Assessment of risk prediction scores for venous thromboembolism in ambulatory cancer patients with solid tumors receiving chemotherapy: A comparative analysis

Objective Cancer patients have a 4−7‐fold increased risk of thrombotic complications due to cancer as well as chemotherapy‐induced hypercoagulable state. This study compared the different risk assessment models (Khorana, PROTECHT, CONKO, and COMPASS‐CAT scores) that help predict venous thromboembolism (VTE) in ambulatory cancer patients. Early identification of high‐risk patients would benefit from thromboprophylaxis, thereby improving the mortality and morbidity due to thrombotic events. Methods This is a single‐center, prospective, cross‐sectional study on ambulatory patients with solid malignancy. The study was conducted over six months, from March 2022 to August 2022. Data on VTE predictors were gathered from 230 ambulatory cancer patients undergoing chemotherapy. Results Among the 230 patients receiving chemotherapy, 20 were diagnosed with VTE, with the majority of this population being either diagnosed with gynecological cancer or lung cancer, constituting 25% of VTE‐diagnosed patients. The Khorana score, with a VTE accuracy of 83.04%, was found to be the highest, followed by the CONKO (80.00%), PROTECHT (69.57%), COMPASS‐CAT Ⅱ (54.35%), and COMPASS‐CAT Ⅰ (38.26%) scores. The cumulative incidence of VTE among high‐risk patients showed that the PROTECHT score had the highest cumulative incidence (CI = 14.28), and the CONKO score had the lowest (CI = 9.40). Conclusion The Khorana score was the most accurate, followed by the CONKO, PROTECHT, and COMPASS‐CAT Ⅱ scores, while the COMPASS‐CAT Ⅰ score was the least accurate. Hence, the Khorana scoring is essential for diagnosing VTE in patients with ambulatory cancer treated with chemotherapy. Different risk assessment models (Khorana, PROTECHT, CONKO, COMPASS‐CAT Ⅰ, and COMPASS‐CAT Ⅱ scores) were used to predict the incidence of venous thromboembolism (VTE) among 230 patients. Even though the Khorana score was found to be more accurate than the other models, it was able to predict only one VTE case. The PROTECHT score was able to predict 50% of the VTE cases. Key points In this study, we examined patient‐related factors, disease‐related factors, and factors associated with VTE among 230 patients receiving chemotherapy. Risk assessment models, such as the Khorana, PROTECHT, CONKO, and COMPASS‐CAT score ratings, consider VTE risk factors related to patient characteristics, malignancies, and therapeutic variables. The Khorana score, with a VTE accuracy of 83.04%, was the highest, followed by the CONKO (80.00%)