The COMPASS-CAT risk assessment model for predicting in-hospital venous thromboembolism in patients with breast, lung, colorectal, and ovarian cancer: A retrospective cohort study
Hualin Wei, Wei Han, Xianbo Zhang, Jing ZhaoObjective
To 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.
Methods
This 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.
Results
Of 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).
Conclusion
The 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.