Background: Gynecologic cancer confers a high risk for developing venous thromboembolism (VTE). Current guidelines recommend VTE prophylaxis for cancer patients with a Khorana score ≥ 2. One report found that <10% of oncology practitioners use a risk assessment tool, leading to low prescribing rates of VTE prophylaxis.

Aims: The primary objective was to assess the utilization of VTE prophylaxis in gynecologic oncology patients before and after implementation of a Khorana score-based smartphrase tool.

Methods: A smartphrase tool for VTE risk assessment was implemented in a gynecologic oncology clinic in October 2020. Adult patients initiating chemotherapy for newly diagnosed or recurrent disease between January 2014 through January 2020 were included in a historical cohort.  Patients initiating chemotherapy between October 2020 and December 2020 were included in a prospective cohort. Data relating to VTE was collected for up to 6 months after treatment initiation.

Results: Of 110 patients included in the historical cohort, 48 (43.6%) had a Khorana score ≥ 2, compared to 6 of 16 (37.5%) in the prospective cohort.  None of the historical patients received prophylaxis, compared to 3 of 6 (50%) in the prospective cohort (p<0.001). Thrombosis occurred in 10 historical patients (9.1%) compared to 2 (12.5%) in the prospective cohort, all in patients not receiving VTE prophylaxis.

Conclusions: Implementation of a Khorana score screening tool significantly increased utilization of VTE prophylaxis in a gynecologic oncology clinic; however, thrombosis rates remained similar. Additional risk factors may need to be incorporated, and ongoing assessment of the intervention impact is necessary. Similar tools should be considered to improve prophylaxis prescribing rates in clinics with low uptake.

« Back to ISTH 2021 Congress

ISTH Congress Abstracts - https://abstracts.isth.org/abstract/impact-of-a-smartphrase-venous-thromboembolism-risk-assessment-tool-on-prophylaxis-prescribing-rates-in-a-gynecologic-oncology-clinic/