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Khorana VTE Score Calculator

Enter cancer site, blood counts and BMI to compute the Khorana VTE score.

How it is calculated

The score is a plain sum of points, starting at 0: score = site + platelets + anemia + leukocytes + BMI. Site gives 2 points for the very-high-risk group, 1 for the high-risk group and 0 for any other cancer. Each of the other four items adds 1 point: platelets ≥ 350 (×109/L), hemoglobin < 10 g/dL, leukocytes > 11 (×109/L) and BMI ≥ 35 kg/m2. Ticking the erythropoiesis-stimulating agent box also scores the anemia point, even if hemoglobin is 10 or higher, and it never scores twice. Cut-offs are exact: platelets of exactly 350 score, leukocytes of exactly 11 do not. All five fields must be filled, otherwise no score appears. The result is a whole number from 0 to 6.

Worked example

Take a lung cancer patient (high-risk site) with platelets 380, hemoglobin 9.4 g/dL, leukocytes 8 and BMI 27. Site: high-risk, so 1 point. Platelets: 380 is at least 350, so 1 point. Hemoglobin: 9.4 is below 10, so 1 point. Leukocytes: 8 is not above 11, so 0 points. BMI: 27 is below 35, so 0 points. Total: 1 + 1 + 1 + 0 + 0 = 3.

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Common mistakes

  • Entering the platelet count in cells per microliter (for example 380000) instead of ×109/L (380); the cut-off is then always met and a point is added wrongly.
  • Entering hemoglobin in g/L (94) instead of g/dL (9.4), which hides the anemia point.
  • Using the BMI or blood counts from after chemotherapy has started, when the score is meant for values taken before treatment.
  • Ticking the ESA box and also expecting a second point for low hemoglobin; the anemia item is worth one point in total.
  • Picking the cancer site by organ system loosely, for example choosing the very-high group for any gastrointestinal cancer, when only stomach and pancreas belong there.

Sources

About this calculator

The Khorana score sums five risk factors: cancer site (2 points for very-high-risk sites like stomach or pancreas, 1 point for high-risk sites like lung, lymphoma, gynecologic, bladder, or testicular cancer), pre-chemotherapy platelet count ≥ 350×10⁹/L (1 point), hemoglobin < 10 g/dL or use of erythropoiesis-stimulating agents (1 point), leukocyte count > 11×10⁹/L (1 point), and BMI ≥ 35 kg/m² (1 point) — a total score of 3 or higher identifies a patient as high-risk for venous thromboembolism (VTE).

Oncologists and hematologists use this validated score before starting outpatient chemotherapy to decide whether a patient's clotting risk justifies prophylactic anticoagulation, following guidance built directly around this scoring system from groups like ASCO and NCCN.

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  • Editorial team

    The cut-offs are strict, so a value sitting on a boundary deserves a second look at the original lab report: platelets of exactly 350 score a point, leukocytes of exactly 11 do not. The tool returns only the total, with no risk band, and it is an aid for a clinician rather than a decision on its own. Which lab report units give you trouble when entering values?

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