Geriatric assessment-integrated prediction model for postoperative deep vein thrombosis in older adults undergoing transurethral resection of the prostate: retrospective cohort study.

Background: Postoperative deep vein thrombosis (DVT) is an important complication in older patients undergoing transurethral resection of the prostate (TURP). Although associations between geriatric vulnerability and thrombosis are established, these domains are not routinely integrated into TURP-specific risk assessment. We therefore evaluated whether preoperative geriatric assessment (GA) domains add predictive information to age-adjusted D-dimer in this setting. Methods: In this retrospective single-center cohort ( Results: The perioperative DVT incidence was 11.19% (47/420). In the internal validation cohort, the primary integrated LR model achieved an AUC of 0.750 (95% CI: 0.557-0.903), a precision-recall AUC of 0.457, and a Brier score of 0.081. Compared with the D-dimer-only clinical model, the integrated model showed improvements in NRI (0.893, 95% CI: 0.360-1.345; Conclusions: A TURP-specific model combining preoperative age-adjusted D-dimer with geriatric assessment domains showed preliminary value for postoperative DVT risk stratification. Because the study was retrospective, single-center, and based on only 47 events, the findings should be considered exploratory and require prospective external validation before clinical implementation.