Evidence mapPaperPMID 40833537Full record

ArticleAnnals of surgical oncology2026

Impact of Social Vulnerability and Allostatic Load on Postoperative Outcomes.

Mujtaba Khalil, Selamawit Woldesenbet, Jasmine King, Shreya Shaw, Zayed Rashid, Abdullah Altaf, Shahzaib Zindani, Samilia Obeng-Gyasi, Timothy M Pawlik

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Article in Annals of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

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3citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

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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.

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3 · Its place in the literature

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3 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Mujtaba KhalilDepartment of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA.
Selamawit WoldesenbetDepartment of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA.
Jasmine KingDepartment of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA.
Shreya ShawDepartment of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA.
Zayed RashidDepartment of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA.
Abdullah AltafDepartment of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA.
Shahzaib ZindaniDepartment of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA.
Samilia Obeng-GyasiDepartment of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA.
Timothy M PawlikDepartment of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, 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

backgroundWe sought to investigate the association between allostatic load (AL), social vulnerability, and postoperative outcomes following hepatopancreatobiliary (HPB) cancer surgery.

methodsIndividuals who underwent HPB surgery were identified using the Epic Cosmos database. AL was calculated based on 10 biomarkers across four physiological systems: cardiovascular, metabolic, renal, and immune. Multivariable regression models were used to examine the association between AL, postoperative outcomes, and failure to rescue (FTR).

resultsAmong 34,253 individuals, mean patient age was 71 years (interquartile range 63-78). Approximately half of patients were male (n = 18,045, 52.7%) and had a high Charlson Comorbidity Index (CCI) score (CCI >2; n = 29,246, 85.4%). The most common cancer site was the pancreas (n = 21,402, 62.5%), followed by the liver (n = 8451, 24.7%) and the biliary tract (n = 4400, 12.8%). Overall, 13.8% (n = 4717) of patients had high AL. On multivariable analysis, the risk of allostasis increased stepwise with higher social vulnerability (reference: low; medium: odds ratio [OR] 1.11, 95% confidence interval [CI] 1.04-1.19; high: OR 1.17, 95% CI 1.11-1.17). Moreover, high AL was associated with a 44% increased risk of Clavien-Dindo grade IV complications (OR 1.44, 95% CI 1.36-1.54) and an 85% increased risk of FTR (OR 1.85, 95% CI 1.60-2.13). In addition, the risk of 30-day mortality was approximately twofold higher with elevated AL (OR 1.92, 95% CI 1.70-2.19).

conclusionIndividuals residing in socially vulnerable areas experience socioeconomic stressors that contribute to long-term physiological damage, resulting in worse outcomes following surgery.

Indexed as

AllostasisLiver NeoplasmsPancreatic NeoplasmsPostoperative ComplicationsVulnerable PopulationsAgedFemaleFollow-Up StudiesHumansMaleMiddle AgedPrognosisSurvival RateAllostatic loadHepatopancreatobiliary surgerySocial vulnerabilitySurgical outcomes

Identifiers

PMID40833537
PMCPMC12765727

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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 Socratic graph.