Frailty and survival in the 1918 influenza pandemic
Frailty and survival in the 1918 influenza pandemic
复制标题
1918 年流感大流行中的虚弱与生存
DOI：
10.1073/pnas.2304545120
复制
发表时间：
2023
期刊：
影响因子：
--
通讯作者：
DeWitte, Sharon N.
中科院分区：
文献类型：
--
作者：
Wissler, Amanda;DeWitte, Sharon N.
1918年流感大流行最为人所知但最不为人所知的一个方面是年轻人的高死亡率。当代的说法还将受害者描述为健康的年轻人，这与对选择性死亡的理解相悖，因为选择性死亡的假设是，一个群体中身体最虚弱的人面临的死亡风险最大。我们使用生物考古学的方法，结合从1918年死亡的个体的骨骼遗骸中收集的个人水平的健康和压力信息，以确定健康的个体是否在1918年大流行期间死亡，或者潜在的脆弱是否导致死亡风险增加。从俄亥俄州克利夫兰的Hamann-Todd记录的骨骼学收集的369名个体中获得胫骨骨膜新骨形成的Skills数据。使用Kaplan-Meier生存率和考克斯比例风险分析，对死亡数据与已知死亡年龄进行分析。结果表明，虚弱或不健康的人比那些不虚弱的人更有可能在大流行期间死亡。在流感期间，估计死亡时活跃的骨膜病变个体的危险比对照组高出两倍多。这一结果与先前关于1918年流感大流行期间选择性死亡率的假设相矛盾。即使在年轻人中，也不是每个人都有同样的死亡可能性那些有系统压力证据的人死亡率更高。这些发现为我们理解生活经历的变化如何影响发病率和死亡率提供了时间深度，即使是在由新病原体引起的大流行期间。
One of the most well-known yet least understood aspects of the 1918 influenza pandemic is the disproportionately high mortality among young adults. Contemporary accounts further describe the victims as healthy young adults, which is contrary to the understanding of selective mortality, which posits that individuals with the highest frailty within a group are at the greatest risk of death. We use a bioarchaeological approach, combining individual-level information on health and stress gleaned from the skeletal remains of individuals who died in 1918 to determine whether healthy individuals were dying during the 1918 pandemic or whether underlying frailty contributed to an increased risk of mortality. Skeletal data on tibial periosteal new bone formation were obtained from 369 individuals from the Hamann–Todd documented osteological collection in Cleveland, Ohio. Skeletal data were analyzed alongside known age at death using Kaplan–Meier survival and Cox proportional hazards analysis. The results suggest that frail or unhealthy individuals were more likely to die during the pandemic than those who were not frail. During the flu, the estimated hazards for individuals with periosteal lesions that were active at the time of death were over two times higher compared to the control group. The results contradict prior assumptions about selective mortality during the 1918 influenza pandemic. Even among young adults, not everyone was equally likely to die—those with evidence of systemic stress suffered greater mortality. These findings provide time depth to our understanding of how variation in life experiences can impact morbidity and mortality even during a pandemic caused by a novel pathogen.
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DOI：
10.1073/pnas.0705460105
发表时间：
2008-02-05
影响因子：
11.1
作者：
DeWitte, Sharon N.;Wood, James W.
通讯作者：
Wood, James W.
DOI：
10.1002/ajpa.24614
发表时间：
2022-11
期刊：
AMERICAN JOURNAL OF BIOLOGICAL ANTHROPOLOGY
影响因子：
--
作者：
Wissler, Amanda;Blevins, Kelly E.;Buikstra, Jane E.
通讯作者：
Buikstra, Jane E.
史前、历史和当代人口研究中压力的生物文化视角
DOI：
--
发表时间：
1988
期刊：
影响因子：
--
作者：
A. Goodman;R. B. Thomas;A. Swedlund;G. Armelagos
通讯作者：
G. Armelagos
骨膜新骨形成活跃且已愈合的个体之间的生存率存在差异。
影响因子：
1.2
作者：
S. DeWitte
通讯作者：
S. DeWitte
疾病和死亡：评估人类骨骼遗骸的脆弱性。
影响因子：
2.8
作者：
K. Marklein;Rachael E. Leahy;D. Crews
通讯作者：
D. Crews