To assess the incidence and risk factors for fat embolism syndrome.
Data from the National Hospital Discharge Survey (NHDS) were analyzed using International
Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes.
From 1979 through 2005 among 928,324,000 patients discharged from short-stay hospitals
in the United States, 41,000 (0.004%) had fat embolism syndrome. Among 21,538,000
patients with an isolated fracture of the femur (any site), tibia, fibula, pelvis,
ribs, humerus, radius, or ulna, 25,000 (0.12%) developed fat embolism syndrome. Patients
with multiple fractures of the femur (excluding neck) more often had fat embolism
syndrome than those with isolated fractures (1.29% versus 0.54%). The incidence of
fat embolism syndrome was lower with isolated fractures of the tibia or fibula (0.30%)
and even lower with isolated fractures of the neck of the femur (0.06%). The incidence
of fat embolism was too low to calculate with isolated fractures of the pelvis, ribs,
humerus, radius, or ulna. Nonorthopedic conditions rarely, if ever, were accompanied
by fat embolism syndrome. The fat embolism syndrome was more frequent in men (relative
risk 5.71). Children, aged 0 to 9 years rarely had fat embolism syndrome. The fat
embolism syndrome most commonly affected patients aged 10 to 39 years.
The incidence of the fat embolism syndrome depends on the bone involved, whether fractures
are isolated or multiple, the age of the patient and the gender. It rarely occurs
as a result of medical conditions.