Key result
COMPASS-CAT score outperforms Khorana for predicting in-hospital VTE, yielding an AUC of 0.91 vs 0.70.
Why the study?
To evaluate the predictive accuracy of the COMPASS-CAT risk model compared to the established Khorana score for in-hospital venous thromboembolism in patients with solid tumors.
Does the COMPASS-CAT risk assessment model improve the prediction of in-hospital venous thromboembolism compared to the Khorana score in inpatients with solid tumors?
Cohort (n=482)
Blinded adjudication
No
Does the COMPASS-CAT risk assessment model improve the prediction of in-hospital venous thromboembolism compared to the Khorana score in inpatients with solid tumors?
The COMPASS-CAT risk assessment model demonstrates superior discriminative accuracy and higher specificity compared to the Khorana score for predicting in-hospital venous thromboembolism in patients with solid tumors.
May improve in-hospital VTE stratification in solid tumor patients; hypothesis-generating and requires prospective validation before adoption.
ObjectiveTo assess the predictive accuracy of the comparison of methods for thromboembolic risk assessment with clinical perceptions and awareness in real-life patients with cancer-associated thrombosis (COMPASS-CAT) risk model against the established Khorana score for predicting in-hospital venous thromboembolism in patients with solid tumors.MethodsThis retrospective cohort study analyzed 482 inpatients with breast, lung, colorectal, or ovarian cancer. Venous thromboembolism risk was stratified using the COMPASS-CAT and Khorana scores. The primary outcome was objectively verified in-hospital venous thromboembolism. Discriminative performance was evaluated using receiver operating characteristic curve analysis.ResultsOf the 482 patients, 53 (11.0%) developed in-hospital venous thromboembolism. The COMPASS-CAT model (score ≥7) demonstrated higher specificity (98.13% vs. 81.77%) and positive predictive value (82.22% vs. 35.00%) compared with the Khorana score (score ≥2). The COMPASS-CAT model exhibited significantly better overall discrimination, with an area under the curve of 0.913 versus 0.695 for the Khorana score (p < 0.001). Univariate logistic regression revealed that a COMPASS-CAT score ≥7 was strongly associated with elevated venous thromboembolism risk (odds ratio = 20.66, 95% confidence interval: 9.96-42.83). A Khorana score ≥2 was also associated with an increased risk, but the magnitude was weaker (odds ratio = 3.26).ConclusionThe COMPASS-CAT model exhibited a promising discriminative trend over the Khorana score for identifying the risk of in-hospital venous thromboembolism. Its notably higher specificity and positive predictive value suggest that it may serve as a helpful supplementary tool for targeted thromboprophylaxis in the inpatient oncology setting.
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Wei et al. (2026) conducted a cohort in Breast, lung, colorectal, or ovarian cancer (n=482). COMPASS-CAT risk model vs. Khorana score was evaluated on In-hospital venous thromboembolism (OR 20.66, 95% CI 9.96-42.83, p=<0.001). The COMPASS-CAT risk model demonstrated superior discrimination for predicting in-hospital venous thromboembolism compared to the Khorana score, with an AUC of 0.913 versus 0.695 (p < 0.001).
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