Fat embolism syndrome. Changing prognosis.

Patients with the fat embolism syndrome are reported to have a severe course, with mortality as high as 15 percent. Recent studies have attributed improved prognosis to one or another treatment modality. We reviewed the 54 patients with clinical evidence of the posttraumatic fat embolism syndrome documented at the Foothills Hospital from 1968 to 1977. The criteria for diagnosis were fever (54/54), hypoxemia (52/52), diffuse pulmonary infiltrates (49/54), changes in sensorium (41/54), and petechiae (39/54). Therapy included supplemental oxygen (54), assisted ventilation with positive end-expiratory pressure (5), and corticosteroids (7). There were no deaths. Patients who have the fat embolism syndrome without associated life-threatening disease have a relatively good prognosis with modern therapy, in contrast to reports in most of the published literature.