Abstract
Introduction: Khorana score (KS) stratifies patients into low, intermediate, and high risk groups for venous thromboembolism (VTE). We examined the generalizability of the KS to risk of VTE and association with mortality.Methods: A retrospective cohort study was conducted at Mount Auburn Hospital, Cambridge, Massachusetts. Patients aged 18 years or older undergoing chemotherapy were included. All patients were evaluated for a six-month period. Primary study endpoints were VTE or mortality.Results: Some 277 participants were included with a mean age of 63.95 (standard deviation, SD ± 12.47). The incidence proportion was 6.13% and a total of 17 VTE events were reported over a 2.5-year period. Compared to those with a low KS (0), those with a high KS (3 or above) had 6.4 times (p=0.032) while with an intermediate KS (1-2) had 2.6 times the odds of having a VTE event (p=0.22).Those who had a VTE had 4.03 times the odds of death compared to those who did not have a VTE (p=0.006). Compared to those with a low KS, those with a high KS had 5.7 times (p=0.02) the odds of six-month mortality and 5.04 odds (p=0.001) of mortality at any time.Conclusion: High KS was associated with increased odds of VTE and mortality in our study.
Highlights
Khorana score (KS) stratifies patients into low, intermediate, and high risk groups for venous thromboembolism (VTE)
For example pancreatic cancer is reported to be associated with 22%-36% risk of having a VTE [4]
De-identified data collected during the study included patient characteristics, past medical history, characteristics of cancer
Summary
Khorana score (KS) stratifies patients into low, intermediate, and high risk groups for venous thromboembolism (VTE). Venous thromboembolism (VTE) is one of the major causes of morbidity, and the second most frequent cause of death in a cancer population [1,2]. Cancer patients are at a more than four times greater risk of thrombosis as compared to the general population [3]. For example pancreatic cancer is reported to be associated with 22%-36% risk of having a VTE [4]. Patients with both cancer and VTE have an up to eight-fold greater risk of death as a result of a thrombotic event compared to patients without cancer [5]. While there is significant evidence supporting the relationship between cancer and thrombosis in the literature, the pathophysiology remains unclear [5]
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