Accurate prediction of 90-day mortality in hospitalised cancer patients is critical for guiding personalised treatment decisions and optimising oncologic care. However, existing prognostic models often lack sufficient precision, particularly in distinguishing between high- and low-risk patients. In this retrospective study, we independently evaluated the prognostic performance of three scoring systems—the Prognostic Score for Hospitalised Cancer Patients (PROMISE), the Gustave Roussy Immune (GRIm) score, and the C-reactive protein–Triglyceride–Glucose Index (CTI)—in patients admitted for unplanned hospitalisations. This retrospective observational study was conducted at the Medical Oncology Clinic of Ankara Etlik City Hospital, Turkey, and included patients aged 18 years or older with a diagnosis of cancer who were hospitalised unexpectedly between February 2023 and February 2024. Laboratory data were retrieved from the institutional hospital information system. The PROMISE score was calculated using its original specification via the online tool (https://promise.vhio.net/). The GRIm score was calculated based on neutrophil-to-lymphocyte ratio (NLR), albumin, and lactate dehydrogenase (LDH). The CTI score was computed as: CTI = [0.412 × ln (C-reactive protein [CRP])] + ln [Triglyceride × Glucose/2], with a cut-off value of 4.78. A PROMISE–CTI Combined score was derived using regression-based weighting. Risk stratification was performed for all three scores using validated thresholds. Statistical analyses included Kaplan–Meier survival analysis, log-rank tests, univariable and multivariable logistic regression to assess predictors of 90-day mortality, and receiver operating characteristic (ROC) curve analysis to evaluate discriminatory performance. Among 1657 hospitalised cancer patients screened during the study period, 1109 met the inclusion criteria and were included in the analysis. PROMISE and GRIm scores were calculated for all 1109 patients, while CTI score was assessed in 333 patients with complete laboratory data. The 90-day mortality rate was 63.7% (n = 707). High PROMISE score (OR: 3.32, 95% CI: 1.40–7.86; p = 0.006) and high CTI score (OR: 2.85, 95% CI: 1.32–6.18; p = 0.008) were associated with increased 90-day mortality. Low PROMISE score (OR: 0.22, 95% CI: 0.10–0.49; p = 0.001) and low CTI score (OR: 0.35, 95% CI: 0.17–0.73; p = 0.003) were associated with reduced 90-day mortality. High GRIm score (OR: 1.83, 95% CI: 0.83–2.91; p = 0.07) and low GRIm score (OR: 0.73, 95% CI: 0.47–1.20; p = 0.08) were not significantly associated with 90-day mortality. The area under the curve (AUC) of the PROMISE–CTI Combined score was 0.884 (95% CI: 0.849–0.919; p < 0.0001). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of the PROMISE–CTI Combined score were 92.4%, 81.1%, 85.3%, 89.6%, and 86.7%, respectively. The PROMISE score demonstrated strong discriminatory ability in predicting 90-day mortality among cancer patients admitted for unplanned hospitalisations. Integration of the CTI score further improved risk stratification by incorporating nutritional and inflammatory markers. The PROMISE–CTI Combined score may serve as a practical clinical tool for short-term prognostic assessment in this setting. Prospective, multicentre, randomised studies are needed to confirm the clinical utility and generalisability of the PROMISE–CTI Combined score. This study received no funding.

Thyroid dysfunction in older adults often mimics the signs of aging, impacting metabolism and overall physiological balance. While age-related chronic conditions have been extensively studied, the relationship between thyroid function and frailty remains underexplored. This study aimed to evaluate the effects of thyroid dysfunction on frailty among individuals aged 65 years and older. Thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), free thyroxine (fT4), and thyroid peroxidase antibody (anti-TPO) levels were analyzed. The study further examined the correlation between thyroid dysfunction, chronic diseases, sociodemographic factors, and optimal TSH levels in relation to frailty, using the Study of Osteoporotic Fractures (SOF), Edmonton Frail Scale (EFS), and FRAIL scales. This cross-sectional study included 220 older adults with either treated or untreated thyroid dysfunction. Comprehensive geriatric assessments were conducted, including detailed medical histories, sociodemographic data collection, and thyroid function tests. Frailty was assessed using the SOF, EFS, and FRAIL scales. Multivariate logistic regression analyses were performed to identify significant associations between thyroid parameters and frailty. The median age of participants was 73 years, and 68.2% (n = 150) were women. Frailty prevalence was significantly higher in individuals with abnormal TSH levels (outside the 0.5–6 mIU/L range). Lower fT3 levels and the fT3/fT4 ratio were significantly associated with frailty, particularly as assessed by the SOF and EFS scales. In contrast, the FRAIL scale revealed a significant association between increased frailty and lower fT3 levels only. Subgroup analysis indicated that in individuals aged ≥ 80 years, a lower fT3/fT4 ratio was consistently associated with frailty across all frailty scales, whereas in those aged < 80 years, lower TSH levels showed a strong association with frailty as assessed by the FRAIL scale. These findings underscore age-specific variations in the relationship between thyroid function and frailty. This study highlights the significant impact of thyroid dysfunction on frailty in older adults. Lower fT3 levels and the fT3/fT4 ratio emerged as key indicators of increased frailty, particularly on the SOF and EFS scales. Subgroup analysis further emphasized the importance of age-specific assessments, with a lower fT3/fT4 ratio being a critical indicator of frailty in individuals aged ≥ 80 years, while lower TSH levels were significant in those aged < 80 years. Abnormal TSH levels were strongly associated with frailty on the SOF scale, suggesting the need to consider thyroid dysfunction as a modifiable risk factor. Additionally, factors such as age, sex, education, thyroid medication use, and comorbidities influenced frailty status. Incorporating thyroid function tests into frailty assessments could enhance early identification and targeted interventions for at-risk older adults, particularly when age-specific thresholds are applied. To investigate the impact of thyroid function on frailty in geriatric patients using the Edmonton Frail Scale (EFS), Study of Osteoporotic Fractures (SOF) scale, and FRAIL scale. The study identified significant correlations between altered thyroid function parameters and increased frailty scores across the EFS, SOF, and FRAIL scales, highlighting the substantial influence of thyroid dysfunction on geriatric health. Thyroid function plays a critical role in determining frailty status among older adults, emphasizing the need for targeted monitoring and management to improve health outcomes in this population.