Unifying Concepts

Modified Khorana Risk Score for Prediction of Venous Thromboembolic Events (VTE) in Patients with Cancer

Risk assessment tools can incorporate multiple variables to identify patients or subpopulations at risk for events. A recently developed risk score can identify cancer patients at high risk for VTE using a combination of easily available clinical and laboratory variables.

Modified Khorana Risk Score for Prediction of Venous Thromboembolic Events (VTE) in Patients with Cancer

Patient Characteristic Points
Site of cancer: Very high risk (stomach, pancreas, primary brain tumor) 2
Site of cancer: High risk (lung, lymphoma, gynecologic, bladder, testicular, renal tumors) 1
Pre-chemotherapy platelet count  350,000/µL or more 1
Hemoglobin level <10 g/dL or use of red-cell growth factors 1
Prechemotherapy leukocyte count  >11,000/µL 1
Body mass index  35 kg/m2 or more 1

Calculate total score, adding points for each criterion in the model.

  • High risk  >/= 3 points
  • Intermediate risk, 1 to 2 points
  • Low risk, 0 points

Abbreviation: VTE, venous thromboembolism.



  1. Lyman GH, Khorana AA, Kuderer NM, Lee AY, Arcelus JI, Balaban EP, Clarke JM, Flowers CR, Francis CW, Gates LE, Kakkar AK, Key NS, Levine MN, Liebman HA, Tempero MA, Wong SL, Prestrud AA, Falanga A; American Society of Clinical Oncology Clinical Practice. Venous thromboembolism prophylaxis and treatment in patients with cancer: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol. 2013 Jun 10;31(17):2189-204. [Medline]
  2. Khorana AA, McCrae KR. Risk stratification strategies for cancer-associated thrombosis: an update. Thromb Res. 2014 May;133 Suppl 2:S35-8. [Medline]
  3. Gomes M, Khorana AA. Risk assessment for thrombosis in cancer. Semin Thromb Hemost. 2014 Apr;40(3):319-24. [Medline]


Created Sep 19, 2014.

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