Risk Factors and Prediction Models for Venous Thromboembolism in Ambulatory Patients with Lung Cancer

Ann-Rong Yan; Indira Samarawickrema; Mark Naunton; Gregory M Peterson; Desmond Yip; Salvatore De Rosa; Reza Mortazavi

doi:10.3390/healthcare9060778

Risk Factors and Prediction Models for Venous Thromboembolism in Ambulatory Patients with Lung Cancer

Healthcare (Basel). 2021 Jun 21;9(6):778. doi: 10.3390/healthcare9060778.

Authors

Ann-Rong Yan¹, Indira Samarawickrema², Mark Naunton¹, Gregory M Peterson^{1

3}, Desmond Yip^{1

4

5}, Salvatore De Rosa⁶, Reza Mortazavi^{1

7}

Affiliations

¹ School of Health Sciences, Faculty of Health, University of Canberra, Canberra 2617, Australia.
² School of Nursing, Midwifery and Public Health, Faculty of Health, University of Canberra, Canberra 2617, Australia.
³ College of Health and Medicine, University of Tasmania, Hobart 7005, Australia.
⁴ Department of Medical Oncology, The Canberra Hospital, Garran 2605, Australia.
⁵ ANU Medical School, Australian National University, Canberra 0200, Australia.
⁶ Department of Medical and Surgical Science, Magna Graecia University, 88100 Catanzaro, Italy.
⁷ Prehab Activity Cancer Exercise Survivorship Research Group, Faculty of Health, University of Canberra, Canberra 2617, Australia.

Abstract

Venous thromboembolism (VTE) is a significant cause of mortality in patients with lung cancer. Despite the availability of a wide range of anticoagulants to help prevent thrombosis, thromboprophylaxis in ambulatory patients is a challenge due to its associated risk of haemorrhage. As a result, anticoagulation is only recommended in patients with a relatively high risk of VTE. Efforts have been made to develop predictive models for VTE risk assessment in cancer patients, but the availability of a reliable predictive model for ambulate patients with lung cancer is unclear. We have analysed the latest information on this topic, with a focus on the lung cancer-related risk factors for VTE, and risk prediction models developed and validated in this group of patients. The existing risk models, such as the Khorana score, the PROTECHT score and the CONKO score, have shown poor performance in external validations, failing to identify many high-risk individuals. Some of the newly developed and updated models may be promising, but their further validation is needed.

Keywords: anticoagulant; lung cancer; prediction rules; risk assessment; risk factors; risk model; risk prediction; thromboprophylaxis; venous thromboembolism.

Publication types

Review