Fat Embolism Syndrome

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Abstract
Background: The effect of recent advances in critical care and the emphasis on early fracture fixation in patients with fat embolism syndrome (FES) are unknown. Objective: To better define FES in current practice by conducting a 10-year review of the experiences at our level I trauma center. Design: The medical records of all patients in whom FES was diagnosed from July 1, 1985, to July 1, 1995, were reviewed for demographics, injury severity and pattern, diagnostic criteria, and management. Setting: A level I trauma center. Results: Twenty-seven patients with clinically apparent FES were identified. This resulted in an incidence of 0.9% of all patients with long-bone fractures. The mean injury severity score was 9.5 (range, 4-22). The diagnosis of FES was made by clinical criteria, including hypoxia, 26 patients (96%); mental status changes, 16 patients (59%); petechiae, 9 patients (33%); temperature higher than 39°C, 19 patients (70%); tachycardia (heart rate >120 beats per minute), 25 patients (93%); thrombocytopenia (platelet count Arch Surg.1997;132:435-439