Abstract
OBJECTIVE: To evaluate the effectiveness of early rehabilitation nursing in preventing deep vein thrombosis (DVT) and promoting functional recovery in patients with lower limb traumatic fractures, and to identify independent risk factors for DVT. METHODS: A retrospective cohort study was conducted, including 162 patients treated for lower limb traumatic fractures at Hanzhong Hospital of TCM from January 2022 to December 2023. The control group (n=78) received conventional nursing care prior to January 2023, while the observation group (n=84) received early rehabilitation nursing after January 2023. The control group received routine care, including preoperative education, intraoperative temperature monitoring, and postoperative vital signs monitoring, along with basic guidance for lower limb movement. The observation group received additional personalized early rehabilitation interventions, including tailored preoperative education, psychological support, optimized anesthesia management, advanced postoperative pain control, and progressive lower limb functional exercises. Collected data included baseline characteristics, rehabilitation indicators (e.g., catheter retention time, time to first feeding, and time to first ambulation), postoperative complications, and assessments of pain (Visual Analogue Scale, VAS), quality of life (World Health Organization Quality of Life [WHOQOL]-BREF), and lower limb functional recovery (Fugl-Meyer lower limb function score). Multivariate logistic regression was performed to identify independent risk factors for DVT. RESULTS: There were no significant differences in baseline characteristics between the control and observation groups (all P>0.05). The observation group exhibited significantly lower VAS scores at 7 days postoperatively (P<0.001), along with significantly higher WHOQOL-BREF scores across physical, psychological, social, and environmental domains, and significantly higher Fugl-Meyer lower limb function scores one month after the intervention (P<0.001). Rehabilitation indicators, such as catheter retention time, time to first feeding, time to first ambulation, initiation of exercises, and hospital stay duration, were all shorter in the observation group compared to the control group (all P<0.05). The incidence of DVT was significantly lower in the observation group (P=0.002). Multivariate logistic regression analysis identified nursing intervention (OR=3.086, P=0.024), age ≥60 years (OR=2.589, P=0.043), body mass index (BMI) of 21-25 kg/m(2) (OR=2.444, P=0.037), and catheter retention time ≥19.5 hours (OR=2.401, P=0.061) as independent risk factors for DVT. CONCLUSION: Early rehabilitation nursing is highly effective in preventing DVT and enhancing lower limb functional recovery in patients with traumatic fracture. It significantly reduces rehabilitation time and improves quality of life. Independent risk factors for DVT include nursing protocol, advanced age, BMI, and prolonged catheter retention time, all of which should be prioritized in clinical care.