Abstract | November 8, 2021

Association of the RIETE Score with Occult Cancer in Patients with Venous Thromboembolism

Presenting Author: Melissa Rose Infosino, BA, Medical Student, 4th Year, Tulane University School of Medicine, New Orleans, LA, New Orleans, LA

Coauthors: Melissa Infosino, BA, Medical Student, Tulane University School of Medicine, New Orleans, LA; Kesany Boupapanh, BS, Medical Student, Tulane University School of Medicine, New Orleans, LA; Yichi Zhang, BS, Medical Student, Tulane University School of Medicine, New Orleans, LA; Lahaina White, BS, Medical Student, Tulane University School of Medicine, New Orleans, LA; Jessica Shank, MD, Assistant Professor, Gynecologic Oncology, Tulane University School of Medicine, New Orleans, LA.

Learning Objectives

  1. Identify the need for better guidelines of occult cancer screening;
  2. Examine a recently-proposed risk prediction score in identifying occult cancer in patients with venous thromboembolism.

Background: Venous thromboembolism (VTE) may be the first sign of cancer in patients; however, current screening guidelines for cancer in patients with VTE remains ambiguous. Here, we investigate the efficacy of the Registro Informatizado Enfermedad TromboEmbolica (RIETE) score in identifying VTE patients at high-risk for cancer.

Methods: In this retrospective analysis, patients diagnosed with a VTE from January to December 2019 at an academic medical institution were assigned a RIETE score and evaluated for subsequent cancer diagnosis within 12 months. Statistical analysis was performed with IBM-SPSS using the Fisher exact test.

Results: A total of 211 patients with a VTE diagnosis were included (50% Female, 55% African American, Average age = 59.6∓15.7, Average BMI = 29.5∓8.8). Seventy-nine (37.4%) patients had a RIETE score ≥ 3 (high-score) while 132 (62.6%) had a score of < 3 (low-score). There was no statistically significant difference in the incidence of cancer diagnosis in high score patients compared to that in low-score patients (n=4 [5.06%] vs. n=2 [1.52%], respectively, p=0.2). We found similar results when patients were stratified by sex. Among female patients, the incidence of cancer diagnosis in high-score patients was greater compared to that in low-score patients, but the difference was not significant (n=2 [11.11%] vs. n=1 [1.14%], respectively, p=0.074). Similar results were found in high- and low-score male patients (n=2 [3.28%] vs. n=1 [2.27%], respectively, p=0.62).

Conclusion: Higher RIETE score is not correlated with increased risk of future cancer diagnoses in neither female nor male patients with VTE at our institution. While the RIETE score was not an effective stratification tool, we recommend larger follow-up studies. In the interim, malignancy evaluation should be offered to patients with VTE.

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