The Khorana score for prediction of venous thromboembolism in cancer patients: a systematic review and meta-analysis

被引：238

作者：

Mulder, Frits I. ^{[1
,2
]}

Candeloro, Matteo ^{[3
]}

Kamphuisen, Pieter W. ^{[1
]}

Di Nisio, Marcello ^{[3
]}

Bossuyt, Patrick M. ^{[2
]}

Guman, Noori ^{[2
]}

Smit, Kirsten ^{[2
]}

Buller, Harry R. ^{[2
]}

van Es, Nick ^{[2
]}

Abdel-Razeq, H. ^{[4
]}

Ades, S. ^{[5
]}

Ayappan, S. R. ^{[6
]}

Borchmann, S. ^{[7
]}

Cella, C. A. ^{[8
]}

Fankhauser, C. D. ^{[9
]}

Ferroni, P. ^{[10
]}

Fuentes, H. E. ^{[11
]}

Kruger, S. ^{[12
]}

Lim, S. H. ^{[13
]}

Lubberts, S. ^{[14
]}

Lustig, D. B. ^{[15
]}

Mansfield, A. S. ^{[16
]}

Munoz Martin, A. J. ^{[17
]}

Noble, S. ^{[18
]}

Panizo, E. ^{[19
]}

Papaxoinis, G. ^{[20
]}

Park, K. ^{[21
]}

Patel, J. N. ^{[22
]}

Posch, F. ^{[23
]}

Ramos, J. D. ^{[24
]}

Roselli, M. ^{[25
]}

Santi, R. ^{[26
]}

Sohal, D. ^{[27
]}

Srikanthan, A. ^{[28
]}

Tafur, A. J. ^{[29
]}

Terbuch, A. ^{[30
]}

Thomas, M. ^{[31
]}

Vathiotis, O. ^{[32
]}

Wang, R. ^{[33
]}

Zahir, M. N. ^{[34
]}

机构：

[1] Tergooi Hosp, Dept Internal Med, Hilversum, Netherlands

[2] Univ Amsterdam, Amsterdam UMC, Dept Vasc Med, Amsterdam Cardiovasc Sci, Amsterdam, Netherlands

[3] Univ G DAnnunzio, Dept Med & Ageing Sci, Chieti, Italy

[4] King Hussein Canc Ctr, Amman, Jordan

[5] Univ Vermont, Burlington, VT USA

[6] Ohio State Univ Comprehens Canc Ctr OSUCCC James, Columbus, OH USA

[7] Univ Hosp Cologne, Cologne, Germany

[8] Univ Naples Federico II, Naples, Italy

[9] Univ Hosp Zurich, Zurich, Switzerland

[10] San Raffaele Roma Open Univ, Rome, Italy

[11] John Stronger Jr Hosp, Chicago, IL USA

[12] Ludwig Maximilians Univ Munchen, Munich, Germany

[13] Samsung Med Ctr, Seoul, South Korea

[14] Univ Med Ctr Groningen, Groningen, Netherlands

[15] Univ Ottawa, Ottawa, ON, Canada

[16] Mayo Clin, Rochester, MN USA

[17] Hosp Gen Univ Gregorio Maranon, Med Oncol Serv, Madrid, Spain

[18] Cardiff Univ, Cardiff, S Glam, Wales

[19] Univ Clin Navarra, Pamplona, Spain

[20] Christie NHS Fdn Trust, Dept Med Oncol, Manchester, Lancs, England

[21] Pusan Natl Univ, Yangsan Hosp, Busan, South Korea

[22] Levine Canc Inst, Charlotte, NC USA

[23] Med Univ Vienna, Vienna, Austria

[24] Univ Washington, Seattle, WA 98195 USA

[25] Univ Roma Tor Vergata, Rome, Italy

[26] AOSS Antonio & Biagio & Cesare Arrigo Alessandria, Alessandria, Italy

[27] Cleveland Clin, Cleveland, OH 44106 USA

[28] Univ Toronto, Princess Margaret Canc Ctr, Toronto, ON, Canada

[29] Univ Oklahoma, Hlth Sci Ctr, Norman, OK 73019 USA

[30] Med Univ, Graz, Austria

[31] Univ Coll London Hosp NHS Fdn Trust, London, England

[32] Univ Athens, Sotiria Gen Hosp, Oncol Unit, Athens, Greece

[33] Tianjin Med Univ, Grad Sch, Tianjin, Peoples R China

[34] Aga Khan Univ Hosp, Karachi, Pakistan

来源：

HAEMATOLOGICA | 2019年 / 104卷 / 06期

关键词：

PATIENTS RECEIVING CHEMOTHERAPY; ADVANCED PANCREATIC-CANCER; MOLECULAR-WEIGHT HEPARIN; RISK PREDICTION; D-DIMER; CLINICAL-SIGNIFICANCE; AMBULATORY PATIENTS; PULMONARY-EMBOLISM; VTE; EVENTS;

D O I：

10.3324/haematol.2018.209114

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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.

引用

页码：1277 / 1287

页数：11

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