Nishimura Akari, Ikeda Yoshiaki
Faculty of Pharmaceutical Sciences, Kinjo Gakuin University.
Yakugaku Zasshi. 2021;141(4):611-622. doi: 10.1248/yakushi.20-00228.
Venous thromboembolism (VTE) is the second most common cause of cancer-related deaths globally. The Khorana score, a VTE prediction model, is calculated using the site of cancer, white blood cell count, hemoglobin level, platelet count, and body mass index. This study aimed to investigate the usefulness of the Khorana score, using data available in the literature. On July 28, 2020, we collected papers using the following keywords: "cancer", "venous thromboembolism", "deep vein thrombosis", "pulmonary embolism", and "Khorana score" on PubMed. Papers published after 2016 were eligible. The selection criteria were as follows: "English or Japanese", "original paper", "abstract and full text", and "comply with the clinical question". There were 131 papers that matched the keywords, and 15 of them complied with the selection criteria. In 15 papers, Khorana score was calculated in 8047 patients. In the low- and intermediate-risk groups, 532 of 6812 patients developed VTE [7.8%, 95%confidence intervals (CI) 7.2-8.5], whereas in the high-risk group, 127 of 1235 patients developed VTE (10.3%, 95% CI 8.7-12.1) [odds ratio (OR) 1.3, 95% CI 1.0-1.6] (I=0%, τ=0, p=0.50). Venous thromboembolism prediction using the Khorana score might be useful. However, most of the number of VTE patients are in the low- and intermediate-risk groups. Therefore, a comprehensive evaluation according to clinical conditions is required, regardless of the risk classification using the Khorana score.
静脉血栓栓塞症(VTE)是全球癌症相关死亡的第二大常见原因。Khorana评分是一种VTE预测模型,通过癌症部位、白细胞计数、血红蛋白水平、血小板计数和体重指数来计算。本研究旨在利用文献中的现有数据,探讨Khorana评分的实用性。2020年7月28日,我们在PubMed上使用以下关键词收集论文:“癌症”、“静脉血栓栓塞症”、“深静脉血栓形成”、“肺栓塞”和“Khorana评分”。2016年后发表的论文符合要求。选择标准如下:“英文或日文”、“原创论文”、“摘要和全文”以及“符合临床问题”。有131篇论文与关键词匹配,其中15篇符合选择标准。在这15篇论文中,对8047例患者计算了Khorana评分。在低风险和中度风险组中,6812例患者中有532例发生VTE[7.8%,95%置信区间(CI)7.2 - 8.5],而在高风险组中,1235例患者中有127例发生VTE(10.3%,95%CI 8.7 - 12.1)[比值比(OR)1.3,95%CI 1.0 - 1.6](I = 0%,τ = 0,p = 0.50)。使用Khorana评分进行静脉血栓栓塞症预测可能是有用的。然而,大多数VTE患者处于低风险和中度风险组。因此,无论使用Khorana评分进行何种风险分类,都需要根据临床情况进行综合评估。