Karnofsky Performance Scale

The Karnofsky Performance Scale Index is an assessment tool for functional impairment.

Karfnofsky performance scale can be used to compare effectiveness of different therapies and to assess the prognosis in individual patients.

Lower the the Karnofsky score, the worse the likelihood of survival. Lower Karnofsky score indicates a severe disease.

The scale is frequently used in hospice and  in cancer patients.

The Karnofsky Performance Score (KPS) ranking runs from 100 to 0, where 100 is “perfect” health and 0 is death.

This scoring system is named after Dr. David A. Karnofsky, who described the scale with Dr. Walter H. Abelmann, Dr. Lloyd F. Craver, and Dr. Joseph H. Burchenal in 1948.

The primary purpose of its development was to allow physicians to evaluate a patient’s ability to survive chemotherapy for cancer.

David A. Karnofsky, MD, (d. 1969) was an oncologist at Sloan-Kettering Institute for Cancer Research. He specialized in cancer chemotherapy and affiliated with the division of experimental chemotherapy.

Karnofsky Performance Scale is  outlined below.

A higher score indicates a better functional status. Typically, someone who is better able to walk and care for themselves has a better prognosis.

100

Normal, no complaints, no evidence of disease

90

Able to carry on normal activity; minor symptoms of disease

80

Normal activity with effort; some symptoms of disease

70

Cares for self; unable to carry on normal activity or active work

60

Requires occasional assistance but is able to care for needs

50

Requires considerable assistance and frequent medical care

40

Disabled: requires special care and assistance

30

Severely disabled; hospitalization is indicated, but death not imminent

20

Very sick, hospitalization necessary; active treatment necessary

10

Moribund, fatal processes progressing rapidly

Patients can be generally categorized into three groups of needs, based on their scores

100-80

• Able to carry on normal activity and to work
• No special care needed

70-50

• Unable to work
• Able to live at home and care for most personal needs
• Varying amount of assistance needed

40-0

• Unable to care for self
• Requires equivalent of institutional or hospital care
• Diseases may be progressing rapidly