High risk factors of fat embolism syndrome in multiple trauma patients combined with femoral shaft fractures / 中华创伤杂志

ABSTRACT

Objective To investigate the high risk factors of fat embolism syndrome (FES) in multiple trauma patients combined with femoral shaft fractures.Methods A case series retrospective study was employed to evaluate 36 patients with FES after multiple fractures of femoral shaft fracture admitted from January 2010 to December 2015,including 30 males and six females aged 18-52 years (mean,36.2 years).According to whether the patients were combined with other parts injuries such as in chest,abdomen and brain,the patients can be divided into two groups,namely,Group A (9 cases) were simple femoral fractures patients with multiple fractures,and Group B (27 cases) were femoral shaft fracture associated with other parts of the fracture or splanchnocoele injury or craniocerebral injury.The quantitative assessment was used by revised trauma severity score (RISS) and the types of the femoral shaft fracture were classified by AO.The relationship of RISS range and types of femoral shaft fractures were evaluated.Results RISS was over 11 points in all cases.Among them,the RISS range of Group A patients was from 11 to 18 points (mean,13 points),with type C in AO classification accounting for 67％ and type B for 33％.The RISS range of Group B patients was from 18 to 25 points (mean,21 points),with type C in AO classification accounting for 78％ and type B for 19％.FES occurrence was positively correlated with the RISS (r =0.684,P ＜ 0.01),with type C the most common classification.Conclusions Clinical doctors should raise vigilance and take the following indicators as high risk factors for FES,ie,the multiple trauma patients combined with femoral shaft fractures plus RISS over 11 points,the multiple trauma patients combined with other parts of the fractures or splanchnocoele injury or craniocerebral injury plus RISS over 18 points,mainly type C femoral shaft fracture.