% intracranial hemorrhage, 4% epilepsy), intoxication/overdose (12%), and trauma (10%). It was often associated with infection (52%), injury (22%), hypovolemia (66%), acute kidney injury (20%), and severe rhabdomyolysis (creatine kinase ≥ 5000 U/l, 21%) as well as severe hypothermia < 32 °C (20%). Overall, 69% of the patients were admitted to an intensive care unit and in-hospital mortality was 50%. CONCLUSION: The term "long lie trauma" describes a complex clinical situation, in which various conditions lead to an incapacitated state with acute onset, which then causes further adverse health effects. Trauma or tissue damage were no obligatory requirement in this syndrome. Considering the high morbidity and in-hospital mortality, patients should initially be treated in the emergency room by an interdisciplinary team.
BACKGROUND: Patients discovered recumbent, helpless and incapacitated, awake or unresponsive are referred to as "long lie trauma" (LLT) in the German medical jargon. Yet, a characterization of this cohort is missing. METHODS: We retrospectively analyzed all LLT patients admitted to the emergency department of the University Hospital Cologne from July 2018 to December 2020. RESULTS: A total of 50 LLT patients (median age 76 years, median time on the ground 13.5 h) were identified. The FD was most often attributed to primary cerebral causes in 40% of the cases (20% ischemic stroke, 16% intracranial hemorrhage, 4% epilepsy), intoxication/overdose (12%), and trauma (10%). It was often associated with infection (52%), injury (22%), hypovolemia (66%), acute kidney injury (20%), and severe rhabdomyolysis (creatine kinase ≥ 5000 U/l, 21%) as well as severe hypothermia < 32 °C (20%). Overall, 69% of the patients were admitted to an intensive care unit and in-hospital mortality was 50%. CONCLUSION: The term "long lie trauma" describes a complex clinical situation, in which various conditions lead to an incapacitated state with acute onset, which then causes further adverse health effects. Trauma or tissue damage were no obligatory requirement in this syndrome. Considering the high morbidity and in-hospital mortality, patients should initially be treated in the emergency room by an interdisciplinary team.
Authors: Bianca Grecu Jacobs; Samuel D Turnipseed; Anna N Nguyen; Edgardo S Salcedo; Daniel K Nishijima Journal: J Emerg Med Date: 2015-06-03 Impact factor: 1.484
Authors: Benjamin M Howard; Lucy Z Kornblith; Amanda S Conroy; Clay Cothren Burlew; Amy E Wagenaar; Konstantinos Chouliaras; J Ryan Hill; Matthew M Carrick; Gina R Mallory; Jeffrey R Watkins; Michael S Truitt; David J Ciesla; Jaime A Davis; Christopher J Vail; Phillip M Kemp Bohan; Mary F Nelson; Rachael A Callcut; Mitchell Jay Cohen Journal: J Trauma Acute Care Surg Date: 2015-12 Impact factor: 3.313
Authors: Lucy Z Kornblith; Matthew E Kutcher; Abigail E Evans; Brittney J Redick; Alicia Privette; William P Schecter; Mitchell Jay Cohen Journal: J Trauma Acute Care Surg Date: 2013-06 Impact factor: 3.313