To Verify The Predictive Value Of Khorana Risk Model For Venous Thromboembolism In Patients With Malignant Tumors

Background:Venous thromboembolism(VTE)includes deep vein thrombosis(DVT)and pulmonary thromboembolism(PTE).It is the second important reason cause to death in patients with malignant tumor.Because the incidence of VTE in malignant tumor patients is high,and its clinical manifestations are lack of specificity and are often obscured by the original disease,Therefore,a reliable and convenient method is urgently needed to be presented,which can screen high-risk patients who may suffer from VTE.And the necessary precautions are taken to minimize the incidence of VTE in patients with malignancies,thus reducing their mortality.The Khorana prediction model for the risk assessment of venous thromboembolism in patients with malignant tumor has been put forward.However,In the domestic,there are few studies on the effectiveness of the evaluation of thromboembolism risk in patients with malignant tumor.Objective:To verify the effectiveness of Khorana predictive model in evaluating the risk of venous thromboembolism in patients with malignant tumor.To explore the guiding value of Khorana prediction model for preventive anticoagulation in patients with malignant tumor.Methods:Retrospective analysis 23 cases of patients diagonsed as malignant tumor by the department of pathology of Shandong Provincal Hospital from January to June 2016 who had Color Doppler Ultrasound of blood vessel in lower limbs or pulmonary CT angiography with VTE as the case group.82 patients with malignant tumor chemotherapy with no VTE in the same period were treated as control group,the risk grade was determined according to the Khorana prediction model,and the relationship between risk grade and VTE occurrence risk was discussed.Results:1.The ratio of males and females in the VTE group and the control group was 3.6:1 and 1.83:1,respectively,P=0.217,with no statistically significant difference in incidence between ma es and females.2.Mean age,platelet count,white blood cell count and height of patients in the VTE group and the control group were not statistically significant(P>0.05).The differences in hemoglobin level and BMI between the two groups were statistically significant(P=0.011,P=0.013).Among all the individual risk factors of Khorana score,the prediction of VTE risk in patients with malignant tumors was more suggestive of hemoglobin level and BMI.3.VTE group:hemoglobin level was positively correlated with Khorana score(p=0.043);Gender.age,platelet count.WBC count,height,weight and BMI(r=0.162.p=0.461)were not correlated with Khorana score(p>0.05).Control group:platelet count(p=0.030),hemoglobin level(p<0.001)were positively correlated with Khorana score.Gender,age.WBC count,height,weight and BMI were not correlated with Khorana score(P>0.05).Khorana score of all subjects was positively correlated with platelet count(p=0.04)and hemoglobin level(p<0.001),but gender,age,white blood cell count.height,weight and BMI were not correlated with Khorana score(p>0.05).Thus,platelet count and hemoglobin level have stronger implications.4.The Khorana score of the VTE group was significantly higher than that of the control group(P=0.003).suggesting that the higher the score,the greater the risk of VTE.5.Gastric cancer,lung cancer,bladder cancer and ovarian cancer all have a higher risk of VTE.In comparison,gastric cancer has a higher risk of VTE than lung cancer,bladder cancer and ovarian cancer.6.The difference in risk level between the VTE group and the control group was statistically significant(P<0.001).7.Khorana risk classification and VTE risk in malignant tumor patients logistics regression analysis indicated that with the increase of Khorana risk classification,the risk of VTE in tumor patients also increased,and the risk of VTE in high-risk patients was 8.21 times higher than that in non-high-risk patients.8.In the VTE group and the control group,the AUC(0.838)of all indexes in the Khorana prediction model was higher than that of each individual index(P<0.05),suggesting that the comprehensive consideration of all indexes in the Khorana prediction model can better predict the risk of VTE in patients with malignant tumors.Conclusion:In the Khorana prediction model,the risk of venous thromboembolism increased with the increase of score and risk level.The Khorana prediction model has a good predictive value for the risk of venous thrombosis in patients with malignant tumors.