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A Practical Guide to Haemostasis


The Vienna Cancer and Thrombosis Study [CATS] Score

Introduction

The CATS Score is based on the Khorana Score but utilises two additional biomarkers: D-dimer and soluble P-selectin to improve its accuracy.
a. D-dimer is part of the algorithm for a number of risk assessment scores that aid both with the diagnosis of VTED and in the prediction of the risk of VTE recurrence, primarily in non-cancer patients.

b. Soluble P-selectin is a marker of platelet activation and elevated soluble P-selectin has been shown to be highly predictive of VTE when combined with a high clinical probability score.

The CATS Score:


The CATS Score is summarised below:


Select Criteria:

Patient Characteristics Score
Site of Cancer
Very High Risk1
[Stomach/Pancreas]
2 Points
High Risk
Lung/Lymphoma/Gynaecological/
Bladder/Testicular
1 Point
Pre-chemotherapy Platelet Count
≥350 x 109/L
Yes 1 Point
No 0 Points
Haemoglobin <100g/L or use of red cell growth factors
Yes 1 Point
No 0 Points
Pre-Chemotherapy White Cell Count
>11.0 x 109/L
Yes 1 Point
No 0 Points
BMI ≥35kg/m2
Yes 1 Point
No 0 Points
D-dimer ≥1.44µg/mL
Yes 1 Point
No 0 Points
Soluble P-selectin ≥53.1mg/mL
Yes 1 Point
No 0 Point

1In the Vienna VTE Risk Assessment Score, brain tumours [high grade glioma] were allocated to the 'very high risk' site of cancer

 


Score

[Max Score 8 Points]

Interpretation
Score VTE Rate
 0 Points  1%
 1 Point  4.4%
 2 Points  3.5%
 3 Points  10.3%
 4 Points  20.3%
 ≥ 5 Points  35%


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