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Published on: August 17, 2017
Epidemiology and risk factors for fat embolism in isolated lower extremity long bone fractures
Natthida Owattanapanich1,2, Meghan Lewis1, Subarna Biswas1
1Division of Trauma and Surgical Critical Care, Los Angeles General Medical Center, University of Southern California, Los Angeles, CA, USA.
Purpose:
Fat embolism syndrome (FES) is a serious complication after orthopedic trauma. The aim of this study was to identify risk factors for FES in isolated lower extremity long bone fractures.
Methods:
The National Trauma Data Bank "NTDB" study included patients with isolated femoral and tibial fractures. A total of 344 patients with FES were propensity score matched with 981 patients without FES. Multivariate logistical regression was used to identify independent risk factors for FES.
Results:
FES was diagnosed in 344 (0.03%) out of the 1,251,143 patients in the study populations. In the two matched groups, the mortality was 7% in the FES group and 1% in the No FES group (p < 0.001). FES was associated with an increased risk of ARDS, VTE, pneumonia, AKI, and stroke. Younger age, femur fractures, obesity, and diabetes mellitus were independent predictors of FES. Early operative fixation (≤ 48 h) was protective against FES.
Conclusion:
FES increases mortality by seven times. Young age, obesity, and diabetes mellitus are significant independent risk factors for FES. Early fixation is independently associated with a reduced risk of FES.
Level Of Evidence:
Level III.
Study Type:
Prognostic study.
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