Risk Assessment Tools For Venous Thromboembolism In Cancer Patients

Part one Khorana Tool and Caprini Tool in Screening Patients with High Risk of Venous Thromboembolism in Cancer Patients: meta-analysisObjective: To systematically evaluate the performance of the Khorana risk assessment tool and the Caprini tool in assessing the risk of venous thromboembolism in cancer patients,and compare the performance of those two tools in assessing the risk of venous thromboembolism.Method: Databases including Cochrane Library,PubMed,Web of Science,CNKI et al.were searched about the application of the two tools in cancer patients according to the inclusion and exclusion criteria.Two researchers independently evaluated the quality of the screened studies,extracted data and input data.RevMan5.3 and MetaDi Sc were used to do the statistical analysis.Results:1.The meta-analysis of Khorana risk assessment tool in screening cancer patients with high risk of venous thromboembolism eventually included 9 studies with a total of 10001 subjects.It showed that the AUC and DOR were 0.65 and 2.26(95% CI 1.51-3.38)respectively.2.Meta-analysis of the Caprini risk assessment tool for screening cancer patients with high risk of venous thromboembolism eventually included 4 studies with 18174 subjects,and AUC and DOR were 0.78 and 5.11(95% CI 1.79-14.58),respectively.Part two the Application of Caprini Tool in Cancer Patients Receiving ChemotherapyObjective: To identify the efficacy of Caprini tool with different cut-off values on receiver operating characteristic(ROC)curve.Method: 345 cases of cancer patients receiving chemotherapy diagnosed as venous thromboembolism were collected from January 2013 to September 2017.A total of 345 patients without VTE in control group were randomly selected using mechanical sampling method in the same hospital.Each patient underwent VTE risk score according to the Caprini tool.The best cut-off value for this tool in cancer patients was obtained by ROC curve analysis.Results: The area under the ROC curve(AUC)was 0.80(95% CI 0.76-0.84)and the best cut-off value was 6 points for the Caprini tool in cancer patients with chemotherapy.Sensitivity,specificity,positive predictive value,negative predictive value,positive likelihood ratio and negative likelihood ratio were 68.09%,77.87%,75.50%,70.90%,3.08 and 0.41,respectively.Conclusion: Compared with Khorana tool,Caprini tool is more effective in assessing the cancer patients with high risk VTE.The Caprini tool gives the best forecast when it is divided by 6.