| Title: | Biological aging increases risk of postoperative morbidity and mortality: an international, multi-cohort study |
| Journal: | npj Aging |
| Published: | 4 Jul 2026 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/42401606/ |
| DOI: | https://doi.org/10.1038/s41514-026-00441-2 |
| URL: | https://www.nature.com/articles/s41514-026-00441-2_reference.pdf |
Publication 20434
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Abstract
Biological age often diverges from chronological age, yet its independent impact on surgical outcomes remains poorly defined. We evaluated PhenoAge, a validated biological age metric, in an international multi-cohort study comprising over 430,000 surgical patients across the UK, USA, and South Korea. In the UK Biobank (N = 291,845), PhenoAge was a robust, independent predictor of 1-year mortality (OR 1.043; p < 0.001), major adverse cardiovascular events (OR 1.041; p < 0.001), and 30-day readmission (OR 1.02; p < 0.001), even after adjusting for chronological age, Fried Frailty Index, Charlson comorbidity score, American Society of Anesthesiologists (ASA) physical status, surgical complexity, and other common surgical risk factors. "Fast Agers" faced a 49% higher risk of mortality than "Normal Agers". The main findings were replicated across three independent international cohorts (MOVER OR 1.03; Weill Cornell OR 1.036; INSPIRE OR: 1.05; all p < 0.001), and validated prospectively at a large academic medical center, where PhenoAge predicted acute 3-day complications (OR 1.20; p = 0.015). As a scalable tool leveraging routine laboratory data, PhenoAge facilitates precision gerisurgery by identifying high-risk individuals for prehabilitation and biologically resilient candidates for complex procedures regardless of chronological age.</p>
4 Authors
- Joseph R. Scarpa
- M. Cary Reid
- Olivier Elemento
- Jan Krumsiek
1 Application
| Application ID | Title |
|---|---|
| 47137 | Polygenic Risk Score and Clinical Information Integration for Disease Prediction |
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