Validation of the Caprini risk assessment model and efficacy of perioperative nutritional support + preventive nursing in reducing DVT among high-risk older adults undergoing hip fracture surgery: a two-phase study

Objective To evaluate the predictive accuracy of the original Caprini risk assessment model for postoperative deep venous thrombosis (DVT) in older adult patients with hip fractures and to assess the effect of perioperative nutritional support combined with preventive nursing on nutritional status and DVT incidence. Methods A total of 112 older adult patients with hip fractures who underwent surgical treatment were included. Patients were retrospectively categorized as DVT ( n = 38) or non-DVT ( n = 74) groups for Phase 1 analysis. For Phase 2, all patients were prospectively randomized into a control or intervention group ( n = 56 each). The predictive accuracy of the original Caprini scale was analyzed using receiver operating characteristic (ROC) curves. The intervention group received preventive nursing (based on original Caprini scores) and perioperative nutritional support, while the control group received routine care. Nutritional status, functional outcomes, DVT incidence, and satisfaction were compared. Results The original Caprini score was higher in the DVT group ( p < 0.05). Using the original classification (low: 0–1, moderate: 2, high: 3–4, highest: ≥5), the proportion of patients in the “highest risk” category (≥5) was significantly higher in the DVT group (94.74%) than in the non-DVT group (70.27%) ( p < 0.05). The AUC was 0.724 (95% CI: 0.657–0.791; p < 0.001). Postoperatively, the intervention group showed superior nutritional biomarkers (ALB, PA, Hb), shorter time to mobilization and hospital stay, better hip function (Harris score) and quality of life (SF-36), a lower DVT incidence ( p < 0.05), and higher nursing satisfaction ( p < 0.05). Conclusion The Caprini risk assessment model demonstrates predictive value for DVT risk in this population. The combined intervention of perioperative nutritional support and preventive nursing improves nutritional status, functional recovery, and reduces DVT incidence.