Abstract
Objective. To evaluate risk factors for fat embolism syndrome (FES) in patients with multiple trauma. Design. Case–control study. Setting. Tertiary care university hospital, surgical intensive care unit. Patients. Sixty adults with multiple trauma, 30 of them with FES. Interventions. None. Measurements and main results. Patients were matched by gender, age (±5 years), injury severity score and date. Thirty patients were considered as the control group. Mortality was significantly higher in the FES group (p<0.001). FES was linked to anaemia (p<0.03), thrombocytopenia (p<0.01) and hypocholesterolaemia (p<0.05). Some characteristics of fracture were associated with a high risk of occurrence of FES: right side (p<0.02), displaced (p<0.05) and closed fracture (p<0.05). The timing of fixation did not statistically differ between the two groups, but orthopaedic treatment was linked with the occurrence of FES (p<0.005). In multivariate analysis, the Acute Physiology and Chronic Health Evaluation System II (APACHE II) score (odds ratio 18.51; 95% confidence interval 12.05–41.66), displaced (odds ratio 2.51; 95% confidence interval 1.20–20.05) and closed fracture (odds ratio 2.70; 95% confidence interval 1.59–8.92), were found to be independent predictors of the occurrence of FES (p<0.001 and p<0.05, respectively). Conclusion. The severity of the initial injury and the characteristic of the fracture were the most important factors linked to the occurrence of FES in multiple trauma patients.