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首页> 美国卫生研究院文献>Proceedings of the National Academy of Sciences of the United States of America >Cranial vault trauma and selective mortality in medieval to early modern Denmark
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Cranial vault trauma and selective mortality in medieval to early modern Denmark

机译：中世纪至近代早期丹麦的颅穹顶创伤和选择性死亡

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摘要

To date, no estimates of the long-term effect of cranial vault fractures on the risk of dying have been generated from historical or prehistoric skeletons. Excess mortality provides a perspective on the efficacy of modern treatment, as well as the human cost of cranial injuries largely related to interpersonal violence in past populations. Three medieval to early modern Danish skeletal samples are used to estimate the effect of selective mortality on males with cranial vault injuries who survived long enough for bones to heal. The risk of dying for these men was 6.2 times higher than it was for their uninjured counterparts, estimated through a simulation study based on skeletal observations. That is about twice the increased risk of dying experienced by modern people with traumatic brain injuries. The mortality data indicate the initial trauma was probably often accompanied by brain injury. Although the latter cannot be directly observed in skeletal remains, it can be inferred through the relative risks of dying. The ability to identify the effects of selective mortality in this skeletal sample indicates it must be taken into account in paleopathological research. The problem is analogous to extrapolating from death register data to modern communities, so epidemiological studies based on mortality data have the same inherent possibility of biases as analyses of ancient skeletons.
机译：迄今为止，尚未从历史或史前骨骼中得出有关颅穹顶骨折对死亡风险的长期影响的估计。死亡率过高为现代治疗的有效性以及过去人群中与人际暴力很大程度上相关的颅脑损伤的人为代价提供了一个视角。使用三个中世纪至早期的现代丹麦骨骼样本来评估选择性死亡率对颅顶穹顶损伤男性的存活时间，该男性存活时间足以使骨骼愈合。根据基于骨骼观察的模拟研究估计，这些男人的死亡风险是未受伤者的6.2倍。这大约是现代颅脑外伤患者死亡风险的两倍。死亡率数据表明，最初的创伤可能经常伴有脑损伤。尽管不能直接在骨骼遗骸中观察到后者，但可以通过死亡的相对风险来推断。能够识别该骨骼样本中选择性死亡率影响的能力表明，在古病理学研究中必须考虑到这一点。这个问题类似于从死亡登记数据推断到现代社区，因此基于死亡率数据的流行病学研究具有与古代骨骼分析相同的固有可能性。

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