Abstract

Purpose: Venous Thromboembolism is a common and frequent complication seen in active cancer patients. The Khorana Risk Score (KRS) is a simple model which helps to guide selection of high risk VTE cancer patients for thromboprophylaxis. However very little information is available on Khorana score validation in low middle incomecountries; hence we aimed to evaluate its performance.

Patients and methods: A retrospective single center study utilizing data of 150 cancer patients with either symptomatic deep venous thrombosis (DVT) and/or pulmonary embolism (PE) from January 1, 2012 to Dec 31, 2017.The primary efficacy outcome was to validate Khorana Risk Score in our population.

Results: Overall, 32.7% of these patients had a low Khorana Risk Score of 0 point, 48% of patients had intermediate KRS of 1 or 2 points, and only 19.3% of patients had a high KRS of 3 or more points. We also looked at additional variables i.e. mean difference in albumin (g/dL) in the three Khorana Risk Score category which was statistically significant i.e. 3.88 g/dL ± 0.52 in low risk, 3.58 g/dL ± 0.65 in intermediate risk and 3.15 g/dL ± 0.85 in high risk [p<0.001]. Similarly the mean age difference was also significantly different in intermediate and high risk. We also looked at metastasis status, chemotherapy status and creatinine clearance in these patients but found they were statistically insignificant.

Summary: Our study showed that Khorana Risk Score tool was only able to risk stratify 19.3% of cancer patients in high risk category who would have benefitted from thromboprophylaxis. We recommend the development of a modified risk prediction model best adapted to local needs.