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A Practical Guide to Haemostasis


The Khorana Score

Introduction

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. The study was a multicentre prospective observational study of 2701 cancer outpatients receiving chemotherapy and the risk model was subsequently validated in an independent cohort of 1365 patients from the same study.
The study identified five predictive variables from a multivariate model and these are summarised below:

The KHORANA Score:



Select Criteria:

Patient Characteristics Score
Site of Cancer
Very High Risk
[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 Point

Score

[Max Score 6 Points]

Interpretation
Score VTE Risk Category
≥ 3 Points High risk score
  VTED Rate 7.1%
1- 2 Points Intermediate risk score
  VTED Rate 1.8%
0 Points Low risk score
  VTED Rate 0.8%


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