The Khorana score for prediction of venous thromboembolism in cancer patients: a systematic review and meta-analysis.
Journal
Haematologica
ISSN: 1592-8721
Titre abrégé: Haematologica
Pays: Italy
ID NLM: 0417435
Informations de publication
Date de publication:
06 2019
06 2019
Historique:
received:
12
10
2018
accepted:
02
01
2019
pubmed:
5
1
2019
medline:
19
5
2020
entrez:
5
1
2019
Statut:
ppublish
Résumé
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.
Identifiants
pubmed: 30606788
pii: haematol.2018.209114
doi: 10.3324/haematol.2018.209114
pmc: PMC6545838
doi:
Types de publication
Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
1277-1287Informations de copyright
Copyright© 2019 Ferrata Storti Foundation.
Références
J Gastrointest Cancer. 2018 Dec;49(4):415-421
pubmed: 28634671
J Thromb Haemost. 2007 Mar;5(3):632-4
pubmed: 17319909
Cochrane Database Syst Rev. 2012 Feb 15;(2):CD008500
pubmed: 22336844
Thromb Res. 2017 Feb;150:30-32
pubmed: 28002757
J Thromb Haemost. 2015 Jun;13(6):998-1003
pubmed: 25809746
Target Oncol. 2017 Aug;12(4):495-503
pubmed: 28580507
Thromb Haemost. 2016 Apr;115(4):817-26
pubmed: 26738412
J Natl Compr Canc Netw. 2015 Sep;13(9):1079-95
pubmed: 26358792
J Clin Oncol. 2018 Jul 10;36(20):2017-2023
pubmed: 29746227
Anticancer Res. 2013 May;33(5):2093-8
pubmed: 23645760
Oncologist. 2018 Feb;23(2):247-255
pubmed: 28951500
J Clin Oncol. 2011 Jun 10;29(17):2405-9
pubmed: 21555690
World J Gastroenterol. 2017 Jul 28;23(28):5187-5195
pubmed: 28811713
Value Health. 2018 Apr;21(4):449-455
pubmed: 29680102
PLoS Med. 2009 Jul 21;6(7):e1000097
pubmed: 19621072
Eur J Cancer. 2016 Aug;63:180-8
pubmed: 27322917
Blood. 2008 May 15;111(10):4902-7
pubmed: 18216292
Thromb Res. 2014 Dec;134(6):1205-7
pubmed: 25288468
J Neurooncol. 2015 Aug;124(1):87-94
pubmed: 25985958
Cancer Res Treat. 2016 Jan;48(1):312-21
pubmed: 25761485
J Clin Oncol. 2011 Sep 1;29(25):3466-73
pubmed: 21810688
J Clin Oncol. 2015 Feb 20;33(6):582-7
pubmed: 25605848
Int J Cancer. 2015 Mar 1;136(5):1234-40
pubmed: 25042739
Acta Oncol. 2018 Jun;57(6):790-798
pubmed: 29308947
J Clin Oncol. 2015 Jun 20;33(18):2028-34
pubmed: 25987694
N Engl J Med. 2012 Feb 16;366(7):601-9
pubmed: 22335737
Dtsch Med Wochenschr. 2013 Oct;138(41):2084-8
pubmed: 24085361
J Thromb Haemost. 2016 Sep;14(9):1773-8
pubmed: 27273134
BMC Cancer. 2017 Jan 16;17(1):57
pubmed: 28093087
Clin Appl Thromb Hemost. 2018 Nov;24(8):1347-1351
pubmed: 29806470
Thromb Res. 2017 Mar;151:89-95
pubmed: 28139259
Eur Respir J. 2017 Jan 4;49(1):
pubmed: 28052954
N Engl J Med. 2018 Feb 15;378(7):615-624
pubmed: 29231094
Med Oncol. 2017 Dec 4;35(1):5
pubmed: 29209847
Thromb Res. 2015 Dec;136(6):1120-5
pubmed: 26475410
Thromb Res. 2015 Dec;136(6):1145-8
pubmed: 26475407
J Clin Oncol. 2016 Feb 10;34(5):488-94
pubmed: 26700124
Thromb Haemost. 2017 Apr 27;:
pubmed: 28447710
Thromb Haemost. 2017 Jan 5;117(1):57-65
pubmed: 27709226
Chest. 2012 Feb;141(2 Suppl):e419S-e496S
pubmed: 22315268
Clin Appl Thromb Hemost. 2018 Apr;24(3):471-476
pubmed: 28288526
J Thromb Haemost. 2012 Oct;10(10):2032-8
pubmed: 22845852
World J Gastrointest Oncol. 2017 Apr 15;9(4):176-183
pubmed: 28451065
Med Oncol. 2018 Apr 3;35(5):63
pubmed: 29616356
J Clin Oncol. 2015 Feb 20;33(6):654-6
pubmed: 25605844
Thromb Res. 2012 Dec;130(6):967-70
pubmed: 23036533
Lancet Haematol. 2018 Jul;5(7):e289-e298
pubmed: 29885940
Thromb J. 2018 Mar 1;16:2
pubmed: 29507532
Ann Intern Med. 2013 Feb 19;158(4):280-6
pubmed: 23420236
BMJ. 2017 Jan 5;356:i6460
pubmed: 28057641
Cancer. 2015 Apr 1;121(7):1025-31
pubmed: 25417775
Blood. 2013 Sep 5;122(10):1712-23
pubmed: 23908465
Haematologica. 2017 Sep;102(9):1494-1501
pubmed: 28550192
Res Pract Thromb Haemost. 2019 Jan 28;3(2):226-233
pubmed: 31011706
Clin Transl Oncol. 2014 Oct;16(10):927-30
pubmed: 24643701
Oncologist. 2017 May;22(5):601-608
pubmed: 28424324
Thromb Res. 2017 Sep;157:9-15
pubmed: 28675831
PLoS One. 2017 Apr 21;12(4):e0176283
pubmed: 28430804
Clin Appl Thromb Hemost. 2017 Oct;23(7):755-760
pubmed: 27637910
Br J Cancer. 2018 Apr;118(8):1056-1061
pubmed: 29588512
Thromb Res. 2015 Dec;136(6):1099-102
pubmed: 26260645
Intern Emerg Med. 2012 Jun;7(3):291-2
pubmed: 22547369
Ann Oncol. 2012 Jun;23(6):1416-21
pubmed: 22052988
Clin Lung Cancer. 2012 Nov;13(6):482-7
pubmed: 22591606