Exploratory analysis of allostatic load and mortality in patients with hepatocellular carcinoma

We conducted a secondary analysis of 139 adults with HCC at two hospitals in Indianapolis (2019-2022). AL was calculated from six physiologic biomarkers, with scores ≥ 3 indicating high AL. HL and cumulative social disadvantage were measured using validated tools. Higher AL (HR 1.27; 95% CI 1.05-1.55) and lower HL (HR 1.83; 95% CI 1.10-3.05) were independently associated with mortality. After adjustment, AL remained significant but was attenuated when HL was included. Stratified analyses showed that AL predicted mortality only among patients with high HL. These exploratory findings suggest AL may help identify higher-risk patients, warranting validation in prospective, multi-center studies.