Key result
Higher biological age via PhenoAge is linked to ~4% increased 1-year postoperative mortality per year.
Why the study?
Biological age often diverges from chronological age, but its independent impact on surgical outcomes remains poorly defined.
Does biological aging, as measured by PhenoAge, predict postoperative morbidity and mortality in surgical patients independent of chronological age?
Cohort (n=416,839)
Yes
Does biological aging, as measured by PhenoAge, predict postoperative morbidity and mortality in surgical patients independent of chronological age?
Odds Ratio: 1.043 (95% CI 1.039–1.047)
p-value: p=<0.001
Biological age, measured by the PhenoAge metric, is a robust and independent predictor of postoperative mortality and morbidity across diverse international cohorts, outperforming chronological age in risk stratification.
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.
No takes yet. Share an insight, caveat, or question.
Scarpa et al. (2026) conducted a cohort in Surgical patients (non-emergent procedures) (n=416,839). PhenoAge (biological age) vs. Chronological age / Normal Agers was evaluated on 1-year postoperative mortality (OR 1.043, 95% CI 1.039-1.047, p=<0.001). Higher biological age, measured by PhenoAge, was independently associated with an increased risk of 1-year postoperative mortality (OR 1.043 per year) across multiple international cohorts.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: