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Khorana score (chemotherapy-associated VTE)

Also called Khorana risk score, Khorana VTE score

Five-item risk score for symptomatic VTE in cancer outpatients starting chemotherapy.

Site of cancer

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Formula and scoring

Very high-risk site (stomach, pancreas) 2; high-risk site (lung, lymphoma, gynaecological, bladder, testicular) 1; platelets ≥350, Hb <10 g/dL or ESA use, WBC >11, BMI ≥35: 1 each. 0 low, 1–2 intermediate, ≥3 high.

Exam and ward pearls

  • Stomach and pancreas are the only 2-point sites.
  • Two of the five items are routine pre-chemotherapy counts (platelets and leucocytes).

When not to rely on it

  • Modest discrimination (C-statistic 0.7 in both cohorts). Derived in ambulatory patients starting chemotherapy — not for inpatients or patients already anticoagulated.

Source

  1. Khorana AA, Kuderer NM, Culakova E, Lyman GH, Francis CW. Development and validation of a predictive model for chemotherapy-associated thrombosis. Blood. 2008;111(10):4902-7. doi:10.1182/blood-2007-10-116327 · PMID 18216292

Formula and cut-offs checked against these sources on 8 Nov 2026. Educational tool for clinicians; it does not replace clinical judgement.

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