Karnofsky performance index (palliative performance scale)
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Introduction
A performance scale for rating a person's usual activities.
Indications
- evaluate a patient's progress after a therapeutic procedure
- assess prognosis in terminally ill patients
Clinical significance
- a palliative performance score of <50% confers eligibility for hospice[6]
- the range of palliative performance score at hospice admission vary from 10% to 70%[5]
- 56% of patients admitted to hospice have a palliative performance score of <= 40%[5]
Procedure
100: normal; no complaints; no evidence of disease
90: able to carry on normal activity; minor signs or symptoms of disease
80: normal activity with effort; some signs or symptoms of disease
70: cares for self; unable to carry on normal activity or do active work
60: requires occasional assistance, but is able to care for most needs
50: requires considerable assistance & frequent medical care
40: disabled; requires special care & assistance
30: severely disabled; hospitalization is indicated although death is not imminent
20: very sick; hospitalization necessary; active support treatment is necessary
10: moribund; fatal processes progressing rapidly
0: dead
More general terms
References
- ↑ Harrison's Principles of Internal Medicine, 14th ed. Fauci et al (eds), McGraw-Hill Inc. NY, 1998, pg 495
- ↑ Medical Guidelines for Determining Prognosis in non-Cancer Diseases, 2nd edition, Stuart et al (eds), National Hospice Organization, Arlington, VA, 1996
- ↑ Lau F et al Use of Palliative Performance Scale in end-of-life prognostication. J Palliat Med. 2006 Oct;9(5):1066-75. PMID: https://pubmed.ncbi.nlm.nih.gov/17040144
- ↑ Prompantakorn P, Angkurawaranon C, Pinyopornpanish K, et al. Palliative Performance Scale and survival in patients with cancer and non-cancer diagnoses needing a palliative care consultation: a retrospective cohort study. BMC Palliat Care. 2021;20(1):74 PMID: https://pubmed.ncbi.nlm.nih.gov/34039322 PMCID: PMC8157447 Free PMC article https://bmcpalliatcare.biomedcentral.com/articles/10.1186/s12904-021-00773-8
- ↑ 5.0 5.1 5.2 Jansen WJ, Buma S, Gootjes JR et al The palliative performance scale applied in high-care residential hospice: a retrospective study. J Palliat Med. 2015 Jan;18(1):67-70. PMID: https://pubmed.ncbi.nlm.nih.gov/25122510
- ↑ 6.0 6.1 Geriatric Review Syllabus (GRS12) Colburn JL, Westcott AM, Potter JF (eds) American Geriatrics Society. 2025