Fat Embolism Syndrome: Mapping to Guide Timely Diagnosis

ABSTRACT

PURPOSE: Fat embolism syndrome (FES) is rare, but can be a critical complication in trauma victims. Diagnostic criteria were made by Gurd and subsequently revised by Gurd and Wilson. Despite numerous attempts to improve the criteria, a suitable justification remains absent. This study was designed to understand the course of FES, and attempt its mapping. METHODS: A retrospective study was performed by reviewing the medical records. Twenty-five patients whose diagnoses are compatible with FES were gathered from 1997 to 2009. Their demographic data, mechanism of injury, numbers of diagnostic criteria fulfilled, days when the symptoms and signs occurred, patterns and severity of injuries, and treatment results were gathered. Statistical analysis was conducted using SPSS 12.0, Chi-square, t-test and correlation analysis. RESULTS: The major criteria, including petechiae, respiratory and neurologic symptoms, occurred most commonly on the 1st and 2nd days after injury. The minor criteria, including tachycardia, fever, anemia, thrombocytopenia and oliguria, occurred frequently during the 1st and 2nd days, but with more variable ranges. There were no significant correlations between injury severity and the onset times of the major criteria. CONCLUSION: Mapping of FES was performed. All the major criteria in FES occurred between days 0 to 3 after injury. The minor criteria, although nonspecific, showed more variable distributions for the day of onset. Health care providers must understand the course of illness, especially the onset times of each criterion, in order to make timely diagnosis and disease prediction.