Venous Thromboembolism Risk Assessment Among Ambulatory Cancer Patients: Demographic Study and Doctor's Adherence to Guidelines

Abstract

Background: Cancer-associated thrombosis (CAT) is the second cause of death for cancer patients. National Comprehensive Cancer Network (NCCN) guidelines recommend assessing CAT risk for all ambulatory cancer patients by Khorana score and prescribing thromboprophylaxis for high-risk patients. Unfortunately, clinical practice in many countries fails to apply this guideline effectively.Objectives: To determine the level of venous thromboembolism (VTE) risk among ambulatory cancer patients and the oncologists' role in prescribing thromboprophylaxis to high-risk patients in Al-Diwaniyah Teaching Hospital, Al-Qadisiyah, Iraq.Materials and methods: A cross-sectional study was conducted from September to October 2023 in the Oncology Center at Al-Diwaniyah Teaching Hospital, Al-Qadisiyah, Iraq. The oncologist's role in prescribing thromboprophylaxis for newly diagnosed ambulatory cancer patients visiting the oncology center was assessed after calculating the thrombosis risk score using the validated Khorana score.Results: 49 patients newly diagnosed  with cancer were enrolled in the study. Most of the participants were females with a normal body weight. Breast cancer was the most common cancer type among study participants. Regarding the risk of VTE, eight (16.3%) participants had a high risk, 24 (48%) had a moderate risk, and 17 (36%) had a low risk. All of the study participants regardless of  their thrombosis risk were not prescribed thromboprophylaxis by oncologists.Conclusion: Most newly diagnosed ambulatory cancer patients had moderate to high risk of VTE. Oncologists did not prescribe thromboprophylaxis to any of these patients. Therefore, we recommended that all oncologists must be adherent to NCCN thromboprophylaxis guidelines.

Keywords

• cancer-associated thrombosis (cat)
• khorana score
• thromboprophylaxis