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Khorana score

Estimates symptomatic venous thromboembolism risk in the first months of outpatient chemotherapy and supports discussion of thromboprophylaxis.

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Check the population, units and version. The result shows the formula or classification; it does not make an automatic treatment decision.

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Method · Limits of application

Khorana 2008: tumor site+platelets+Hb/EPO+leukocytes+BMI, total 0–6

VTE risk score in the context of cancer and outpatient systemic therapy, using prechemotherapy data. The score does not measure bleeding risk and does not, on its own, indicate anticoagulation, a drug or a dose. Classification must be complemented by clinical assessment and bleeding-risk assessment. These local numerical tests do not establish application to pediatric patients, hospital inpatients or the perioperative setting; those uses require specific evidence and protocols.

Conditions of use

Check the population, units, inclusion and exclusion criteria, and version in the original source. A result alone does not establish a diagnosis, discharge decision or prescription.

Documented parameters

Primary cancer site
Prechemotherapy platelet count ≥ 350,000/µL
Hemoglobin < 10 g/dL or use of an erythropoiesis-stimulating agent
Prechemotherapy leukocyte count > 11,000/µL
BMI ≥ 35 kg/m²

3/3 reference cases checked. Numerical tests are not clinical validation.

Sources and documentation

Documented formula

Transcribed from the source or a recorded revision; this is not a clinical recommendation.

Stomach or pancreas 2 · lung, lymphoma, gynecologic, bladder or testicular cancer 1 · platelets ≥ 350,000/µL 1 · Hb < 10 g/dL or an erythropoiesis-stimulating agent 1 · leukocytes > 11,000/µL 1 · BMI ≥ 35 kg/m² 1. Maximum: 6.

References

Identifier: khorana

Original clinical content: Brazilian Portuguese.

Method version

Khorana 2008: tumor site+platelets+Hb/EPO+leukocytes+BMI, total 0–6

khorana@native-2026-10-03+6d3b1f534b04

Source for the active edition

The bibliographic edition identifies the source. By itself, it proves neither full conformity of the formula nor clinical approval.

Synthetic cases checked (3)

Synthetic cases for checking the implementation, with no patient data.

Case 1

reference-001

Inputs

Primary cancer site: Other sites
Prechemotherapy platelet count ≥ 350,000/µL: No
Hemoglobin < 10 g/dL or use of an erythropoiesis-stimulating agent: No
Prechemotherapy leukocyte count > 11,000/µL: No
BMI ≥ 35 kg/m²: No

{
  "sitio": "0",
  "plaq": false,
  "hb": false,
  "leuco": false,
  "imc": false
}

Expected result

{
  "score": 0,
  "level": "low"
}

Actual result

{
  "score": 0
}

Case 2

reference-002

Inputs

Primary cancer site: High risk: lung, lymphoma, gynecologic, bladder or testicular cancer
Prechemotherapy platelet count ≥ 350,000/µL: Yes
Hemoglobin < 10 g/dL or use of an erythropoiesis-stimulating agent: No
Prechemotherapy leukocyte count > 11,000/µL: No
BMI ≥ 35 kg/m²: No

{
  "sitio": "1",
  "plaq": true,
  "hb": false,
  "leuco": false,
  "imc": false
}

Expected result

{
  "score": 2,
  "level": "mid",
  "verdict": "intermediário"
}

Actual result

{
  "score": 2
}

Case 3

reference-003

Inputs

Primary cancer site: Very high risk: stomach or pancreatic cancer
Hemoglobin < 10 g/dL or use of an erythropoiesis-stimulating agent: Yes
Prechemotherapy platelet count ≥ 350,000/µL: No
Prechemotherapy leukocyte count > 11,000/µL: No
BMI ≥ 35 kg/m²: No

{
  "sitio": "2",
  "hb": true,
  "plaq": false,
  "leuco": false,
  "imc": false
}

Expected result

{
  "score": 3,
  "level": "high"
}

Actual result

{
  "score": 3
}

Code and reproducibility

This tool’s code on GitHub

Download code and tests

Sources, version and reproduction instructions

The code tests are technical checks. Clinical approval and professional translation review are recorded separately.

Relationship with cancer research

Specific oncological application

A model originally developed for thromboembolism risk in patients with cancer receiving chemotherapy. Use is conditional on the population and version.

Applications: Adverse effects and safety