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Clinical calculator summary

Khorana VTE Risk Score

A pretreatment score using cancer site and blood-count/body-size factors to estimate chemotherapy-associated VTE risk.

Evidence-based context for fast calculator use

Purpose:
Support ambulatory cancer-associated thrombosis risk assessment before systemic therapy
Population:
Ambulatory adults with cancer starting systemic anticancer therapy
Factors:
Cancer site, Platelets, Hemoglobin or ESA use, Leukocytes, BMI
Reference:
Khorana et al., Blood. 2008
HomeKhorana Score (VTE Risk)
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Khorana Score (VTE Risk)

Clinical Context & Background

The Khorana Score stratifies cancer patients into risk groups for developing venous thromboembolism (VTE) prior to starting chemotherapy. It helps identify patients who might benefit from thromboprophylaxis. Recent guidelines (ASCO 2023) continue to endorse its use for risk assessment.
Primary Source EvidenceKhorana AA, Kuderer NM, Culakova E, Lyman GH, Francis CW. Development and validation of a predictive model for chemotherapy-associated thrombosis. Blood. 2008;111(10):4902-4907.
Formula Logic
Sum points based on cancer site, platelet count, Hb/ESA use, WBC count, and BMI.

Reference Data

Risk GroupScoreVTE Risk Rate
Low Risk00.8% - 3.0%
Intermediate Risk1 - 21.8% - 8.4%
High Risk≥ 37.1% - 12.9%

Clinical Workflow

Use, Interpret, And Continue The Patient Pathway

Expand for workflow guidance, limitations, examples, and related next steps.

When To Use

  • Use before a new outpatient systemic therapy course when considering VTE risk and thromboprophylaxis eligibility.
  • Use only when the patient and clinical setting match the population described for Khorana VTE Risk Score.

How To Interpret

  • Higher scores identify greater VTE risk, but absolute risk varies with tumor type, regimen, biomarkers, and follow-up period.
  • Interpret thresholds with the entered units, current clinical status, and local guideline context.

What To Do Next

  • Balance VTE risk against bleeding risk, drug interactions, renal function, platelet count, patient preference, and current thromboprophylaxis guidance.
  • Document the inputs, result, clinical judgment, and any reason for deviating from the model-guided pathway.

Limitations

  • Do not use as the sole basis for anticoagulation or for hospitalized, perioperative, or already anticoagulated patients.
  • This calculator supports clinical assessment and does not independently prescribe treatment.

Validated Population

Ambulatory adults with cancer starting systemic anticancer therapy

Clinical example

A high-risk cancer site plus thrombocytosis can move an ambulatory patient into a group where prophylaxis merits discussion after bleeding-risk review.

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Frequently Asked Questions

What is Khorana VTE Risk Score used for?

Support ambulatory cancer-associated thrombosis risk assessment before systemic therapy. It is intended for ambulatory adults with cancer starting systemic anticancer therapy.

Does Khorana VTE Risk Score determine treatment by itself?

No. Confirm the population, inputs, contraindications, competing risks, and current guideline recommendations before acting on the result.

Evidence-based oncology decision support. Verify with clinical guidelines.