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9A0-054 Adobe Photoshop CS3 ACE

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9A0-054 exam Dumps Source : Adobe Photoshop CS3 ACE

Test Code : 9A0-054
Test cognomen : Adobe Photoshop CS3 ACE
Vendor cognomen : ADOBE
: 148 true Questions

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ADOBE Adobe Photoshop CS3 ACE

Adobe Photoshop CS3 prolonged (First look evaluation) | killexams.com true Questions and Pass4sure dumps

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    Photoshop CS3 - a course to open raw data? | killexams.com true Questions and Pass4sure dumps

    uncooked images sustain the entire statistics in a photograph, as compared to JPEG which is what's used when a photo is saved on a reminiscence card. When raw photographs are developed the consume of Adobe Photoshop, it gives marvelous component in the photo. To open a uncooked photo in Photoshop CS3,replica every uncooked photograph in your difficult disk. Open the uncooked pictures in the Photoshop CS3 and should you remark any multimedia file it is grayed out, it ability that a plug-in from Adobe is required. fade to adobe.com, download updates and now fade to camera raw replace. choose from an inventory of multimedia supported cameras and involve updates from working systems on your computing device. result the guidelines for manually or automatically downloading the utility. challenge I even believe plot in Photoshop CS3 and am using a Canon EOS 450D camera. i'm trying to edit raw photographs the usage of Photoshop CS3 however they might not open. I additionally downloaded the digicam's uncooked 3.7 application and followed utter of the downloading guidance on this web page:http://www.adobe.com/assist/downloads/aspect.jsp?ftpID=3647

    This didn't help. when I are attempting to open a uncooked lifelike in photoshop CS3 i salvage this message:

    couldn't complete your request since it is not the appropriate variety of doc answer First, you should down load Adobe camera raw Plug-In 4.1.1 here

    To set up with Adobe inventive Suite three or Photoshop CS3:

  • Exit Photoshop CS3.
  • Open My desktop.
  • Double-click on local Disk (C:).
  • Navigate to: C:\program info\general data\Adobe\Plug-Ins\CS3\File formats
  • circulation the present digicam raw.8bi plug-in to a different region (as an example, a new folder on your computing device).
  • be inescapable you hold this edition in the event you need to revert again.
  • replica the digicam uncooked plug-in, camera uncooked.8bi, from the down load into the identical folder as in step 4.
  • Launch Photoshop CS3 or Adobe Bridge.
  • be aware: If common digital camera thumbnails look in Adobe Bridge, comply with these steps:

  • determine to be inescapable the plug-in changed into installed in the rectify directory in step four above.
  • beginning Bridge.
  • opt for tools > Cache > Purge crucial Cache.
  • Now you could open the .CR2 uncooked data in Adobe Photoshop CS3.

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    Adobe Photoshop CS3 ACE

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    Steps to Becoming an Adobe Certified Expert | killexams.com true questions and Pass4sure dumps

    Let us leave to the side for the moment some of the needless complexity and conflicting information in Adobe certifications (covered in my ultimate piece in this series). Today they shall focus on how to become an Adobe Certified Expert, or ACE.

    Our Adobe.com page reference for today's post is this one:

    Adobe.com: Become an Adobe Certified Expert in four smooth steps

    According to Adobe, those four steps are as follows:

  • Choose a certification
  • Register for the exam (Pearson VUE or Prometric)
  • Prepare for the exam
  • Get involved with the Adobe community and sustain abreast concerning recertification requirements
  • Adobe divides their ACE program into three categories:

    * solitary product certification

    * Specialist certification

    * Master certification

    A single-product ACE is an Adobe professional who wants to validate his or her expertise with a solitary Adobe product, such as the following:

  • Acrobat
  • After Effects
  • GoLive
  • Illustrator
  • InDesign
  • Photoshop
  • Premiere
  • On the other hand, a specialist ACE is geared toward using multiple Adobe applications by virtue of his or her job role (i.e., Print specialist, Web specialist, or Video specialist).

    Please visit the The Become an Adobe Certified Expert page to view Adobe's requirement's matrix for the three ACE specialist tracks.

    For example, if I wanted to rate my ACE as a Web specialist, I would believe to pass the following three exams:

  • Dreamweaver or GoLive
  • Photoshop
  • Acrobat Print Production or Illustrator
  • Finally, there is the ACE Master certification. Here you must pass utter exams in an entire Adobe product suite.

    The key issue here, friends, is versioning. You may be an expert in, say, Adobe Dreamweaver CS3, but how would you feel about taking a certification exam on MACROMEDIA Dreamweaver?

    As I mentioned in my ultimate post, in my humble or no-so-humble opinion, Adobe is doing a dreadful job in maintaining their certification program--just dreadful. In a future post this week I will inspirit you design out how to ensure that you are taking the "latest and greatest" version of your desired Adobe certification exams.


    Analysis of Bony and Internal Organ Injuries Associated With 26,357 Adult Femoral Shaft Fractures and Their repercussion on Mortality | killexams.com true questions and Pass4sure dumps

    Femoral shaft fractures are common following major traumas, such as motor vehicle accidents.1 In fact, a femoral shaft fracture occurs in approximately 1 in every 10 road injuries.2 A recent study estimated that the incidence of femoral shaft fractures is approximately 1 to 2.9 million per year worldwide.2 The preferred treatment option of these stern injuries is intramedullary nails.3–5 This surgery has been shown to believe wonderful healing and recovery.6

    Often, fractures are not isolated injuries, and identifying associated injuries is necessary for patient care, especially for seriously injured patients.7 For given injuries, there are often specific known patterns of associated injuries that can inspirit direct patient workups and management. For example, such patterns of associated injuries believe been described for calcaneus fractures (which believe a known association with lumbar fractures)8,9 and clavicle fractures (which believe a known association with lung injuries).10 Along with comorbidities and the patient's common condition, associated injuries can repercussion the fracture management, time to surgery, and outcomes.

    Because femoral shaft fractures typically result from major trauma, they are frequently seen in polytrauma patients.11 However, to the best of the authors' knowledge, no study has identified the associated injury profile for femoral shaft fractures.

    To address the need of literature in this area, the current study sought to consume the National Trauma Data Bank (NTDB), the largest multicenter trauma repository, to define a large cohort of patients with femoral shaft fractures and to assess associated injury profiles. Furthermore, to assess the repercussion of such associated injuries, the correlations of such associated injuries with mortality were defined and compared with other factors believed to strike mortality in this patient population.

    Materials and Methods

    The NTDB, created by the American College of Surgeons, is the largest national, multicenter trauma database and includes registrar distraught and administratively coded data.12 It was established as a “repository of trauma related data voluntarily reported by participating trauma centers.”13 The current study used the NTDB to identify adult patients (18 years and older) with femoral shaft fractures from 2011 and 2012. This was based on International Classification of Diseases, Ninth Revision (ICD-9) codes for either open or closed femoral shaft fractures (821.01, 821.11).

    Patients' age, sex, and comorbidities were characterized. Age was stratified into the following groups: 18 to 39 years, 40 to 64 years, and 65+ years. The following comorbidities contained in the NTDB were used to reckon a modified Charlson Comorbidity Index (CCI): hypertension, alcoholism, diabetes mellitus, respiratory disease, obesity, congestive heart failure, coronary artery disease, prior cerebrovascular accident, liver disease, functionally conditional status, cancer, renal disease dementia, and peripheral vascular disease. These variables were used to reckon CCI based on a previously described algorithm.14 Of note, this modified CCI did not involve an age component, and any mention of “CCI” in this article always refers to this modified CCI.

    Mechanism of injury was then determined from ICD-9 e-codes. Patients were categorized into fall, motor vehicle accident (MVA), or other. Patients with a topple mechanism of injury were determined based on the following ICD-9 e-code ranges: 880.00 to 889.99; 833.00 to 835.99; 844.7; 881; 882; 917.5; 957.00 to 957.99; 968.1; and 987.00 to 987.99. These primarily contained falls from a standing height, ladders, buildings, and sports. Patients with an MVA mechanism of injury were determined based on the following ICD-9 e-code ranges: 800 to 826; 829 to 830; 840 to 845; 958.5; and 988.5. These included patients who were involved in accidents such as motor vehicle drivers, motorcyclists, bicyclists, and pedestrians. utter other e-codes were counted as other; these included firearm and machinery-related injuries, among others.

    Injury severity score (ISS) and mortality were data elements directly distraught from NTDB. Associated injuries were identified by ICD-9 codes. The diagnosis codes that were used to identify associated bony and internal organ injuries are circumstantial elsewhere.15

    For analysis, Adobe Photoshop CS3 (Adobe Systems, San Jose, California) was used to visually demonstrate the associated injury frequencies by shadings on the skeleton and internal organ figures. The purview of shadings from white to black represented increasing injury frequency. Multivariate logistic regression was used to determine the association of age, modified CCI, and various associated injuries with mortality. utter statistical analyses were conducted using Stata version 13.0 statistical software (Stata-Corp LP, College Station, Texas). utter tests were 2-tailed, and a 2-sided α flush of 0.05 was taken as statistically significant. A waiver for this study was issued by the Human Investigations Committee at the authors' institution.

    ResultsPatient Demographics

    For 2011 and 2012, the NTDB included 26,357 adult patients (16,717 men and 9640 women) who had femoral shaft fractures. The age distribution of utter adult patients with femoral shaft fractures is shown in Figure 1. The highest incidences were between the ages of 18 and 39 years. The primary incidence peak was around 20 years. It was establish that the younger patients were predominantly men (10,448 men and 3220 women in the 18–39 years age group), whereas the older patients were predominantly women (3823 women and 1586 men in the 65+ years age group). The middle group (40–65 years) included 4683 men and 2597 women.

    
Distribution of ages of patients with femoral shaft fractures by sex.

    Figure 1:

    Distribution of ages of patients with femoral shaft fractures by sex.

    Comorbidity Index and Injury Severity

    The median modified CCI scores for age categories 18 to 39, 40 to 64, and 65+ years were utter 0 (Table 1). However, comorbidity tribulation did generally multiply with age for this cohort.

    
Distribution of Modified Charlson Comorbidity Index

    Table 1:

    Distribution of Modified Charlson Comorbidity Index

    The median ISS for these 3 age groups were between 10 and 19 for the younger 2 age groups and between 0 and 9 for the 65+ age group (Table 2). This is consistent with decreasing injury severity with increasing age for this cohort.

    
Distribution of Injury Severity Score

    Table 2:

    Distribution of Injury Severity Score

    Mechanism of Injury

    Mechanism of injury distribution by age group is shown in Figure 2. Younger adults sustained femur fractures and had predominantly been involved in MVAs, whereas older adults had predominantly been involved in falls. The middle age category (40–64 years) had a distribution more similar to the younger adults than the older adults, with MVAs dominating the distribution.

    
Distribution of patients with femoral shaft fractures by mechanism of injury and age groups. Abbreviation: MVA, motor vehicle accident.

    Figure 2:

    Distribution of patients with femoral shaft fractures by mechanism of injury and age groups. Abbreviation: MVA, motor vehicle accident.

    Associated Injuries by Age

    On average, younger adults (ages 18–39 years, who as a group had a predominate MVA mechanism of injury) sustained higher frequencies of bony and internal organ associated injuries across the board compared to the older adults (65+ years). The middle age group (40–64 years) had associated injury frequencies more comparable to the younger group (ages 18–39) than the older age group (age 65+ years). Table 3 summarizes the associated injury frequencies by age category.

    
Incidence of Injuries for Each Age Group
Incidence of Injuries for Each Age Group

    Table 3:

    Incidence of Injuries for Each Age Group

    Figure 3 and Figure 4 exhibit the associated bony and internal organ injury profiles for the total adult femoral shaft fracture population (18 years and older). The darker shadings correspond to higher frequencies. Overall, among associated bony injuries, the top 3 were tibia/fibula (20.5%), ribs/sternum (19.1%), and non-shaft femur (18.9%, of which 5.8% of the total cohort were femoral neck) fractures. Among associated internal organ injuries, the top 3 were lung (18.9%), intracranial (13.5%), and liver (6.2%) injuries. In general, the most common associated injuries were establish in the thoracic region (lungs and ribs) and in the lower extremity, especially near the femoral shaft fracture.

    
Schematic representation of percentages of adult patients (18 years and older) with a femoral shaft fracture with an incidence of associated bony injuries in different regions of the skeleton. Darker shadings in gray scale correspond with higher frequencies of associated injuries.

    Figure 3:

    Schematic representation of percentages of adult patients (18 years and older) with a femoral shaft fracture with an incidence of associated bony injuries in different regions of the skeleton. Darker shadings in gray scale correspond with higher frequencies of associated injuries.

    
Schematic representation of percentages of adult patients (18 years and older) with a femoral shaft fracture with an incidence of associated internal organ injuries in different regions of the body. Darker shadings in gray scale correspond with higher frequencies of associated injuries. Abbreviation: GI, gastrointestinal.

    Figure 4:

    Schematic representation of percentages of adult patients (18 years and older) with a femoral shaft fracture with an incidence of associated internal organ injuries in different regions of the body. Darker shadings in gray scale correspond with higher frequencies of associated injuries. Abbreviation: GI, gastrointestinal.

    Effects of Associated Injuries on Mortality

    Overall mortality after femoral shaft fractures was 4.3%. Multivariate analysis was used to determine the independent effects of age, modified CCI, and specific associated injuries on mortality (Table 4).

    
Multivariate Mortality Analysis

    Table 4:

    Multivariate Mortality Analysis

    Regarding age (while controlling for modified CCI and associated injuries), compared with the 18 to 39 age group, the 40 to 64 age group had a 1.92 times increased odds of death and the 65+ age group had a 4.29 increased odds of death. Regarding the modified CCI (while controlling for age and associated injuries), values of 2 and above utter had increased odds of death compared with a modified CCI of 0. Both age and modified CCI had a statistically significant correlation with mortality (P<.05).

    Lastly, the effects of associated injuries (by anatomic region) on the odds of death were assessed (while controlling for age and modified CCI). These are shown in the order of increasing odds of mortality in Table 4. The associated injuries by anatomic region that correlated with the greatest multiply in odds of death were thoracic organ injuries (adjusted odds ratio [AOR]=3.53), head injuries (AOR=2.93), abdominal organ injuries (AOR=2.78), and pelvic fractures (AOR=1.80).

    Discussion

    Femoral shaft fractures are relatively common injuries that can result from high-energy trauma. Noting that there can be associated injuries with femoral shaft fractures, traditional teaching demands a solicitous evaluation of the femoral neck because the incidence of this concomitant injury with femoral shaft fractures has been documented anywhere from 2.5% to 9%.16–19 However, to the current authors' knowledge, there has been no reported compelling data defining the likelihood of the overall spectrum of injuries that can be associated with femoral shaft fractures.

    The current study used the NTDB to identify a cohort of 26,357 adult femoral shaft fractures patients. This is a much large sample size than those establish in previous femoral shaft studies.20,21 That said, the demographics of the identified cohort were in line with the prior studies. For example, the majority of these femoral shaft fractures occurred in patients between 18 and 39 years of age, which is comparable to previously identified peak incidences between 15 and 24 years of age.21 As another example, the identified cohort had a male:female ratio of 1.7:1, which is comparable to a previously reported ratio of 1.4:1.20 Furthermore, consistent with what would be anticipated, modified CCI was establish to multiply with age, and the predominant mechanism of injury was establish to transition from MVAs to falls with increasing age.

    Injury Severity Score provides an overview of the severity of both the femoral shaft fracture and the associated injuries. In the current study, ISS was higher in younger patients than in older patients, which is consistent with the expected higher-energy mechanisms and greater overall injury flush for younger patients.22 However, importantly, ISS lonely does not define the specific injuries associated with femoral shaft fractures, which was the focus of the current work. Specific associated injuries were evaluated, and results are presented in tabular and lifelike formats in the current article.

    As an sample of a specific associated injury, femoral neck fractures believe been reported to be associated with femoral shaft fractures, with an incidence ranging from 2.5% to 9%. This was confirmed by the current analysis, which showed that 5.8% of femoral shaft fractures had concomitant femoral neck fractures (completely in line with prior reports).16,23 This is clearly of clinical import for the treating surgeon, who should be awake of this when managing patients with this combination of injuries.

    From the current analyses of bony injuries associated with femoral shaft fractures, it was establish that 38.1% had other lower extremity fractures (notably 20.5% had tibia/fibula fractures), whereas 22.4% had upper extremity fractures. These lofty incidences suggest that the extremities need to be thoroughly assessed for concomitant injuries and that there should be a low threshold for imaging any region of question.

    In addition, spinal injuries were relatively common in this population (16.8% of patients with femoral shaft fractures had a concomitant spinal fracture). This is notable because this incidence is comparable to that of patients with a known spinal fracture who furthermore believe a noncontiguous spinal fracture (range, 6.4%–19%).24,25 For patients with a spinal fracture, conventional teaching promotes a low threshold to evaluate for noncontiguous fractures. The very appears to be wholehearted for the need to evaluate for any spinal fracture in the femoral shaft fracture patient as well.

    From the current analysis of internal organ injuries associated with femoral shaft fractures, it was establish that thoracic (19.5%), abdominal (14.2%), and intracranial (13.5%) injuries were common. This suggests a higher incidence than that from a previous study, which showed concomitant thoraco-abdominal injuries (10.9%) with femoral shaft fractures.21 The lofty incidence of internal organ injuries identified underscores the import of the “pan scan” for patients with high-energy injuries when clinically appropriate to ensure that such associated internal organ injuries are not missed.

    Finally, multivariate analysis showed that increasing age, increasing modified CCI, and many of the associated injuries (most notably thoracic organ, head, and abdominal organ injuries) had significant associations with a higher risk of mortality. This underscores the import and repercussion of associated injuries, highlighting the clinical import of appreciating the associated injuries defined in the current study.

    The major limitation of the current study deals with the data acquired from the NTDB. Because the NTDB focuses on trauma patients, the studied population may be biased toward femoral shaft fractures, which occur in the setting of more severely injured patients than in the common population. In addition, because the NTDB is a convenience sample, the data “may not be representative of utter hospitals.”13 It is necessary to note that trauma victims who die before transport to a hospital are not included in the NTDB; therefore, the current study does not picture femoral shaft fractures that result in immediate death.13 Finally, although information was gathered for utter patients with a femoral shaft fracture in the NTDB using ICD-9 diagnosis coding, it is crucial that the potential variability within this group is emphasize because fracture classification was not available in the data set.

    Conclusion

    Overall, this study characterized the distribution of age, comorbidity burden, ISS, mechanism of injury, and associated injuries in adult patients with femoral shaft fractures, as well as identified the associations of such associated injuries with mortality. It was establish that these injuries more commonly occur in younger and healthier patients, who were most likely to believe suffered the injury from a high-energy mechanism. lofty rates of associated bony and internal organ injuries were identified, and rates were defined. Moreover, the mortality associated with femoral shaft fractures is most closely related to such associated injuries and less related to overall health status. This underscores the import for orthopedists and trauma surgeons to treasure these associated injuries when assessing, managing, and treating patients with femoral shaft fractures.

    References
  • Neumann MV, Südkamp NP, Strohm PC. Management of femoral shaft fractures. Acta Chir Orthop Traumatol Cech. 2015; 82(1):22–32.
  • Agarwal-Harding KJ, Meara JG, Greenberg SL, Hagander LE, Zurakowski D, Dyer GS. Estimating the global incidence of femoral fracture from road traffic collisions: a literature review. J Bone Joint Surg Am. 2015; 97(6):e31. doi:10.2106/JBJS.N.00314 [CrossRef]
  • Metsemakers WJ, Roels N, Belmans A, Reynders P, Nijs S. Risk factors for nonunion after intramedullary nailing of femoral shaft fractures: remaining controversies. Injury. 2015; 46(8):1601–1607. doi:10.1016/j.injury.2015.05.007 [CrossRef]
  • Zhu ZG, Yu YY, Hou L-j, Gai W, Yang Y. Treatment of femoral shaft fractures by closed reduction and interlocking intramedullary nailing [in Chinese]. Zhongguo Gu Shang. 2014; 27(10):819–822.
  • Iannacone WM, Bennett FS, DeLong WG Jr, Born CT, Dalsey RM. Initial experience with the treatment of supracondylar femoral fractures using the supracondylar intramedullary nail: a preparatory report. J Orthop Trauma. 1994; 8(4):322–327. doi:10.1097/00005131-199408000-00008 [CrossRef]
  • Kempf I, Grosse A, Beck G. Closed locked intramedullary nailing: its application to comminuted fractures of the femur. J Bone Joint Surg Am. 1985; 67(5):709–720. doi:10.2106/00004623-198567050-00005 [CrossRef]
  • Pierce JL, McCrum EC, Rozas AK, Hrelic DM, Anderson MW. Tip-of-the-iceberg fractures: tiny fractures that express stout trouble. AJR Am J Roentgenol. 2015; 205(3):524–532. doi:10.2214/AJR.15.14739 [CrossRef]
  • Walters JL, Gangopadhyay P, Malay DS. Association of calcaneal and spinal fractures. J Foot Ankle Surg. 2014; 53(3):279–281. doi:10.1053/j.jfas.2014.01.012 [CrossRef]
  • Worsham JR, Elliott MR, Harris AM. Open calcaneus fractures and associated injuries. J Foot Ankle Surg. 2016; 55(1):68–71. doi:10.1053/j.jfas.2015.06.015 [CrossRef]
  • Taitsman LA, Nork SE, Coles CP, Barei DP, Agel J. Open clavicle fractures and associated injuries. J Orthop Trauma. 2006; 20(6):396–399. doi:10.1097/00005131-200607000-00005 [CrossRef]
  • Shah S, Desai P, Mounasamy V. Retrograde nailing of femoral fractures: a retrospective study. Eur J Orthop Surg Traumatol. 2015; 25(6):1093–1097. doi:10.1007/s00590-015-1658-6 [CrossRef]
  • American College of Surgeons. National Trauma Data Bank 2012 Annual Report. https://www.facs.org/~/media/files/qualityprograms/trauma/ntdb/ntdbannualreport2012.ashx. Accessed September 10, 2016.
  • American College of Surgeons. National Trauma Data Bank Research Data Set Admission Year 2012 User Manual. Chicago, IL: American College of Surgeons; 2013.
  • Samuel AM, vouchsafe RA, Bohl DD, et al. Delayed surgery after acute traumatic central cord syndrome is associated with reduced mortality. Spine (Phila Pa 1976). 2015; 40(5):349–356. doi:10.1097/BRS.0000000000000756 [CrossRef]
  • Anandasivam NS, Russo GS, Samuel AM, vouchsafe R, Bohl DD, Grauer JN. Injuries associated with subdural hematoma: a study of the National Trauma Data Bank. Conn Med. Accepted for publication February 2017.
  • Casey MJ, Chapman MW. Ipsilateral concomitant fractures of the hip and femoral shaft. J Bone Joint Surg Am. 1979; 61(4):503–509. doi:10.2106/00004623-197961040-00003 [CrossRef]
  • Paul GR, Sawka MW, Whitelaw GP. Fractures of the ipsilateral femur and tibia: emphasis on intra-articular and soft tissue injury. J Orthop Trauma. 1990; 4(3):309–314. doi:10.1097/00005131-199004030-00013 [CrossRef]
  • Watson JT, Moed BR. Ipsilateral femoral neck and shaft fractures: complications and their treatment. Clin Orthop Relat Res. 2002; (399):78–86. doi:10.1097/00003086-200206000-00011 [CrossRef]
  • Wiss DA, Sima W, Brien WW. Ipsilateral fractures of the femoral neck and shaft. J Orthop Trauma. 1992; 6(2):159–166. doi:10.1097/00005131-199206000-00005 [CrossRef]
  • Rodriguez-Merchan EC, Moraleda L, Gomez-Cardero P. Injuries associated with femoral shaft fractures with special emphasis on occult injuries. Arch Bone Jt Surg. 2013; 1(2):59–63.
  • Salminen ST, Pihlajamäki HK, Avikainen VJ, Böstman OM. Population based epidemiologic and morphologic study of femoral shaft fractures. Clin Orthop Relat Res. 2000; (372):241–249. doi:10.1097/00003086-200003000-00026 [CrossRef]
  • Langlois JA, Rutland-Brown W, Wald MM. The epidemiology and repercussion of traumatic brain injury: a brief overview. J Head Trauma Rehabil. 2006; 21(5):375–378. doi:10.1097/00001199-200609000-00001 [CrossRef]
  • Wu CC, Shih CH. Ipsilateral femoral neck and shaft fractures: retrospective study of 33 cases. Acta Orthop Scand. 1991; 62(4):346–351. doi:10.3109/17453679108994467 [CrossRef]
  • Keenen TL, Antony J, Benson DR. Non-contiguous spinal fractures. J Trauma. 1990; 30(4):489–491. doi:10.1097/00005373-199030040-00022 [CrossRef]
  • Miller CP, Brubacher JW, Biswas D, Lawrence BD, Whang PG, Grauer JN. The incidence of noncontiguous spinal fractures and other traumatic injuries associated with cervical spine fractures: a 10-year experience at an academic medical center. Spine (Phila Pa 1976). 2011; 36(19):1532–1540. doi:10.1097/BRS.0b013e3181f550a6 [CrossRef]
  • Table 1

    Distribution of Modified Charlson Comorbidity Index

    Charlson Comorbidity IndexAge Group, yTotal18–3940–6465+093.7%a77.8%a56.5%a81.7%15.6%15.5%25.4%12.4%20.6%3.6%10.0%3.3%30.1%1.7%4.2%1.4%≥40.0%1.4%3.9%1.2%Total100%100%100%100%Table 2

    Distribution of Injury Severity Score

    Injury Severity ScoreAge Group, yTotal18–3940–6465+0–930.7%41.0%73.0%a42.2%10–1940.1%a33.9%a18.7%34.0%20–2916.6%14.5%5.4%13.7%30+12.6%10.6%3.0%10.1%Total100%100%100%100%Table 3

    Incidence of Injuries for Each Age Group

    InjuryAge Group, yTotal18–3940–6465+Head injury26.2%21.4%7.0%21.0%  Skull fracture14.9%11.2%3.0%11.4%  Intracranial injury16.5%14.3%5.0%13.5%Spinal injury18.1%20.9%7.7%16.8%  Cervical spine5.4%6.5%2.9%5.2%  Thoracic spine5.3%6.7%2.4%5.1%  Lumbar spine9.5%11.6%3.8%8.9%  Sacral spine4.6%4.8%1.4%4.0%Ribs/sternum18.9%26.5%9.7%19.1%Pelvic fracture15.6%15.2%5.8%13.5%  Acetabulum8.4%7.1%2.4%6.8%  Pubis5.9%6.2%2.7%5.4%  Ilium2.0%2.4%0.7%1.8%  Ischium0.5%0.6%0.3%0.5%Upper extremity fracture25.8%24.5%10.8%22.4%  Clavicle4.2%4.2%1.6%3.7%  Scapula3.6%3.5%1.0%3.0%  Humerus5.8%6.6%3.5%5.5%    Proximal humerus1.6%2.6%2.0%2.0%    Humeral shaft2.7%2.5%0.8%2.2%    Distal humerus1.4%1.5%0.7%1.3%  Radius/ulna12.7%12.2%5.0%11.0%    Proximal radius/ulna2.9%2.7%0.8%2.4%    Radial/ulnar shaft4.3%3.6%1.1%3.4%    Distal radius/ulna6.1%6.4%3.0%5.6%  Hand7.3%5.9%2.3%5.8%Lower extremity fracture38.0%47.1%26.2%38.1%  Non-shaft femur fracture15.1%25.6%19.5%18.9%    Proximal femur9.5%16.1%10.5%11.6%      Femoral neck5.8%6.8%4.5%5.8%    Distal femur5.4%10.3%8.7%7.5%  Patella5.8%5.0%1.8%4.8%  Tibia/fibula fracture22.1%26.6%8.4%20.5%    Proximal tibia/fibula6.5%10.9%3.4%7.1%    Tibial/fibular shaft8.8%10.6%2.7%8.1%  Ankle8.5%9.8%3.3%7.8%  Foot10.1%10.2%2.4%8.6%Thoracic organ injury25.3%18.6%6.0%19.5%  Heart0.8%1.2%0.4%0.8%  Lung24.7%17.8%5.7%18.9%    Pneumothorax15.1%12.6%4.3%12.2%  Diaphragm0.8%1.0%0.2%0.7%Abdominal organ injury18.4%14.2%3.6%14.2%  Gastrointestinal tract4.7%4.5%0.9%3.8%  Liver8.7%5.0%1.4%6.2%  Spleen7.9%5.5%1.1%5.9%  Kidney3.7%2.0%0.5%2.6%Pelvic organ injury1.5%1.4%0.2%1.2%Table 4

    Multivariate Mortality Analysis

    Outcome: MortalityAdjusted Odds Ratio95% assurance IntervalPAge (reference, 18–39 y)<.001  40–64 y1.921.65–2.23  65+ y4.273.55–5.16Modified Charlson<.001  Comorbidity Index (reference, 0)  10.700.56–0.88  21.451.04–2.03  32.881.95–4.27  4+2.691.78–4.07Associated Injuries (in increasing order of odds of mortality)  Lumbar spine0.720.60–0.86<.001  Lower extremity0.960.84–1.10.541  Thoracic spine1.110.90–1.36.342  Upper extremity1.301.13–1.50<.001  Cervical spine1.401.15–1.70.001  Pelvic fracture1.801.55–2.08<.001  Abdominal organ2.782.39–3.23<.001  Head2.932.54–3.38<.001  Thoracic organ3.533.01–4.14<.001

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