Fat embolism syndrome in blunt trauma patients with extremity fractures

Miriam Alpert; Areg Grigorian; John Scolaro; James Learned; Matthew Dolich; Catherine M Kuza; Michael Lekawa; Jeffry Nahmias

doi:10.1016/j.jor.2020.08.040

Fat embolism syndrome in blunt trauma patients with extremity fractures

J Orthop. 2020 Sep 6:21:475-480. doi: 10.1016/j.jor.2020.08.040. eCollection 2020 Sep-Oct.

Authors

Miriam Alpert¹, Areg Grigorian², John Scolaro³, James Learned³, Matthew Dolich², Catherine M Kuza⁴, Michael Lekawa², Jeffry Nahmias²

Affiliations

¹ Western University of Health Sciences, College of Osteopathic Medicine of the Pacific, 309 E. Second St, Pomona, CA, 91766, USA.
² University of California, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, 333 the City Blvd West, Suite 1600, Orange, CA, 92868, USA.
³ University of California, Department of Orthopaedic Surgery, Division of Trauma, 101 the City Blvd South, Building 29A, Orange, CA, 92868, USA.
⁴ University of Southern California, Keck School of Medicine, Department of Anesthesiology, 1450 San Pablo St, Suite 3600, Los Angeles, CA, 90033, USA.

Abstract

Objective: This study sought to provide a national, descriptive analysis to determine fat embolism syndrome (FES) risk factors, hypothesizing that femur fractures and multiple fractures are associated with an increased risk.

Methods: The Trauma Quality Improvement Program was queried (2010-2016) for patients with extremity fractures. A multivariable logistic regression analysis model was used.

Results: From 324,165 patients, 116 patients (0.04%) were diagnosed with FES. An age ≤30, closed femur fracture, and multiple long bone fractures were associated with an increased risk of FES.

Conclusion: Future research to validate these findings and develop a clinical risk stratification tool appears warranted.

Keywords: Extremity fracture; Fat embolism syndrome; Femur fracture; Humerus fracture; Tibia fracture.