Nursing-Led Deep Vein Thrombosis Prevention in Neurosurgery

Neurointerdisciplinary Nursing Prevention Strategies for Deep Vein Thrombosis (DVT) After Neurosurgical Procedures: A Multicenter Randomized Controlled Trial and Nomogram Development

The goal of this clinical trial is to see if a nurse-led program (early movement, leg-sleeve squeezes, and blood tests) can prevent dangerous leg blood clots in adults who have just had brain or spine surgery.

Main questions it aims to answer:

• Does the program lower the number of clots within 30 days after surgery?
• Is the program safer and more accurate than the usual clot-risk score nurses already use?

Researchers will compare patients who receive the nurse-led program with patients who receive standard hospital care.

Participants will:

• Be randomly assigned to one of the two groups.
• Have regular leg ultrasounds to check for clots.
• Wear a small activity tracker if they are in the nurse-led group.

Inclusion Criteria

• Age ≥ 18 years
• Any elective or emergency craniotomy, spinal, or other neurosurgical procedure
• Expected post-operative hospital stay ≥ 3 days
• Patient or legally authorized representative willing and able to give written informed consent

Exclusion Criteria

• Pre-operative ultrasound or imaging proven DVT or pulmonary embolism
• Known hereditary bleeding disorder (e.g., hemophilia) or platelet count < 50 × 10⁹/L
• Chronic therapeutic anticoagulation (warfarin, DOAC, heparin) that cannot be safely stopped, or need for full-dose post-op anticoagulation
• Severe liver disease (Child-Pugh class C) or eGFR < 30 mL/min/1.73 m²
• Life-limiting co-morbidity with expected survival < 30 days
• Pregnancy or breastfeeding
• Current participation in another interventional VTE trial