Incidence and severity analysis of pulmonary arterial fat embolism as the result of blunt force injury fatalities

A prospective study was performed to investigate the incidence, severity, and origin of pulmonary arterial fat embolism (PAFE) in persons dying from blunt force trauma within 24 hours. The control population consisted of persons dying of natural causes or missile-type injury.;The blunt force group consisted of 56 decedents (40 male vs. 16 female). Ages ranged from 5-95 years. Most had sustained multiple injuries; soft-tissue damage was also prevalent. Fractures were recorded in 96% of decedents. Examination of lung sections determined that 38 of 56 (68%) showed evidence of PAFE vs. 3 of 20 (15%) in controls.;Average score for PAFE differed significantly between the blunt force group and controls. (Abstract shortened by UMI.);Tissue was taken from each lobe of both lungs; histologic technique included osmium tetroxide straining for fat. Two investigators independently graded the sections on a scale of 0 (no emboli in section) to 4 (five or more emboli in a majority of 40x fields). Scoring by two investigators did not differ significantly.