Distribution and modification of Khorana score in hospitalized patients with malignant tumors
Objective To investigate the distribution of Khorana score and risk factors of venous thromboembolism(VTE)in hospitalized patients with malignant tumors,and to explore the value of modified Khorana score model in predicting the risk of VTE in hospitalized patients with malignant tumors.Methods The clinical data of 389 hospitalized patients with malignant tumors admitted to Weifang People's Hospital from November 2019 to October 2022 were retrospectively analyzed,including 233 males and 156 females,aged(57.95±11.71)years.The Khorana score was used to assess the risk of VTE,and the incidence of VTE was calculated.Independent sample ttest,x2 test,logistic regression analysis,and receiver operating characteristic curve(ROC)were used for analysis.Results Among the 389 patients,19 occurred VTE,with an overall incidence of 4.88％.The proportions of the patients with Khorana score of 0,1,2,and ≥3 points were 36.25％(141/389),37.79％(147/389),19.54％(76/389),and 6.43％(25/389),respectively.The corresponding incidences of VTE were 2.84％(4/141),4.08％(6/147),7.89％(6/76),and 12.00％(3/25).The higher the Khorana score was,the higher the incidence of VTE was,but the difference was not statistically significant(x2=4.936,P=0.177).The rates of Khorana score ≤2 points in the patients with or without drinking history were 95.16％(118/124)and 92.83％(246/265)(P＜0.05).Coronary heart disease,high-risk VTE cancer,and high D-dimer were the risk factors for VTE in hospitalized patients with malignant tumors(OR=3.844,2.010,and 1.102,all P＜0.05),among which coronary heart disease was an independent risk factor(OR=4.048,P=0.023).The sensitivity,specificity,and Youden index of modified Khorana score for predicting the risk of VTE in hospitalized patients with malignant tumors were 68.421％,68.378％,and 0.368(P＜0.01),respectively,and the area under the curve(AUC)was increased by 0.135 compared with the original score,with higher predicted value(Z=2.251,P=0.018).Conclusions The higher the Khorana score,the higher the incidence of VTE,but its predictive value is not high.Coronary heart disease is an independent risk factor for VTE in hospitalized patients with malignant tumors.Modified Khorana score combined with D-dimer has a higher predictive value for the risk of VTE in in hospitalized patients with malignant tumors than the original score.
万方数据
维普
