Karnofsky Score


Name

Karnofsky Score.

Synonyms

Karnofsky Scale, Karnofsky Scoring, Karnofsky Index, Karnofsky Performance Scale, Karnofsky Performance Status Scale.

Source Article
Karnofsky DA, Burchenal JH. (1949). "The Clinical Evaluation of Chemotherapeutic Agents in Cancer." In: MacLeod CM (Ed), Evaluation of Chemotherapeutic Agents. Columbia Univ Press. Page 196.

Description
The Karnofsky Performance Scale Index is used to quantify patients' general well-being and activities of daily life. The scoring system was named after Dr. David A. Karnofsky, who described the scale with Dr Joseph H. Burchenal in 1949. Karnofsky Score allows patients to be classified as to their functional impairment. Thus, the scale can be used to compare effectiveness of different therapies and to assess the prognosis in individual patients. Also, it is useful to track it over time, to see ups and downs in the disease process. 


Structure / Content
The Karnofsky score runs from 100 to 0. The lower the Karnofsky score, the worse the survival for most serious illnesses. 100 point means complete healthy status and 0 is death. Although the score has been described with intervals of 10, a practitioner may choose decimals if the observer feels that a patient's situation holds somewhere between two marks.

    100% – normal, no complaints, no signs of disease
    90% – capable of normal activity, few symptoms or signs of disease
    80% – normal activity with some difficulty, some symptoms or signs
    70% – caring for self, not capable of normal activity or work
    60% – requiring some help, can take care of most personal requirements
    50% – requires help often, requires frequent medical care
    40% – disabled, requires special care and help
    30% – severely disabled, hospital admission indicated but no risk of death
    20% – very ill, urgently requiring admission, requires supportive measures or treatment
    10% – moribund, rapidly progressive fatal disease processes
    0% – death.


Interpretation

Able to carry on normal activity and to work; no special care needed.

  100  

90

80

Unable to work; able to live at home and care for most personal needs; varying amount of assistance needed.

70

60

50

Unable to care for self; requires equivalent of institutional or hospital care; disease may be progressing rapidly.

40

30

20

10

0

 


References

Karnofsky DA, Burchenal JH. (1949). "The Clinical Evaluation of Chemotherapeutic Agents in Cancer." In: MacLeod CM (Ed), Evaluation of Chemotherapeutic Agents. Columbia Univ Press. Page 196.

Crooks, V, Waller S, et al. The use of the Karnofsky Performance Scale in determining outcomes and risk in geriatric outpatients. J Gerontol. 1991; 46: M139-M144.
de Haan R, Aaronson A, et al. Measuring quality of life in stroke. Stroke. 1993; 24:320- 327.
Hollen PJ, Gralla RJ, et al. Measurement of quality of life in patients with lung cancer in multicenter trials of new therapies. Cancer. 1994; 73: 2087-2098.
O'Toole DM, Golden AM. Evaluating cancer patients for rehabilitation potential. West J Med. 1991; 155:384-387.
Oxford Textbook of Palliative Medicine, Oxford University Press. 1993;109.
Schag CC, Heinrich RL, Ganz PA. Karnofsky performance status revisited: Reliability, validity, and guidelines. J Clin Oncology. 1984; 2:187-193. 







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