Biological Age Predicts 90-Day Mortality in Advanced Cancer

Ankara Etlik City Hospital1,615 enrolled

Overview

This retrospective study evaluates whether biological age, calculated using the PhenoAge model, predicts short-term outcomes in patients with advanced cancer who were hospitalized. The main goal is to investigate associations between biological age and short-term mortality, functional status (ECOG), comorbidity burden (mCCI), and length of hospital stay. All data were collected from medical records without any patient intervention.

This is a retrospective observational study including hospitalized adult patients with stage III or IV solid tumors admitted to Etlik City Hospital between November 5, 2022 and December 31, 2024. Patients were included if they stayed for ≥48 hours and had all required laboratory values for calculating biological age using the Levine PhenoAge model. The study aimed to evaluate the association between biological age and (1) 30- and 90-day mortality, (2) ECOG performance score, (3) modified Charlson Comorbidity Index (mCCI), and (4) hospital length of stay. Regression and survival analyses were used to identify prognostic factors. All data were anonymized and collected retrospectively from hospital records.

Study Type

OBSERVATIONAL

Enrollment

1,615

Conditions

Advanced Solid Tumors Cancer Hospitalizations

Interventions

PhenoAge-Based Biological Age AssessmentOTHER

Biological age was retrospectively calculated using the PhenoAge algorithm, based on nine routine laboratory parameters and chronological age. This model estimates phenotypic aging and was used to predict short-term outcomes including mortality, functional status, comorbidity burden, and hospital length of stay. No new intervention was administered; all data were collected from existing medical records.

Eligibility

Sex: ALL

Medical Language ↔ Plain English

Inclusion Criteria: * Hospitalized in the Medical Oncology Department between November 5, 2022, and December 31, 2024 Histologically confirmed advanced-stage (stage III-IV) solid tumors Age ≥18 years Hospital stay of at least 48 hours Actively receiving chemotherapy or received it within the last 6 months Availability of all 9 required laboratory tests (albumin, creatinine, glucose, CRP, lymphocyte %, MCV, RDW, ALP, WBC) for PhenoAge calculation during the first admission Patients with multiple hospitalizations who meet the inclusion criteria will be included Exclusion Criteria: * Elective hospitalizations (e.g., planned chemotherapy, biopsy) Patients who died during the first admission Missing required laboratory parameters ICU patients and unconscious patients

Locations (1)

Etlik City Hospital

Ankara, Yenimahalle, Turkey (Türkiye)

Outcomes

Primary Outcomes

90-Day All-Cause Mortality

All-cause mortality within 90 days following the date of hospital admission (index hospitalization).

Time frame: Up to 90 days post-admission

Secondary Outcomes

Modified Charlson Comorbidity Index (mCCI)

The Modified Charlson Comorbidity Index (mCCI) is a validated scoring system used to quantify comorbidity burden. It includes 19 comorbid conditions with weighted values and incorporates age adjustment. Scores range from 0 to 33. In this study, age points are added only for patients aged 50 years and above: +1 point for ages 50-59, +2 for 60-69, +3 for 70-79, and +4 for ≥80. Higher mCCI scores indicate greater comorbidity burden and are associated with poorer clinical outcomes. The score is calculated retrospectively from documented diagnoses in the medical records at baseline.

Time frame: Baseline (Day of hospital admission)

Data from ClinicalTrials.gov

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