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Comprehensive geriatric assessment (CGA) can inform treatment decisions, but has not yet been evaluated in older patients eligible for pancreatic surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This prospective observational study included patients \u2265\u200970 years of age eligible for pancreatic surgery. Frailty was defined as impairment in at least two of five domains: somatic, psychological, functional, nutritional, and social. Outcomes included postoperative complications, functional decline, and mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 88 patients included, 87 had a complete CGA. Sixty\u2010five patients (75%) were frail and 22 (25%) were non\u2010frail. Frail patients were more likely to receive nonsurgical treatment (43.1% vs. 9.1% <jats:italic>p<\/jats:italic>\u2009=\u20090.004). Fifty\u2010seven patients underwent surgery, of which 52 (59%) underwent pancreaticoduodenectomy. The incidence of postoperative delirium was three times higher in frail patients (29.7% vs. 0%, <jats:italic>p<\/jats:italic>\u2009=\u20090.005). The risk of mortality was three times higher in frail patients (HR: 3.36, 95% CI: 1.43\u20137.89, <jats:italic>p<\/jats:italic>\u2009=\u20090.006).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Frailty is common in older patients eligible for pancreatic surgery and is associated with treatment decision, a higher incidence of delirium and a three times higher risk of all\u2010cause mortality. CGA can contribute to shared decision\u2010making and optimize perioperative care in older patients.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jso.27862","type":"journal-article","created":{"date-parts":[[2024,9,18]],"date-time":"2024-09-18T06:54:20Z","timestamp":1726642460000},"page":"1643-1653","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Comprehensive Geriatric Assessment, Treatment Decisions, and Outcomes in Older Patients Eligible for Pancreatic Surgery"],"prefix":"10.1002","volume":"130","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-4386-4683","authenticated-orcid":false,"given":"Marij","family":"Hartog","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Division of Geriatric Medicine, Erasmus MC University Medical Center Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara J. 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