THROMBOTIC RISK ASSESSMENT, P SELECTIN AND THROMBOPROPHYLAXIS USE AMONG CANCER PATIENTS AT UCTH, CALABAR

Venous thromboembolism (VTE) stands as ensuing cause of mortality among cancer patient. Khorana Risk Assessment Score (KRAS) is the most acknowledged validated tool in this context. Modification of KRAS to include biomarkers like P-selectin holds the promise of refining the scoring system, enabling early identification of cancer patients susceptible to thrombosis and who would benefit from thromboprophylaxis. Our local context sees a surge in VTE among cancer patients, yet there is scarcity of information on modified KRAS and thromboprophylaxis practices. Therefore, this study seeks to evaluate thrombotic risk among cancer patients using KRAS, to assess the correlation between modified KRAS,soluble P-selectin levels, and document the utilization of thromboprophylaxis among cancer patients at the University of Calabar Teaching Hospital(UCTH).

cross-sectional study at the UCTH, Calabar, and100 cancer patients were recruited with 7mls blood used for full blood count and P-selectin assay. BMI was determined using weight and height. Data analysis was performed using the Statistical Package for Social Sciences version 26. Continuous variables were expressed as mean and standard deviation, while categorical variables were summarized using frequencies. Chi-square was employed to compare VTE risk status across genders, different cancer types, and guideline compliance. The significance level was set at 0.05.

Subjects' ages ranged from 19 to 87 years, with a male-to-female ratio of 1:1.6. Female cancers included Breast (40.32%), ovarian (24.19%), lymphoma (11.29%), cervical, leukaemia, and vulva (4.84% each), while endometrial and pancreatic cancers were 3.23% each, and lungs and osteosarcoma 1.61% each. Male cancers comprised prostate (65.79%), lymphoma (13.16%), leukaemia (7.89%), bladder (5.26%), and gastric, glioblastoma, and lungs (2.63% each). Notably, 79% and 21% had intermediate and high-risk scores based on the modified Khorana Risk Assessment Score. The median (IQR) level of soluble P-selectin among cancer patients was 23.00 within the interquartile range. Significant associations were observed between cancer types and sex, VTE risk assessment and cancer types, and cancer types and risk score. Thromboprophylaxis use was observed in only 4% of cancer patients. The analysis also revealed a low utilization of thromboprophylaxis vis-à-vis the thrombosis risk among cancer patients at the UCTH. Based on these findings.

cancer patients exhibit a moderate to high risk of developing VTE using the modified KRAS. It was recommended that stakeholders in the cancer space should formulate a policy or develop an algorithm to ensure a risk stratification with strict adherence to KRAS of all cancer patients at risk of VTE and use of thromboprophylaxis.