@article{3183983, title = "The Khorana score for prediction of venous thromboembolism in cancer patients: a systematic review and meta-analysis", author = "Mulder, Frits I. and Candeloro, Matteo and Kamphuisen, Pieter W. and Di and Nisio, Marcello and Bossuyt, Patrick M. and Guman, Noori and Smit, and Kirsten and Buller, Harry R. and van Es, Nick and Abdel-Razeq, H. and and Ades, S. and Ayappan, S. R. and Borchmann, S. and Cella, C. A. and and Fankhauser, C. D. and Ferroni, P. and Fuentes, H. E. and Kruger, S. and and Lim, S. H. and Lubberts, S. and Lustig, D. B. and Mansfield, A. S. and and Munoz Martin, A. J. and Noble, S. and Panizo, E. and Papaxoinis, G. and and Park, K. and Patel, J. N. and Posch, F. and Ramos, J. D. and Roselli, M. and and Santi, R. and Sohal, D. and Srikanthan, A. and Tafur, A. J. and and Terbuch, A. and Thomas, M. and Vathiotis, O. and Wang, R. and Zahir, M. and N. and CAT-prediction Collaborators", journal = "Haematologica-the hematology journal", year = "2019", volume = "104", number = "6", pages = "1277-1287", publisher = "Ferrata Storti Foundation", doi = "10.3324/haematol.2018.209114", abstract = "We aimed to evaluate the performance of the Khorana score in predicting venous thromboembolic events in ambulatory cancer patients. Embase and MEDLINE were searched from January 2008 to June 2018 for studies which evaluated the Khorana score. Two authors independently screened studies for eligibility, extracted data, and assessed risk of bias. Additional data on the 6-month incidence of venous thromboembolism were sought by contacting corresponding authors. The incidence in each Khorana score risk group was estimated with random effects meta-analysis. A total of 45 articles and eight abstracts were included, comprising 55 cohorts enrolling 34,555 ambulatory cancer patients. For 27,849 patients (81%), 6-month follow-up data were obtained. Overall, 19% of patients had a Khorana score of 0 points, 64% a score of 1 or 2 points, and 17% a score of 3 or more points. The incidence of venous thromboembolism in the first six months was 5.0% (95% CI: 3.9-6.5) in patients with a low-risk Khorana score (0 points), 6.6% (95% CI: 5.6-7.7) in those with an intermediate-risk Khorana score (1 or 2 points), and 11.0% (95% CI: 8.8-13.8) in those with a high-risk Khorana score (3 points or higher). Of the patients with venous thromboembolism in the first six months, 23.4% (95% CI: 18.4-29.4) had been classified as high risk according to the Khorana score. In conclusion, the Khorana score can be used to select ambulatory cancer patients at high risk of venous thromboembolism for thromboprophylaxis; however, most events occur outside this high-risk group." }