Healthcare & Clinical
Padua Medical Inpatient VTE Score & Khorana Ambulatory Cancer VTE Score
Calculate the Khorana Chemotherapy VTE Score (0–6 points across cancer site, platelets >= 350k, Hb < 10/ESA, WBC > 11k, BMI >= 35) and compare with the Padua >= 4 medical inpatient VTE threshold.
Stratify thrombosis risk in ambulatory oncology clinics (Khorana) and medical wards (Padua)!
Caprini governs surgical wards, whereas Alok Khorana's validated 0–6 point Khorana Score identifies ambulatory cancer patients starting systemic chemotherapy who face high symptomatic VTE risk: Primary cancer site (+2 for Very High Risk stomach or pancreas; +1 for High Risk lung, lymphoma, gynecologic, bladder, or testicular; 0 for other sites like breast/colorectal) plus +1 point each for pre-chemotherapy Platelets >= 350 x10^9/L, Hemoglobin < 10 g/dL (or ESA use), Leukocytes (WBC) > 11 x10^9/L, and BMI >= 35 kg/m^2!
Notice the exact inequality signs in Khorana: Platelets >= 350, BMI >= 35, Hemoglobin < 10, and WBC STRICTLY > 11! Under ASCO / ASH guidelines, Khorana 0 is Low Risk (<1%), 1 is Intermediate, and Khorana >= 2 (up to 6) defines elevated risk where direct oral anticoagulant (apixaban/rivaroxaban) or LMWH thromboprophylaxis is considered (with Khorana >= 3 marking classic High Risk ~7%+ at 2.5 months). Meanwhile, for hospitalized non-surgical medical inpatients, Barbar's Padua Prediction Score triggers inpatient VTE prophylaxis at Padua >= 4 points (3 pts each for active cancer, prior VTE, reduced mobility >= 3d, known thrombophilia; 2 pts trauma/surgery < 1 mo; 1 pt age >= 70, heart/resp failure, MI/stroke, infection/rheum, BMI >= 30, hormones)!
| Oncology Presentation | Khorana Breakdown | Total Khorana Score | VTE Risk Tier |
|---|---|---|---|
| Pancreatic Cancer (+2), Plt 380 (+1), WBC 12.4 (+1) | 2 + 1 + 0 + 1 + 0 | 4 points (>= 3) | High VTE Risk (Prophylaxis Eligible) |
| Breast Cancer (0), Plt 240, Hb 12.5, WBC 7.2, BMI 26 | 0 + 0 + 0 + 0 + 0 | 0 points | Low VTE Risk (~0.3%-0.8%) |
| Lung Cancer (+1), Hb 9.4 (+1) | 1 + 0 + 1 + 0 + 0 | 2 points (>= 2) | Intermediate-High (ASCO Cutoff >= 2) |
Total Khorana Ambulatory Chemotherapy VTE Score (0 to 6 Points)
Sums Cancer_Site_Code B2 (0, 1, or 2) plus binary pre-chemo lab/BMI cutoffs (Plt >= 350, Hb < 10, WBC > 11, BMI >= 35).
=IF(OR(B2 < 0, B2 > 2, B3 <= 0, B4 <= 0, B5 <= 0, B6 <= 0), "Invalid Khorana Inputs", B2 + --(B3 >= 350) + --(B4 < 10) + --(B5 > 11) + --(B6 >= 35))Khorana Oncology VTE Prophylaxis Stratum
Classifies Khorana score into Low (0), Intermediate (1), Intermediate-High (2), or High (>= 3).
=IF((B2 + --(B3 >= 350) + --(B4 < 10) + --(B5 > 11) + --(B6 >= 35)) >= 3, "High Cancer VTE Risk (>= 3)", IF((B2 + --(B3 >= 350) + --(B4 < 10) + --(B5 > 11) + --(B6 >= 35)) = 2, "Intermediate-High Risk (Score = 2: ASCO DOAC/LMWH Cutoff)", IF((B2 + --(B3 >= 350) + --(B4 < 10) + --(B5 > 11) + --(B6 >= 35)) = 1, "Intermediate Risk (Score = 1)", "Low Cancer VTE Risk (Score = 0)")))Try the example
Use the original values or change them to test your understanding.