Correlation of fat embolism severity and subcutaneous fatty tissue crushing and bone fractures |
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Authors: | Stephan Andreas Bolliger Karin Muehlematter Michael Josef Thali Garyfalia Ampanozi |
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Institution: | (1) Department of Forensic Medicine, Institute of Forensic Medicine, IRM, University of Bern, Buehlstrasse 20, CH 3012 Bern, Switzerland |
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Abstract: | Pulmonary fat embolism (PFE) is frequently encountered in blunt trauma. The clinical manifestation ranges from no impairment
in light cases to death due to right-sided heart failure or hypoxaemia in severe cases. Occasionally, pulmonary fat embolism
can give rise to a fat embolism syndrome (FES), which is marked by multiorgan failure, respiratory disorders, petechiae and
often death. It is well known that fractures of long bones can lead to PFE. Several authors have argued that PFE can arise
due to mere soft tissue injury in the absence of fractures, a claim other authors disagree upon. In this study, we retrospectively
examined 50 victims of blunt trauma with regard to grade and extent of fractures and crushing of subcutaneous fatty tissue
and presence and severity of PFE. Our results indicate that PFE can arise due to mere crushing of subcutaneous fat and that
the fracture grade correlated well with PFE severity (p = 0.011). The correlation between PFE and the fracture severity (body regions affected by fractures and fracture grade) showed
a lesser significant correlation (p = 0.170). The survival time (p = 0.567), the amount of body regions affected by fat crushing (p = 0.336) and the fat crush grade (p = 0.485) did not correlate with the PFE grade, nor did the amount of body regions affected by fractures. These results may
have clinical implications for the assessment of a possible FES development, as, if the risk of a PFE is known, preventive
steps can be taken. |
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