Validation of the Khorana Venous Thromboembolism Risk Score in Japanese Cancer Patients

Fumie Akasaka-Kihara, MD; Daisuke Sueta, MD, PhD; Masanobu Ishii, MD, PhD, MPH; Yuji Maki, MD; Kyoko Hirakawa, MD, PhD; Noriaki Tabata, MD, PhD; Miwa Ito, MD, PhD; Kenshi Yamanaga, MD, PhD; Koichiro Fujisue, MD, PhD; Tadashi Hoshiyama, MD, PhD; Shinsuke Hanatani, MD, PhD; Hisanori Kanazawa, MD, PhD; Seiji Takashio, MD, PhD; Yuichiro Arima, MD, PhD; Satoshi Araki, MD, PhD; Hiroki Usuku, MD, PhD; Taishi Nakamura, MD, PhD; Satoru Suzuki, MD, PhD; Eiichiro Yamamoto, MD, PhD; Hirofumi Soejima, MD, PhD; Koichi Kaikita, MD, PhD; Kenichi Matsushita, MD, PhD; Masao Matsuoka, MD, PhD; Koichiro Usuku, MD, PhD; Kenichi Tsujita, MD, PhD

JACC: Asia (Sep 2021)

Validation of the Khorana Venous Thromboembolism Risk Score in Japanese Cancer Patients

Fumie Akasaka-Kihara, MD,
Daisuke Sueta, MD, PhD,
Masanobu Ishii, MD, PhD, MPH,
Yuji Maki, MD,
Kyoko Hirakawa, MD, PhD,
Noriaki Tabata, MD, PhD,
Miwa Ito, MD, PhD,
Kenshi Yamanaga, MD, PhD,
Koichiro Fujisue, MD, PhD,
Tadashi Hoshiyama, MD, PhD,
Shinsuke Hanatani, MD, PhD,
Hisanori Kanazawa, MD, PhD,
Seiji Takashio, MD, PhD,
Yuichiro Arima, MD, PhD,
Satoshi Araki, MD, PhD,
Hiroki Usuku, MD, PhD,
Taishi Nakamura, MD, PhD,
Satoru Suzuki, MD, PhD,
Eiichiro Yamamoto, MD, PhD,
Hirofumi Soejima, MD, PhD,
Koichi Kaikita, MD, PhD,
Kenichi Matsushita, MD, PhD,
Masao Matsuoka, MD, PhD,
Koichiro Usuku, MD, PhD,
Kenichi Tsujita, MD, PhD

Affiliations

Fumie Akasaka-Kihara, MD: Department of Cardiovascular Medicine, Kumamoto University School of Medicine, Kumamoto, Japan
Daisuke Sueta, MD, PhD: Department of Cardiovascular Medicine, Kumamoto University School of Medicine, Kumamoto, Japan; Address for correspondence: Dr Daisuke Sueta, Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto 860-8556, Japan.
Masanobu Ishii, MD, PhD, MPH: Department of Cardiology, Miyazaki Prefectural Nobeoka Hospital, Nobeoka, Japan
Yuji Maki, MD: Department of Cardiovascular Medicine, Kumamoto University School of Medicine, Kumamoto, Japan
Kyoko Hirakawa, MD, PhD: Department of Cardiovascular Medicine, Kumamoto University School of Medicine, Kumamoto, Japan
Noriaki Tabata, MD, PhD: Department of Cardiovascular Medicine, Kumamoto University School of Medicine, Kumamoto, Japan
Miwa Ito, MD, PhD: Department of Cardiovascular Medicine, Kumamoto University School of Medicine, Kumamoto, Japan
Kenshi Yamanaga, MD, PhD: Department of Cardiovascular Medicine, Kumamoto University School of Medicine, Kumamoto, Japan
Koichiro Fujisue, MD, PhD: Department of Cardiovascular Medicine, Kumamoto University School of Medicine, Kumamoto, Japan
Tadashi Hoshiyama, MD, PhD: Department of Cardiovascular Medicine, Kumamoto University School of Medicine, Kumamoto, Japan
Shinsuke Hanatani, MD, PhD: Department of Cardiovascular Medicine, Kumamoto University School of Medicine, Kumamoto, Japan
Hisanori Kanazawa, MD, PhD: Department of Cardiovascular Medicine, Kumamoto University School of Medicine, Kumamoto, Japan
Seiji Takashio, MD, PhD: Department of Cardiovascular Medicine, Kumamoto University School of Medicine, Kumamoto, Japan
Yuichiro Arima, MD, PhD: Department of Cardiovascular Medicine, Kumamoto University School of Medicine, Kumamoto, Japan
Satoshi Araki, MD, PhD: Department of Cardiovascular Medicine, Kumamoto University School of Medicine, Kumamoto, Japan
Hiroki Usuku, MD, PhD: Department of Cardiovascular Medicine, Kumamoto University School of Medicine, Kumamoto, Japan
Taishi Nakamura, MD, PhD: Department of Cardiovascular Medicine, Kumamoto University School of Medicine, Kumamoto, Japan
Satoru Suzuki, MD, PhD: Department of Cardiovascular Medicine, Kumamoto University School of Medicine, Kumamoto, Japan
Eiichiro Yamamoto, MD, PhD: Department of Cardiovascular Medicine, Kumamoto University School of Medicine, Kumamoto, Japan
Hirofumi Soejima, MD, PhD: Department of Cardiovascular Medicine, Kumamoto University School of Medicine, Kumamoto, Japan
Koichi Kaikita, MD, PhD: Department of Cardiovascular Medicine, Kumamoto University School of Medicine, Kumamoto, Japan
Kenichi Matsushita, MD, PhD: Department of Cardiovascular Medicine, Kumamoto University School of Medicine, Kumamoto, Japan; Division of Advanced Cardiovascular Therapeutics, Kumamoto University Hospital, Kumamoto Japan
Masao Matsuoka, MD, PhD: Department of Hematology, Rheumatology, and Infectious Diseases, Kumamoto University School of Medicine, Kumamoto Japan
Koichiro Usuku, MD, PhD: Department of Medical Information Science and Administration Planning, Kumamoto University Hospital, Kumamoto Japan
Kenichi Tsujita, MD, PhD: Department of Cardiovascular Medicine, Kumamoto University School of Medicine, Kumamoto, Japan

Journal volume & issue: Vol. 1, no. 2
pp. 259 – 270

Abstract

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Background: Although the Khorana venous thromboembolism (VTE) risk score (KRS) is well recognized as a simple VTE risk assessment method in patients with cancer, whether it is suitable for Asian populations is unclear. Objectives: This study validated KRS for the prediction of VTE and investigated the value of the KRS in predicting mortality in Japanese patients with cancer. Methods: A body mass index value of 25 kg/m2 or more was defined as obesity according to World Health Organization consensus. A total of 27,687 patients with cancer were subdivided into low- (0), intermediate- (1-2), and high-score (3) groups by the KRS. The primary and secondary endpoints were VTE and all-cause mortality, respectively. Results: The prevalence of VTE was 1.7%, 7.3%, and 11.0% for low-, intermediate-, and high-score patients, respectively. Receiver operating characteristic (ROC) analysis showed that the KRS significantly predicted VTE (area under the curve, 0.679; 95% confidence interval [CI] 0.666-0.692; P < 0.001). The cutoff value for the KRS was 1.0. Logistic regression analysis demonstrated that the KRS was an independent predictor of VTE (odds ratio 1.766; 95% CI 1.673-1.865; P < 0.01). The cutoff value of the KRS for all-cause mortality determined by ROC analysis was 2.0. Kaplan–Meier analysis demonstrated a significantly higher incidence of mortality in the KRS ≥2 group than in the KRS 0-1 group (log-rank: P < 0.01). Conclusions: The KRS was useful in Japanese patients with cancer and might be a potentially useful marker for the prediction of mortality. Establishing optimal scores for Japanese subjects is mandatory because of its low diagnostic ability. (KUMAMON Cancer registry; UMIN000047554)

Published in JACC: Asia

ISSN: 2772-3747 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the circulatory (Cardiovascular) system
Website: https://www.sciencedirect.com/journal/jacc-asia

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