Experiences of diagnosis and treatment of fat embolism syndrome

Abstract

Objective To investigate the clinical characteristics of fat embolism syndrome(FES) and explore the diagnosis and therapy efficacy. Methods The etiology, clinical manifestations, laboratory and radiological characteristics, diagnosis, treatments and outcomes of 11 patients with FES, admitted to our hospital from 2004 to 2014, were retrospectively analyzed. Results There were 9 patients with traumatic long bone fracture, 2 with artificial knee joint replacement in 11 patients. Disturbance of consciousness was noted in 10 patients, dyspnea in one in the first onset. There were 2 with snow storm appearance in chest X-ray, 8 with abnormality in pulmonary CT and 3 with multiple cerebral infarction in MRI. The rates of final diagnosis and misdiagnosis within 72 h were 63.63% and 36.36%, respectively. After comprehensive treatment, 7 patients were cured, one was at vegetative state and 3 died, with a mortality rate of 27.2%. Conclusions The main causes of FES include traumatic long bone fracture and operation of joint. Early definite diagnosis and effective combined modality therapy are key points of successful treatment. Key words: Fat embolism syndrome; Clinical characteristic; Fracture