Epidemiology and Risk Factors for Fat Embolism in Isolated Lower Extremities Long Bone Fractures

Abstract BACKGROUND: 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: NTDB study, included patients with isolated femoral and tibial fractures. 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 were independent predictors of FE. Early operative fixation (≤ 48 h) was protective against FES. CONCLUSIONS: FES increases mortality by seven times. Young age, obesity, and diabetes are significant independent risk factors for FES. Early fixation is independently associated with a reduced risk of FES.