Optimal authoritative risk assessment score of Cancer-associated venous thromboembolism for hospitalized medical patients with lung Cancer

Abstract

Background Cancer-associated venous thromboembolism (VTE) is common in patients with primary lung cancer. It has been understudied which authoritative risk assessment score of cancer-associated VTE is optimal for the assessment of VTE development in hospitalized medical patients with lung cancer. Methods Patients with lung cancer who had undergone computed tomography pulmonary angiography (CTPA), compression ultrasonography (CUS) of lower and upper extremities, and/or planar ventilation/perfusion (V/Q) scan to confirm the presence or absence of VTE during a medical hospitalization were retrospectively reviewed. Based on the actual prevalence of VTE among all patients, the possibility of VTE were reassessed with the Khorana score, the PROTECHT score, the CONKO score, the ONKOTEV score, the COMPASS-CAT score, and the CATS/MICA score, to compare their assessment accuracy for VTE development. Results A total of 1263 patients with lung cancer were incorporated into the final analysis. With respect to assessment efficiency for VTE occurrence, the scores with adjusted agreement from highest to lowest were the ONKOTEV score (78.6%), the PROTECHT score (73.4%), the CONKO score (72.1%), the COMPASS-CAT score (71.7%), the Khorana score (70.9%), and the CATS/MICA score (60.3%). The ONKOTEV score had the highest Youden index which was 0.68, followed by the PROTECHT score (0.58), the COMPASS-CAT score (0.56), the CONKO score (0.55), the Khorana score (0.53), and the CATS/MICA score (0.23). Conclusions Among the Khorana score, the PROTECHT score, the CONKO score, the ONKOTEV score, the COMPASS-CAT score, and the CATS/MICA score which are approved by authoritative guidelines, the ONKOTEV score is optimal for the assessment of VTE development in hospitalized medical patients with lung cancer.

The Diagnostic Value of the Systemic Immune-Inflammation Index for Venous Thromboembolism in Lung Cancer Patients: A Retrospective Study

“…The Khorana score, the most canonical risk forecast model advocated by current guidelines, was widely used for VTE in patients with malignant tumors [ 4 , 5 ], with the following items: diagnosed as pulmonary carcinoma, body mass index (BMI) ≥35 kg/m 2 , hemoglobin (HB) <100 g/L, white blood cells (WBC) >11 × 10 9 /L, and platelets ≥350 × 10 9 /L [ 6 ]. However, its clinical prediction accuracy has been contentious, so novel predictive markers specifically for lung cancer patients are required to be explored like never before [ 7 ].…”

The Efficacy of the Systemic Immune-Inflammation Index and Prognosis Nutritional Index for the Diagnosis of Venous Thromboembolism in Gastrointestinal Cancers

“…Therefore, it’s essential to seek simple but effective biomarkers for tumor-associated VTE, as well as to develop screening tools for people with gastrointestinal cancer. 7 …”

“…Therefore, it's essential to seek simple but effective biomarkers for tumor-associated VTE, as well as to develop screening tools for people with gastrointestinal cancer. 7 Substantial clinical studies have revealed that the first six months after the initial diagnosis was the most dangerous period for thrombosis. 8,9 At this stage, tumor burden and injurious therapies lead to the body's hypercoagulable state and vascular endothelial damage that synergistically promote thrombosis.…”

Diagnostic Strategy Using an Elevated Age-Adjusted D-Dimer Threshold and Thromboembolic Events in the Emergency Department

“…Fifth, clinical applicability and predictive accuracy are 2 important factors to consider when evaluating a VTE risk assessment score . The new diagnostic strategy proposed in this study had similar diagnostic efficiency and moderately reduced image testing (10%) compared with conventional management.…”