diagnostic criteria for FAT EMBOLISM

Gurd’s criteria for the diagnosis of fat embolism syndrome


Major criteria
1 Axillary or subconjuctival petechia. This occurs transiently over 4–6 h in
50%–60% of patients
2 Hypoxemia (PaO2 <60mmHg; FiO2 <0.4)
3 Central nervous system depression disproportionate to hypoxemia, and
pulmonary edema
Minor criteria
1 Tachycardia (>110 beats/min)
2 Pyrexia (>38.5°)
3 Emboli in the retina on fundoscopic examination
4 Fat present in urine
5 Sudden unexplained drop in hematocrit or platelet values
6 Increasing erythrocyte sedimentation rate
7 Fat globules in the sputum
8 Symptoms within 72h of skeletal trauma
9 Shortness of breath
10 Altered mental status
11 Occasional long tract signs and posturing
12 Urinary incontinence

Criteria for the diagnosis of fat embolism syndrome according to Gurd and Wilson

Major criteria
1 Respiratory insufficiency
2 Cerebral involvement
3 Petechial rash
Minor criteria
1 Pyrexia (usually <39°C)
2 Tachycardia (>120 beats/min)
3 Retinal changes (fat or petechiae)
4 Jaundice
5 Renal changes (anuria or oliguria)
6 Anemia (a drop of more than 20% of the admission hemoglobin value)
7 Thrombocytopenia (a drop of >50% of the admission thrombocyte value)
8 High erythrocyte sedimentation rate (ESR >71mm/h)
9 Fat macroglobulinemia

At least two major symptoms
or signs or one major and four minor symptoms or
signs must be present to diagnose the syndrome