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A Practical Guide to Haemostasis


VTE Risk Assessment Scores in Cancer Patients

Introduction

Venous Thromboembolic Disease [VTED]) is common in patients with an underlying malignancy and can lead to significant morbidity and an increased morality. However, the management of VTED in this group of patients and the identification of patients who may benefit from thromboprophylaxis is complex and a number of clinical risk algorithms have been developed to assist with this.

The Khorana Score


The Khorana Score was the first risk assessment algorithm to stratify a cancer patients' risk of VTED and has been validated in a number of retrospective and prospective studies.

Click HERE to access the Khorana Score.

The Vienna Cancer and Thrombosis Study [CATS]


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 with both the diagnosis of VTED and in predicting 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.

Click HERE to access the CATS Score.

 

Additional Risk Assessment Algorithms

 

A number of additional risk assessment algorithms have been developed to help with the VTED risk stratification of patients with cancer.  These are listed below.  For additional information see References 2 and 3.

The PROTECHT Score


The ONKOTEV Score


The COMPASS-CAT Score

 

The Tic-ONCO Score


The Ottawa Score