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Inverse Probability of Treatment Weighting Propensity Score using the Military Health System Data Repository and National Death Index
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The Gamma Gap and All-Cause Mortality.

Stephen P Juraschek1,2,3, Alison R Moliterno4, William Checkley5,6

  • 1Department of Epidemioloy, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America.

Plos One
|December 3, 2015
PubMed
Summary
This summary is machine-generated.

The gamma gap, a measure of total protein minus albumin, is an independent risk factor for mortality. Elevated gamma gap levels, starting at 3.1 g/dl, are linked to increased all-cause mortality and strongly associated with pulmonary death.

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Area of Science:

  • Clinical chemistry
  • Epidemiology
  • Public health

Background:

  • The gamma gap (total serum protein minus albumin) is a screening tool for infection and malignancy.
  • A precise definition of a positive gamma gap and its independent impact on mortality remain undefined.

Purpose of the Study:

  • To define a positive gamma gap.
  • To investigate the association between gamma gap and all-cause and cause-specific mortality.

Main Methods:

  • Analysis of 12,260 participants from the National Health and Nutrition Examination Survey (NHANES) (1999-2004).
  • Comprehensive metabolic panels were linked to National Death Index vital status data.
  • Cox proportional hazards models were used to adjust for mortality risk factors.

Main Results:

  • A gamma gap of ≥3.1 g/dl was associated with a 30% increased risk of all-cause mortality (HR: 1.30; 95%CI: 1.08, 1.55).
  • The gamma gap was most strongly associated with death from pulmonary causes (HR 2.22; 95%CI: 1.19, 4.17).

Conclusions:

  • The gamma gap is an independent risk factor for all-cause mortality, with a threshold as low as 3.1 g/dl.
  • The gamma gap shows a strong association with mortality from pulmonary causes.