We aimed to establish an effective model to identify metastatic lung cancer patients at high risk of venous thromboembolism (VTE). Patients diagnosed with stage IV lung cancer from January 2011 to June 2019 were included in the development cohort; those recruited from July 2019 to June 2021 were included in the validation cohort. Univariable and multivariable analyses determined the risk factors for VTE. Then we assessed the value for predicting VTE of the Khorana score and modified Khorana score in these two cohorts; 575 patients were included in the development cohort, and 202 patients in the validation cohort. Adenocarcinoma, D-dimer, and the Khorana score were independent risk factors for VTE. In the development cohort, the area under the receiver operating characteristic curve (AUC) of the Khorana score in patients with newly diagnosed stage IV lung cancer was 0.598 (95% CI, 0.512-0.684). The AUC of the modified Khorana score was 0.747 (95% CI, 0.689-0.805). The difference was statistically significant (P <.001). The AUC of the modified Khorana score in the validation cohort was 0.763 (95% CI, 0.661-0.865). The modified Khorana score is more able to accurately predict VTE in patients with newly diagnosed stage IV lung cancer than the Khorana score.

中文翻译：

---

用于预测新诊断的 IV 期肺癌静脉血栓栓塞的改良 Khorana 评分的开发和验证。

我们的目的是建立一个有效的模型来识别具有静脉血栓栓塞（VTE）高风险的转移性肺癌患者。2011年1月至2019年6月诊断为IV期肺癌的患者被纳入开发队列；2019 年 7 月至 2021 年 6 月招募的人员被纳入验证队列。单变量和多变量分析确定了 VTE 的危险因素。然后我们评估了 Khorana 评分和修改后的 Khorana 评分在这两个队列中预测 VTE 的价值；开发队列中包括 575 名患者，验证队列中包括 202 名患者。腺癌、D-二聚体和 Khorana 评分是 VTE 的独立危险因素。在开发队列中，新诊断 IV 期肺癌患者 Khorana 评分的受试者工作特征曲线下面积 (AUC) 为 0.598（95% CI，0.512-0.684）。修改后的 Khorana 评分的 AUC 为 0.747（95% CI，0.689-0.805）。差异具有统计学意义（P <.001）。验证队列中修改后的 Khorana 评分的 AUC 为 0.763（95% CI，0.661-0.865）。与 Khorana 评分相比，修改后的 Khorana 评分能够更准确地预测新诊断 IV 期肺癌患者的 VTE。