Risk stratification for the development of venous thromboembolism in hospitalized patients with cancer

Essentials

• The Khorana score is validated for risk of venous thromboembolism (VTE) in cancer outpatients.
• We conducted a multicenter analysis of medically hospitalized cancer patients.
• Patients with a higher Khorana score on admission were more likely to develop VTE.
• The Khorana score is predictive of in‐hospital, symptomatic VTE development.

Summary

Introduction

The Khorana score is a validated risk assessment score for estimating the risk of symptomatic venous thromboembolism (VTE) in outpatients with cancer. The objective of this study was to assess the Khorana score for predicting the development of VTE in cancer patients during hospital admission.

Methods

We conducted an analysis of consecutive, adult cancer patients hospitalized for medical reasons between January and June 2010 in three academic medical centers. Information on objectively diagnosed, symptomatic VTE during hospitalization, use of anticoagulant thromboprophylaxis (TP) and Khorana score variables at the time of admission was collected.

Results

A total of 1398 patients were included. Mean age was 62 years, 51.2% were male, and mean BMI was 25.9 kg m^?2. The most frequent reasons for hospitalization were chemotherapy administration (22.3%), followed by pain control and palliation (21.4%). The overall incidence of VTE was 2.9% (95% CI, 2.0–3.8%), occurring in 5.4% (95% CI, 1.9–8.9%) of the high‐, 3.2% (95% CI, 2.0–4.4%) of the intermediate‐ and 1.4% (95% CI, 0.3–2.6%), of the low‐risk groups. High‐risk patients were more likely than low‐risk patients to have VTE (OR, 3.9; 95% CI, 1.4–11.2).

Conclusion

The Khorana score is predictive of in‐hospital, symptomatic VTE development in cancer patients who are hospitalized for medical reasons and may be a useful tool for tailoring inpatient anticoagulant thromboprophylaxis.