TY - JOUR
TI - The Khorana score for prediction of venous thromboembolism in cancer
patients: a systematic review and meta-analysis
AU - Mulder, Frits I.
AU - Candeloro, Matteo
AU - Kamphuisen, Pieter W.
AU - Di
AU - Nisio, Marcello
AU - Bossuyt, Patrick M.
AU - Guman, Noori
AU - Smit,
AU - Kirsten
AU - Buller, Harry R.
AU - van Es, Nick
AU - Abdel-Razeq, H. and
AU - Ades, S.
AU - Ayappan, S. R.
AU - Borchmann, S.
AU - Cella, C. A. and
AU - Fankhauser, C. D.
AU - Ferroni, P.
AU - Fuentes, H. E.
AU - Kruger, S. and
AU - Lim, S. H.
AU - Lubberts, S.
AU - Lustig, D. B.
AU - Mansfield, A. S. and
AU - Munoz Martin, A. J.
AU - Noble, S.
AU - Panizo, E.
AU - Papaxoinis, G. and
AU - Park, K.
AU - Patel, J. N.
AU - Posch, F.
AU - Ramos, J. D.
AU - Roselli, M.
AU - and Santi, R.
AU - Sohal, D.
AU - Srikanthan, A.
AU - Tafur, A. J. and
AU - Terbuch, A.
AU - Thomas, M.
AU - Vathiotis, O.
AU - Wang, R.
AU - Zahir, M.
AU - N.
AU - CAT-prediction Collaborators
JO - Haematologica-the hematology journal
PY - 2019
VL - 104
TODO - 6
SP - 1277-1287
PB - Ferrata Storti Foundation
SN - null
TODO - 10.3324/haematol.2018.209114
TODO - null
TODO - 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.
ER -