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    Patent Pending

    Khorana Risk Score for Venous Thromboembolism in Cancer Patients

    Predicts risk of VTE for cancer patients depending on type of cancer and other factors.
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    INSTRUCTIONS

    Use in general cancer patients (i.e., solid tumors and lymphomas). Do not use in patients with brain tumors or myelomas.

    When to Use
    Pearls/Pitfalls
    Why Use
    • Patients with a general cancer diagnosis (solid tumors and lymphomas) starting chemotherapy.
    • Do not use in patients with brain tumors or myelomas.
    • Categorizes cancer patients for VTE risk.
    • Higher risk cohorts (e.g. inpatients, lower performance scores) have even higher risks than shown.
    • Most validations were completed in outpatients settings with higher risk cancer patients.
    • Not intended to be used for diagnosis (i.e., clinical suspicion of DVT or PE) but to predict future risk of VTE (see Creator Insights for more).

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

    Stomach
    +2
    Pancreas
    +2
    Lung
    +1
    Lymphoma
    +1
    Gynecologic
    +1
    Bladder
    +1
    Testicular
    +1
    Other
    0
    No
    0
    Yes
    +1
    No
    0
    Yes
    +1
    No
    0
    Yes
    +1
    No
    0
    Yes
    +1

    Result:

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    Next Steps
    Evidence
    Creator Insights

    Advice

    The Khorana Risk Score stratifies risk well. In outpatients, VTE risk remains relatively low (~10%) even in the highest score groups.

    Management

    At least one author group has applied a binary version of the Khorana Risk Score in practice, using the result for clinical decision making.

    Critical Actions

    The Khorana Risk Score requires multiple laboratory variables, and it may not stratify as consistently or accurately in higher risk patients and those with cancers not indicated in the score.

    About the Creator
    Dr. Alok Khorana