Analyzing fat embolism syndrome in trauma patients at AIIMS Apex Trauma Center, New Delhi, India.

Background: Fat embolism syndrome (FES) is a constellation of symptoms and signs subsequent to orthopedic trauma.

Methods: The clinical profile of FES in the trauma population was studied over 2 years and 8 months.

Results: The incidence of FES among all patients with long bone and pelvic fractures was 0.7% (12). The mean injury severity score was 10.37 (SD 1.69) (range 9-14). The diagnosis of FES was made by clinical and laboratory criteria. Hypoxia was the commonest presentation (92%). The average days of onset of symptoms were 3.5 (SD1.29) days. Management included ventilator support in 75%, average ventilator days being 7.8 (SD 4.08) days. The average ICU stay and hospital stay were 9.1 days and 29.7 days, respectively. A mortality of 8.3% (1) was observed.

Conclusions: Fat embolism remains a diagnosis of exclusion and is a clinical dilemma. Clinically apparent FES is unusual and needs high index of suspicion, especially in long bone and pelvic fractures.