Khorana Risk Score for Venous Thromboembolism in Cancer Patients online calculator

Khorana Risk Score for Venous Thromboembolism in Cancer Patients online calculator

Khorana Risk Score for Venous Thromboembolism in Cancer Patients predicts risk of VTE for cancer patients depending on type of cancer and other factors.

This score system available to use in general cancer patients starting chemotherapy (i.e., solid tumors and lymphomas).

Please, note!

  • Do not use this score system in patients with brain tumors or myelomas.
  • The assessment based on this scale not intended to be used for diagnosis (i.e., clinical suspicion of DVT or PE) but to predict future risk of VTE.

Cancer type:
Stomach
Pancreas
Lung
Lymphoma
Gynecologic
Bladder
Testicular
Other

Pre-chemotherapy platelet count ≥350×10⁹/L:
Yes
No
Hemoglobin level <10 g/dL or using RBC growth factors:
Yes
No
Pre-chemotherapy leukocyte count >11×10⁹/L:
Yes
No
BMI ≥35 kg/m²:
Yes
No



Patient’s score Risk Group Score range 2.5-month rate of VTE
0 0 0 0

Based on Khorana Risk Score for Venous Thromboembolism cancer patients categorizes on the VTE risk.

Most validations of Khorana Risk Score for Venous were completed in outpatients settings with higher risk cancer patients.

Predicting VTE in cancer patients is complicated and likely improved by a scoring system.

Cancer typeStomach+2
 Pancreas+2
 Lung+1
 Lymphoma+1
 Gynecologic+1
 Bladder+1
 Testicular+1
 Other+2
Pre-chemotherapy platelet count ≥350×10⁹/L+1
Hemoglobin level <10 g/dL or using RBC growth factors+1
Pre-chemotherapy leukocyte count >11×10⁹/L+1
BMI ≥35 kg/m²+1

Score interpretation

Addition of selected points.

Risk GroupScore2.5-month rate of VTE
Low00.3 – 0.8%
Intermediate1 – 21.8 – 2.0%
High≥36.7 – 7.1%

If high, the clinician seeing the patient is alerted, and a lower extremity ultrasound for early detection of DVT is suggested.

The main goal of Khorana Risk Score for Venous Thromboembolism in Cancer Patients is to improve understanding of risk prediction and to focus on at-risk patients with strategies for early detection or prophylaxis.

Literature:
Khorana AA, et al. Development and validation of a predictive model for chemotherapy-associated thrombosis. Blood 2008;111:4902-7 (https://ashpublications.org/blood/article/111/10/4902/24209/Development-and-validation-of-a-predictive-model )
Dutia M, et al. Risk Assessment Models for Cancer-Associated Venous Thromboembolism. Cancer 2012;118:3468-76 (https://pubmed.ncbi.nlm.nih.gov/22086826/)
Lyman GH, et al. Venous thromboembolism prophylaxis and treatment in patients with cancer: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol. 2013 Jun 10;31(17):2189-204. doi: 10.1200/JCO.2013.49.1118. Epub 2013 May 13 (https://pubmed.ncbi.nlm.nih.gov/25873061/)
Khorana AA, Soff GA, Kakkar AK, et al. Rivaroxaban for Thromboprophylaxis in High-Risk Ambulatory Patients with Cancer. N Engl J Med. 2019;380(8):720-728 (https://www.nejm.org/doi/full/10.1056/NEJMoa1814630) Carrier M, Abou-nassar K, Mallick R, et al. Apixaban to Prevent Venous Thromboembolism in Patients with Cancer. N Engl J Med. 2019;380(8):711-719 (https://www.nejm.org/doi/full/10.1056/NEJMoa1814468)

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Charlson Comorbidity Index (CCI) Online Calculator

Charlson Comorbidity Index predicts 10-year survival in patients with multiple comorbidities.

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History of definite or probable MI (EKG changes and/or enzyme changes)

Exertional or paroxysmal nocturnal dyspnea and has responded to digitalis, diuretics, or afterload reducing agents

Intermittent claudication or past bypass for chronic arterial insufficiency, history of gangrene or acute arterial insufficiency, or untreated thoracic or abdominal aneurysm (≥6 cm)

History of a cerebrovascular accident with minor or no residua and transient ischemic attacks

Chronic cognitive deficit

Any history of treatment for ulcer disease or history of ulcer bleeding

Severe = cirrhosis and portal hypertension with variceal bleeding history, moderate = cirrhosis and portal hypertension but no variceal bleeding history, mild = chronic hepatitis (or cirrhosis without portal hypertension)

Severe = on dialysis, status post kidney transplant, uremia, moderate = creatinine >3 mg/dL (0.27 mmol/L)


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