Theoretical Trajectories of Dying
KARNOFSKY PERFORMANCE STATUS SCALE DEFINITIONS RATING (%) CRITERIA
The Karnofsky Performance Scale Index allows patients to be classified as to their functional impairment . This can be used to compare effectiveness of different therapies and to assess the prognosis in individual patients . The lower the Karnofsky score , the worse the survival for most serious illnesses .
Able to carry on normal activity and to work ; no special care needed .
Unable to work ; able to live at home and care for most personal needs ; varying amount of assistance needed .
Unable to care for self ; requires equivalent of institutional or hospital care ; disease may be progressing rapidly .
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
70
60
Cares for self ; unable to carry on normal activity or to do active work . Requires occasional assistance , but is able to care for most of his personal needs .
50 Requires considerable assistance and frequent medical 40 Disabled ; requires special care and assistance . 30
20
Severely disabled ; hospital admission is indicated although death not imminent .
Very sick ; hospital admission necessary ; active supportive treatment necessary .
10 Moribund ; fatal processes progressing rapidly . 0 Dead
References : 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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