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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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Hospitalized Advanced Cancer Patients | Patients hospitalized with advanced solid tumors (Stage III or IV) in the oncology clinic were retrospectively analyzed. Biological age was calculated using the PhenoAge model. Clinical outcomes such as mortality, ECOG score, mCCI, and length of stay were assessed. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| PhenoAge-Based Biological Age Assessment | Other | 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. |
| Measure | Description | Time Frame |
|---|---|---|
| 90-Day All-Cause Mortality | All-cause mortality within 90 days following the date of hospital admission (index hospitalization). | Up to 90 days post-admission |
| Measure | Description | Time Frame |
|---|---|---|
| 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. |
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Inclusion Criteria:
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:
Patients who died during the first admission
Missing required laboratory parameters
ICU patients and unconscious patients
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This study includes adult patients (≥18 years old) with advanced-stage solid tumors who were hospitalized at Etlik City Hospital, Turkey, between November 5, 2022, and December 31, 2024. Only patients with at least 48 hours of hospitalization and complete laboratory data necessary for PhenoAge calculation were included. The study population represents a real-world sample of hospitalized cancer patients at elevated risk of short-term adverse outcomes.
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Etlik City Hospital | Ankara | Yenimahalle | 06210 | Turkey (Türkiye) |
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| Baseline (Day of hospital admission) |