Evidence map›Paper›PMID 40544205›Full record

ArticleAnnals of surgical oncology2025

The Hidden Burden: Impact of Allostatic Load on Colorectal Cancer Surgery Outcomes.

Mujtaba Khalil, Selamawit Woldesenbet, Zayed Rashid, Abdullah Altaf, Shahzaib Zindani, Emily Huang, Syed Husain, Matthew Kalady, Samilia Obeng-Gyasi, Timothy M Pawlik

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Article in Annals of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Review
  4. Review
  5. Review
  6. Article
  7. Article
  8. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Mujtaba KhalilDepartment of Surgery, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, James Comprehensive Cancer Center, Wexner Medical Center, The Ohio State University, Columbus, OH, USA.
Selamawit WoldesenbetDepartment of Surgery, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, James Comprehensive Cancer Center, Wexner Medical Center, The Ohio State University, Columbus, OH, USA.
Zayed RashidDepartment of Surgery, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, James Comprehensive Cancer Center, Wexner Medical Center, The Ohio State University, Columbus, OH, USA.
Abdullah AltafDepartment of Surgery, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, James Comprehensive Cancer Center, Wexner Medical Center, The Ohio State University, Columbus, OH, USA.
Shahzaib ZindaniDepartment of Surgery, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, James Comprehensive Cancer Center, Wexner Medical Center, The Ohio State University, Columbus, OH, USA.
Emily HuangDepartment of Surgery, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, James Comprehensive Cancer Center, Wexner Medical Center, The Ohio State University, Columbus, OH, USA.
Syed HusainDepartment of Surgery, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, James Comprehensive Cancer Center, Wexner Medical Center, The Ohio State University, Columbus, OH, USA.
Matthew KaladyDepartment of Surgery, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, James Comprehensive Cancer Center, Wexner Medical Center, The Ohio State University, Columbus, OH, USA.
Samilia Obeng-GyasiDepartment of Surgery, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, James Comprehensive Cancer Center, Wexner Medical Center, The Ohio State University, Columbus, OH, USA.
Timothy M PawlikDepartment of Surgery, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, James Comprehensive Cancer Center, Wexner Medical Center, The Ohio State University, Columbus, OH, USA. tim.pawlik@osumc.edu.ORCID http://orcid.org/0000-0002-7994-9870

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAllostatic load (AL) is a composite measure of the physiological damage caused by socioenvironmental stressors. We sought to investigate the association between AL, social vulnerability index (SVI), and postoperative outcomes following colorectal cancer (CRC) surgery. PATIENTS AND

methodsIndividuals who underwent surgery for CRC between 2022 and 2024 were identified using the Epic Cosmos database. AL is calculated on the basis of ten biomarkers from four physiological systems (cardiovascular, metabolic, renal, immune). Multivariable regression models were utilized to examine the association between AL and postoperative outcomes.

resultsAmong 40,520 individuals, mean patient age was 67.7 years (SD ±13.9), roughly half of the patients were male (n = 20,573; 50.8%), and patients generally had a high Charlson comorbidity index score (CCI > 2; n = 33,132; 81.8%). Overall, 7.1% (n = 2897) of patients had a high AL. Notably, AL increased with increasing SVI (ref: low; medium: 1.10 [95% CI 1.01-1.20]; high: 1.17 [95% CI 1.07-1.28]). High AL was associated with a 48% increased risk of postoperative complications (OR 1.48; 95% CI 1.38-1.58), a 79% increased risk of an extended length of stay (OR 1.79; 95% CI 1.67-1.90), and a twofold (OR 2.13; 95% CI 1.90-2.37) increase in the risk of mortality within 30 days of surgery.

conclusionsIndividuals with CRC living in socially vulnerable neighborhoods experience high physiological damage and are at a higher risk of postoperative complications and mortality. Therefore, patients from socially vulnerable neighborhoods may require preoperative screening and optimization to mitigate disparities in surgical outcomes.

Indexed as

AllostasisColorectal NeoplasmsPostoperative ComplicationsAgedFemaleFollow-Up StudiesHumansMaleMiddle AgedPrognosisRisk FactorsSurvival RateAllostatic loadColorectal cancerSocial vulnerabilitySurgical outcomes

Identifiers

PMID40544205
PMCPMC12454506

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.