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Calculator: Khorana score for estimating venous thromboembolism risk in adults with cancer


Calculator: Khorana score for estimating venous thromboembolism risk in adults with cancer

 
Site of primary tumor

Very high risk (stomach, pancreas) (2 points)

High risk (lung, lymphoma, gynecologic, bladder, testicular) (1 point)

All other sites (0 points)
Laboratory results and BMI

Prechemotherapy platelet count ≥350,000/microL [≥350 X 109/L] (1 point)

Hemoglobin level <10 g/dL [<100 g/L] or use of ESAs (1 point)

Prechemotherapy WBC >11,000/microL [≥11 X 109/L] (1 point)

BMI ≥35 kg/m2 (1 point)

 
Important: Inputs must be complete to perform calculation.

 
Total criteria point count:
 

 

Incidence of VTE based on Khorana score

 
Khorana score points Risk Derivation cohort[1] VTE risk after 2.5 months Validation cohort[1] VTE risk after 2.5 months Independent cohort[2] VTE risk after 6 months Patients in phase I trials[3] VTE risk after 2 months
0 Low 0.8% 0.3% 1.5% 1.5%
1 to 2 Intermediate 1.8% 2% 3.8% (1 point); 9.6% (2 points) 4.8%
3 to 6 High 7.1% 6.7% 17.7% 12.9%

 
Notes
  • The Khorana score was developed from a cohort of 2701 patients with cancer receiving a first course of chemotherapy to predict the cumulative incidence of VTE at 2.5 months.[1] The score was validated in a cohort of 1365 patients, most of whom (91%) had an ECOG performance status of 0 or 1.[1]
  • The score was tested independently in 819 patients with newly diagnosed cancer or cancer progression who had not received chemotherapy within the preceding 3 months to predict the cumulative incidence of VTE at 6 months,[2] and in 1415 patients enrolled in phase I clinical trials followed for a median of 2 months.[3]
  • BMI: body mass index; ESAs: erythropoiesis-stimulating agents; WBC: white blood count; BMI: body mass index; VTE: venous thromboembolism; ECOG: Eastern Cooperative Oncology Group.

 
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