Association of the Geriatric‐8 Score With In‐Hospital Mortality in Older Patients Undergoing Endoscopic Retrograde Cholangiopancreatography

INTRODUCTION: With an aging population, endoscopic retrograde cholangiopancreatography (ERCP) is increasingly performed in older patients; however, conventional risk stratification tools may not adequately capture geriatric vulnerability. We aimed to evaluate whether the Geriatric-8 (G8) screening tool predicts in-hospital mortality in older patients undergoing ERCP. METHODS: This retrospective, single-center study included 201 hospitalized patients aged ≥ 75 years who underwent ERCP between January 2023 and September 2024. The G8 score was assessed during the first ERCP. The primary outcome was in-hospital mortality. Receiver operating characteristic (ROC) analysis determined the G8 cutoff value, and logistic regression was used to examine the association between a low G8 score and in-hospital mortality. RESULTS: Patients who died during hospitalization had significantly lower G8 scores than survivors (p = 0.004). The ROC analysis demonstrated an area under the curve of 0.769, with a cutoff G8 score of 10. In-hospital mortality was significantly higher in the low-G8 group than in the high-G8 group (10.2% vs. 0.9%, p < 0.001). In multivariable logistic regression models adjusted for one clinically relevant confounder at a time, a low G8 score (≤ 10) was associated with in-hospital mortality. CONCLUSION: G8 may help identify vulnerable older patients undergoing ERCP who are at increased risk of in-hospital mortality.