The effects of allostatic load on patients undergoing surgery: a systematic review
Abstract
Introduction: Allostatic load (AL) is a measure of physiologic adaptation to repetitive environmental stressors and is associated with poor health outcomes and chronic conditions, ranging from cardiovascular disease and type 2 diabetes to malignancy. Given the acute rise in physiologic stress that accompanies surgically induced trauma, AL has the potential to affect surgical outcomes, particularly for the invasive, complex, lengthy procedures common in surgical oncology. The aims of this study were to systemically review existing literature surrounding AL and surgery, and to contextualize these findings accordingly.
Methods: A systematic review was conducted in May 2024 via PubMed, Embase, Cochrane, Web of Science, and PsycINFO to identify existing literature on AL and surgery. Study quality and sources of bias were assessed via the Mixed Methods Appraisal Tool. Data from original studies were extracted and compiled, and a similar process was repeated for related review articles.
Results: A total of 10 original research studies explored the relationship between AL and surgical topics. Eight of these studies attempted to quantify AL as either a numerical composite index or via single or multiple representative biomarkers. AL emerged as (1) a specific predictor of surgical outcomes and (2) an explanatory mechanism for racial and socioeconomic disparities in surgical populations, as AL is known to be increased in socially disadvantaged individuals. Four of 10 included studies…
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Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
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