Comparison among three predictive models for cancer-associated thromboembolism in a Hispanic population.

Abstract

e24074 Background: Several predictive scores have been developed to assess the risk of venous thromboembolism (VTE) among cancer patients. Although their use is currently recommended by several guidelines, it is unknown if these scores can accurately predict the risk of VTE in Hispanic patients that are at different risk for thrombosis. Methods: We retrospectively evaluated all outpatients with newly diagnosed solid tumors receiving systemic chemotherapy in Hospital San Juan Dios, San José, Costa Rica, from January to December 2021. For each patient, the Khorana, PROTECHT, and CONKO scores were calculated at the beginning of treatment. The sixth-month cumulative incidence of VTE was estimated using the Fine & Gray competing risk model for the overall population and stratified according to each risk category. A Kaplan-Meier analysis was used to compare the cumulative VTE incidences between high- and low-risk categories of the three predictive scores. The Cox regression analysis was used to calculate the hazard ratio (HR) and its corresponding 95% confidence interval (CI). The receiver operating characteristic (ROC) curve was used to assess the performance of each predictive tool through the analysis of the c-statistic, sensitivity, and specificity. Results: 708 patients were included in the analysis. After a median follow-up of 8.13 months, the cumulative VTE incidence at six months was 4.45% (95%CI: 3.25-6.91%). At the conventional positivity threshold of 3 points, these scores classified from 17.7 to 27.5% of all patients as high-risk for VTE. The 6-month incidence of VTE among high-risk patients ranged from 7.6% for the Khorana score to 9.3% for the CONKO score. Patients belonging to the high-risk category of the Khorana, PROTECHT, and CONKO scores had significantly higher risk of VTE in comparison to low-risk patients (Khorana score: HR: 2.66; 95%CI:1.20-5.89; p = 0.042; PROTECHT score: HR: 3.44; 95%CI:1.63-7.21; p = 0.001; CONKO score HR: 3.68; 95%CI:1.72-7.85; p = 0.001). Table 1 resumes the performance of the studied scores. Table 1. Performance of the Khorana, PROTECHT, and CONKO scores for the prediction of venous thromboembolism. Conclusions: The Khorana, PROTECHT, and CONKO scores accurately predict the risk of VTE in Hispanic patients with solid tumors with similar performance among them. However, their sensitivity and specificity remain poor for identifying all patients at risk for thromboembolic events.[Table: see text]