Diagnostic features of the fat embolism syndrome

A series of 444 patients with multiple blunt injuries were analysed with respect to the incidence of symptoms and signs generally described in connection with the fat embolism syndrome. During hospital treatment, a diagnosis of fat embolism was established for 47 patients and suspected in 23 patients. In retrospect, the latter patients had a morbid picture similar to that of the former. Hypoxia, anemia, disturbances of consciousness, and hyperpyrexia were constant signs. A high incidnece of petechiae and snowstorm infiltrations of the lung was also found. These six signs showed a marked tendency to combine; and placed the fat embolism patients in a distinctive group. The most susceptible patients were young adults with diaphyseal fractures of the lower extremities. Hypoxia was the most important early sign and the most important factor in terms of treatment. We conclude that the fact embolism syndrome is a clinical entity and that its diagnosis can be made on the basis of the symptom complex.