["Geriatrics &Gerontology International, Volume 26, Issue 6, June 2026. ", "\nLow G8 scores were associated with increased in‐hospital mortality in older patients undergoing ERCP, whereas ERCP‐related adverse events were not increased. G8 may help identify vulnerable older patients undergoing ERCP who require closer peri‐procedural monitoring and multidisciplinary supportive care.\n\nABSTRACT\n\nIntroduction\nWith 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.\n\n\nMethods\nThis 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.\n\n\nResults\nPatients 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.\n\n\nConclusion\nG8 may help identify vulnerable older patients undergoing ERCP who are at increased risk of in‐hospital mortality.\n\n"]