Development and validation of a nomogram for predicting postoperative lower extremity deep vein thrombosis in patients with traumatic spinal fractures: a retrospective study

Background: Patients undergoing surgery for traumatic spinal fractures are at high risk for postoperative venous thromboembolism (VTE), with deep vein thrombosis (DVT) incidence approaching 20% despite standard prophylaxis. This highlights the need for enhanced and specialized risk stratification. We aimed to develop and internally validate a preoperative prediction model for postoperative lower extremity DVT in this population. Methods: ultrasonography. Predictors were identified from 29 candidate variables through univariate analysis, followed by stepwise multivariable logistic regression. Model performance was evaluated using discrimination (area under the receiver operating characteristic curve, AUC), calibration (calibration plot, Hosmer-Lemeshow test), and clinical utility (decision curve analysis, DCA). A nomogram was constructed for visualization. Results: > 0.7), high sensitivity (90.5-91.2%), and moderate specificity (74.3-74.5%). DCA confirmed its clinical utility across a wide range of threshold probabilities. Conclusion: This study developed and validated a novel preoperative nomogram for predicting postoperative DVT in patients undergoing surgery for traumatic spinal fractures. Incorporating six readily accessible variables, this tool enables individualized risk stratification and may inform targeted prophylactic strategies.