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Karnofsky performance index (palliative performance scale)

A performance scale for rating a person's usual activities. Indications: 1) evaluate a patient's progress after a therapeutic procedure 2) 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: Performance status: 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

General

performance scale index functional assessment

References

  1. Harrison's Principles of Internal Medicine, 14th ed. Fauci et al (eds), McGraw-Hill Inc. NY, 1998, pg 495
  2. Medical Guidelines for Determining Prognosis in non-Cancer Diseases, 2nd edition, Stuart et al (eds), National Hospice Organization, Arlington, VA, 1996
  3. Lau F et al Use of Palliative Performance Scale in end-of-life prognostication. J Palliat Med. 2006 Oct;9(5):1066-75. PMID: 17040144
  4. 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: 34039322 PMCID: PMC8157447 Free PMC article https://bmcpalliatcare.biomedcentral.com/articles/10.1186/s12904-021-00773-8
  5. 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: 25122510
  6. Geriatric Review Syllabus (GRS12) Colburn JL, Westcott AM, Potter JF (eds) American Geriatrics Society. 2025