de Winter et al reported a score for evaluating a patient with cancer-associated thrombosis being treated with anticoagulants. The score can help to identify a patient at risk for bleeding. The authors are from multiple institutions in Europe.
Patient selection: history of cancer-associated thrombosis being treated with anticoagulants
Parameters:
(1) regionally advanced or metastatic cancer
(2) genitourinary tumor
(3) creatinine clearance in mL per minute
(4) chemotherapy in the past 4 weeks with a drug that causes gastrointestinal toxicity
(5) gastrointestinal cancer AND edoxaban therapy
(6) age in years
Parameter
Finding
Points
advanced or metastatic
no
0
yes
0.194
GU cancer
no
0
yes
0.908
creatinine clearance
-0.005 * (clearance)
chemo with GI toxicity
no
0
yes
0.55
GI cancer and edoxaban
no
0
yes
0.787
age in years
<= 75 years
0
> 75 years
0.027
value of X =
= SUM(points for all of the parameters) + 0.128
probability of being free of clinically relevant bleeding for 6 months =
= 1 - (0.128^EXP(X))
Performance:
• The area under the ROC curve is 0.61, which is suboptimal.
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