Fat embolism Syndrome: Is it common in smokers

Abstract

Introduction: Diagnosis of Fat Embolism Syndrome (FES) depends mainly on clinical features and there are no diagnostic laboratory tests available. In spite of so many advancements in the management of long bone fractures, management of FES is mainly supportive. Patients who are prone to develop FES are to be carefully screened as a part of pre-operative work up in order to prevent the complications later. There are very few studies which establish the risk factors associated with fat embolism. Materials and methods: 26 orthopaedic trauma patients who were diagnosed with fat embolism syndrome according to Gurd and Wilson criteria and Schonfeld’s FES index, and as per inclusion- exclusion criteria of the study were included. All demographic data, bone involved, type of fracture, timing and type of surgery was noted and data regarding their smoking status was taken into consideration. Observation: Out of 26 patients of FES, 25 were male and 1 was female. Mean age was 27.1 years. 11 were fractures of Femur and 15 were fractures of Tibia, 4 patients had multiple fractures. There were 5 cases of open fractures. Among the 26 patients who developed FES, 80.7% of them were cigarette smokers and all of them were male patients. Conclusion: It is our observation that among the patients who developed FES, 80.7% were cigarette smokers. Though this study does not establish a direct causal relationship between smoking and FES which requires further detailed analytical studies, there appears to be an association between FES and cigarette smoking. Hence, we conclude that smokers are prone to develop FES.