This table does not apply to selected populations for whom anticoagulation is warranted, such as those undergoing surgical procedures with high VTE risk or those with multiple myeloma receiving an immunomodulatory drug and high-dose glucocorticoids. Some individuals may reasonably choose primary prophylaxis with a LMW heparin or with a direct factor Xa inhibitor if they have a high risk of VTE. Examples include:
- Khorana score ≥3
- Khorana score of 2 with a high value placed on avoiding VTE
- Prior VTE not currently receiving anticoagulation
- Severe immobility
Tools for estimating VTE risk are imprecise, but the Khorana score may be used; pancreatic cancer and gastric cancer give a Khorana score of at least 2.