Assessment of risk prediction scores for venous thromboembolism in ambulatory cancer patients with solid tumors receiving chemotherapy: A comparative analysis

Abstract

Objective

Cancer patients have a 4−7-fold increased risk of thrombotic complications due to cancer as well as chemotherapy-induced hypercoagulable state. This study compared the different risk assessment models (Khorana, PROTECHT, CONKO, and COMPASS-CAT scores) that help predict venous thromboembolism (VTE) in ambulatory cancer patients. Early identification of high-risk patients would benefit from thromboprophylaxis, thereby improving the mortality and morbidity due to thrombotic events.

Methods

This is a single-center, prospective, cross-sectional study on ambulatory patients with solid malignancy. The study was conducted over six months, from March 2022 to August 2022. Data on VTE predictors were gathered from 230 ambulatory cancer patients undergoing chemotherapy.

Results

Among the 230 patients receiving chemotherapy, 20 were diagnosed with VTE, with the majority of this population being either diagnosed with gynecological cancer or lung cancer, constituting 25% of VTE-diagnosed patients. The Khorana score, with a VTE accuracy of 83.04%, was found to be the highest, followed by the CONKO (80.00%), PROTECHT (69.57%), COMPASS-CAT Ⅱ (54.35%), and COMPASS-CAT Ⅰ (38.26%) scores. The cumulative incidence of VTE among high-risk patients showed that the PROTECHT score had the highest cumulative incidence (CI = 14.28), and the CONKO score had the lowest (CI = 9.40).

Conclusion

The Khorana score was the most accurate, followed by the CONKO, PROTECHT, and COMPASS-CAT Ⅱ scores, while the COMPASS-CAT Ⅰ score was the least accurate. Hence, the Khorana scoring is essential for diagnosing VTE in patients with ambulatory cancer treated with chemotherapy.