What is the Khorana Score used for?

The Khorana Score predicts the risk of developing venous thromboembolism (DVT or pulmonary embolism) in cancer patients who are about to start chemotherapy. It helps oncologists decide whether preventive anticoagulation is appropriate.

Which cancers score 2 points in the Khorana model?

Stomach (gastric) cancer and pancreatic cancer are classified as very high-risk and each scores 2 points for the cancer site category. All other cancer types score 0 or 1 depending on their risk grouping.

What does a Khorana Score of 3 or higher mean?

A score of 3 or above indicates high VTE risk. Studies show these patients have a roughly 7–13% rate of symptomatic VTE within 2.5 months. Current guidelines (ASCO, ITAC) recommend considering prophylactic anticoagulation with DOAC or LMWH for this group, if bleeding risk allows.

Is this tool a substitute for physician judgment?

No. The Khorana Score is a clinical aid, not a decision mandate. Individual patient factors — renal function, bleeding history, drug interactions, patient preference — must be assessed by a qualified clinician before prescribing anticoagulation.

Does this tool store patient data?

No. All calculations run entirely in your browser. No data is transmitted to any server.

What blood draw timing should I use for the CBC inputs?

The Khorana Score was validated using CBC values obtained immediately before the start of a new chemotherapy cycle. Use the most recent pre-chemotherapy CBC for accurate results.

Khorana VTE Risk Score for Cancer Patients

Name: Khorana VTE Risk Score for Cancer Patients
Availability: InStock
Author: Nham Vu

Enter cancer site, pre-chemotherapy CBC values, and BMI to calculate Khorana VTE risk score and thromboprophylaxis guidance.

Patient Parameters

Cancer site / type

Very high-risk: stomach, pancreas (2 pts). High-risk: lung, lymphoma, gynecologic, bladder, testicular (1 pt).

Pre-chemo platelet count (× 10⁹/L)

≥ 350 × 10⁹/L adds 1 point.

Hemoglobin (g/dL)

{"<"} 10 g/dL or use of erythropoiesis-stimulating agents adds 1 point.

Patient is receiving red blood cell growth factors (ESAs / erythropoiesis-stimulating agents) Check this if Hgb is ≥ 10 g/dL but ESAs are used (still scores 1 pt).

Pre-chemo WBC / leukocyte count (× 10⁹/L)

> 11 × 10⁹/L adds 1 point.

BMI (kg/m²)

≥ 35 kg/m² adds 1 point.

Fill in the patient parameters and click Calculate to see the Khorana Score.

Khorana Score — Scoring Reference

Parameter	Criterion	Points
Cancer site	Stomach or pancreas	2
	Lung, lymphoma, gynecologic, bladder, testicular	1
Platelets	Pre-chemo count ≥ 350 × 10⁹/L	1
Hemoglobin	{"<"} 10 g/dL or use of ESAs	1
WBC	Pre-chemo count > 11 × 10⁹/L	1
BMI	≥ 35 kg/m²	1

Summary

Enter cancer site, pre-chemotherapy CBC values, and BMI to calculate Khorana VTE risk score and thromboprophylaxis guidance.

How it works

Select the primary cancer site from the dropdown — very high-risk cancers (stomach, pancreas) score 2 points; high-risk cancers (lung, lymphoma, gynecologic, bladder, testicular) score 1 point.
Enter the pre-chemotherapy platelet count — a count of 350 × 10⁹/L or above adds 1 point.
Enter the hemoglobin level — values below 10 g/dL, or use of red blood cell growth factors, add 1 point.
Enter the pre-chemotherapy white blood cell (leukocyte) count — a count above 11 × 10⁹/L adds 1 point.
Enter BMI — a BMI of 35 kg/m² or higher adds 1 point.
The tool sums all points and displays the Khorana Score with risk category and clinical guidance.

Use cases

Identify ambulatory cancer patients at high VTE risk before starting chemotherapy.
Guide clinical decisions on thromboprophylaxis in outpatient oncology settings.
Communicate quantified clot risk to patients and caregivers.
Support oncology nursing staff in pre-chemo assessments.
Teach oncology trainees about chemotherapy-associated thrombosis risk factors.
Document risk stratification in oncology clinic notes.

Frequently Asked Questions

Last updated: 2026-07-01 · Reviewed by Nham Vu