Prevalence of pulmonary fat embolism and its association with death in traumatic and non-traumatic autopsies
摘要
Pulmonary fat embolism (PFE) is a potentially fatal complication resulting from the occlusion of pulmonary vasculature by fat globules. While commonly associated with long bone fractures and trauma, PFE can also occur in non-traumatic conditions. This study aimed to emphasize prevalence and association of PFE in autopsied cases at the Egyptian Forensic Medicine Authority in Dakahlia Governorate. The study was conducted on 80 cadavers autopsied between May 2023 and April 2024. Cadavers were categorized into traumatic and non-traumatic deaths based on history and autopsy findings. Comprehensive autopsy examination including gross and histopathological analysis of lung tissues with hematoxylin and eosin staining was performed.
ResultsThe overall prevalence of PFE was 7.5% (6/80 cases), exclusively observed in traumatic deaths (12.2% of traumatic cases). All identified PFE cases were classified as Grade 1 according to Mudd’s grading system. A marginal significant association was found between PFE and traumatic death (P = 0.047). Associations were observed between PFE and each of falling from height (2 cases), electrocution (1 case), and chest and lower limb injuries (1 case); however, these finding were based on very small numbers of cases and could be considered as hypothesis-generating only.
ConclusionAlthough PFE could not be interpreted as a definitive mechanism of death, it is associated with traumatic death, particularly those involving specific injury patterns. Comprehensive autopsy with histological examination remains crucial for accurate diagnosis. This descriptive regional study confirms the well-established association between trauma and PFE in an Egyptian forensic population using routine H&E staining.