Khorana et al identified risk factors for venous thromboembolism in a patient with cancer starting chemotherapy. This can help identify a patient who may require closer monitoring or additional therapy to reduce the risk of this complication. The authors are from the University of Rochester in Rochester, New York.
NOTE: The authors did not create a risk score. The score below is one way to use the data included in the paper.
Parameters:
(1) platelet count prior to chemotherapy
(2) site of cancer
(3) use of WBC growth factor (granulocyte colony stimulating factor, CSF)
(4) hemoglobin and erythropoietin therapy
|
Parameter |
Finding |
Points |
|
platelet count prior to chemotherapy |
< 350,000 per µL |
0 |
|
|
>= 350,000 per µL |
3 |
|
site of cancer |
upper GI tract (gastric, pancreas, hepatobiliary) |
4 |
|
|
lung |
2 |
|
|
other |
0 |
|
use of WBC CSF |
absent |
0 |
|
|
present |
2 |
|
hemoglobin and erythropoietin |
hemoglobin >= 10 g/dL AND erythropoietin not used |
0 |
|
|
hemoglobin < 10 g/dL OR erythropoietin therapy |
2 |
where:
• The points assigned in the table are based on the odds ratios shown in Table 3, rounded to an integer.
• The hemoglobin may be at any time, rather than the level prior to chemotherapy.
total score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 0
• maximum score: 13 (if the patient has multiple cancers)
• The higher the score the greater the risk of venous thromboembolism.
Limitation:
• The score needs to be validated.
Purpose: To evaluate a cancer patient starting chemotherapy for the risk of venous thromboembolism as reported by Khorana et al.
Specialty: Hematology Oncology, Clinical Laboratory
Objective: risk factors
ICD-10: C00-D49,
