Pulmonary and systemic fat embolism as a cause of death in forensic autopsy practice

Turan, Arzu Ak�ay; �elik, Safa; Karayel, Ferah; Paki�, I��l; Ar�can, Nadir

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Pulmonary and systemic fat embolism as a cause of death in forensic autopsy practice [Ulus Travma Acil Cerrahi Derg]

Ulus Travma Acil Cerrahi Derg. 2006; 12(2): 129-134

Pulmonary and systemic fat embolism as a cause of death in forensic autopsy practice

Arzu Ak�ay Turan¹, Safa �elik², Ferah Karayel¹, I��l Paki�¹, Nadir Ar�can³
¹Department Of Forensic Medicine, Ministry Of Justice, �stanbul, Turkey
²Department of Forensic Medicine, I.U. Cerrahpafla Medicine Faculty, �stanbul, Turkey
³Department of Forensic Medicine, I.U. �stanbul Medicine Faculty, �stanbul, Turkey

BACKGROUND: The aim of this study was to evaluate the possible correlations between the grade of fat embolism and age, gender, severity of trauma and post-traumatic survival time.
METHODS: Thirty-one cases with pulmonary and/or systemic fat embolism, auotopsied at the Morgue Department of Council of Forensic Medicine were evaluated retrospectively.
RESULTS: Twenty-eight cases (90%) died due to trauma and its complications. Nineteen cases (61%) were injured in motor vehicle-related accidents. Post-traumatic survival time varied between 0-384 hours (61.6 � 86.2 hours). Abbreviated injury scale (AIS) was 8.1 �3.9 and injury severity score (ISS) was 26.5�19.7 SD. Twenty-four (77%) cases were determined as isolated pulmonary fat embolism and 7 (23%) cases as systemic fat embolism on histopathological examination. Possible correlations between the grade of fat embolism and age, gender, severity of trauma and post-traumatic survival time were evaluated statistically with using Chi-square and Spearman's correlation tests. CONCLUSION: There were no correlations between the grade of fat embolism and age, gender, the severity of trauma. Post-traumatic survival time and the severity of trauma had a very weak negative correlation without any statistical significance.

Keywords: Autopsy, embolism, fat/etiology/mortality/pathology, forensic medicine, pulmonary embolism/etiology/mortality/pathology; trauma

Adli otopsilerde �l�m nedeni olarak akci�er ve sistemik ya� embolizmi

Arzu Ak�ay Turan¹, Safa �elik², Ferah Karayel¹, I��l Paki�¹, Nadir Ar�can³
¹Adalet Bakanl�� Adli T�p Kurumu, �stanbul, T�rkiye
²�.�. Cerrahpafla T�p Fak�ltesi Adli T�p Anabilim Dal�, �stanbul, T�rkiye
³�.�. �stanbul T�p Fak�ltesi Adli T�p Anabilim Dal�, �stanbul, T�rkiye

AMA�: Bu �al��mada akci�er ve/veya sistemik ya� embolisi geli�en olgularda ya� embolisinin yayg�nl�� ile ya�, cins, travman�n a��rl�� ve travma sonras� ya�am s�resi, aras�ndaki ili�kiler sorguland�.
GERE�-Y�NTEM: Adli T�p Kurumu Morg �htisas Dairesi�nde otopsileri yap�lan, akci�er ve/veya di�er ya�amsal organlar�nda histopatolojik olarak, ya� embolisi saptanan 31 olgu geriye d�n�k olarak de�erlendirildi.
BULGULAR: Travma ve travmaya ba�l� komplikasyonlar nedeni ile hayat�n� kaybeden 28 olgunun (%90) 19�unu (%61) ara� i�i ve ara� d�� trafik kazalar� olu�turmaktayd�. Travma sonras� ya�am s�resi 0-384 saat (61.6�86.2) aras�nda de�i�mekteydi. Olgularda saptanan travmatik de�i�iklikler k�salt�lm�� yaralanma cetveli (AIS) ve yaralanma a��rl�k cetveline (ISS) g�re de�erlendirildi; AIS de�eri 8.1�3.9 (SD), ISS de�eri 26.5�19.7 (SD) olarak bulundu. Olgular�n histopatolojik de�erlendirmesinde 24 olguda (%77) izole akci�er ya� embolisi, 7 olguda (%23) sistemik ya� embolisi saptand�. Ya� embolisinin yayg�nl�� ile ya�, cinsiyet, travma derecelendirmesi, travma sonras� ya�am s�resi aras�ndaki ili�kiler istatistiksel olarak, Ki-kare ve Spearman korelasyon testleri ile ara�t�r�ld�.
SONU�: Ya�, cinsiyet ve ISS de�erleri ile akci�er ya� embolisinin derecelendirilmesi aras�nda anlaml� ili�ki saptanmad�. Travma sonras� ya�am s�resi ve ISS de�erleri aras�nda ise istatistiksel anlaml�l�k olmad�� halde negatif bir ili�ki oldu�u belirlendi.

Anahtar Kelimeler: Otopsi, emboli, ya�/etyoloji/mortalite/patoloji, adli t�p; akci�er embolisi/etyoloji/mortalite/patoloji; travma

Arzu Ak�ay Turan, Safa �elik, Ferah Karayel, I��l Paki�, Nadir Ar�can. Pulmonary and systemic fat embolism as a cause of death in forensic autopsy practice. Ulus Travma Acil Cerrahi Derg. 2006; 12(2): 129-134

Corresponding Author: Arzu Ak�ay Turan, T�rkiye
Manuscript Language: Turkish

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