Performance status Details, Meaning Performance status Article and Explanation Guide

Performance status Guide, Meaning , Facts, Information and Description

In medicine (oncology and other fields), performance status is an attempt to quantify cancer patients' general wellbeing. This measure is used to determine whether they can receive chemotherapy, whether dose adjustment is necessary, and as a measure for the required intensity of palliative care. It is also used in oncological randomized controlled trials as a measure of quality of life.

Table of contents

1 Scoring systems
2 Karnofsky scoring
3 Zubrod score
4 Lansky score
5 References

Scoring systems

There are various scoring systems. The most generally used are the Karnofsky score and the Zubrod score, the latter being used in publications by the WHO. For children, the Lansky score is used.

Parallel scoring systems include the Global Assessment of Functioning (GAF) score, which has been incorporated as the fifth axis of the Diagnostic and Statistical Manual (DSM) of psychiatry.

Karnofsky scoring

The Karnofsky score runs from 100 to 0, where 100 is "perfect" health and 0 is death. Although the score has been described with intervals of 10, a practitioner may choose decimals if he or she feels 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.

Zubrod score

The WHO/Zubrod score (also sometimes called the "Eastern Cooperative Oncology Group" score) runs from 0 to 5, with 0 denoting perfect health and 5 death:

0 - Asymptomatic
1 - Symptomatic but completely ambulant
2 - Symptomatic, <50% in bed during the day
3 - Symptomatic, >50% in bed, but not bedbound
4 - Bedbound
5 - Death

Lansky score

Children, who might have more trouble expressing their experienced quality of life, require a somewhat more observational scoring system:

100 - fully active, normal
90 - minor restrictions in strenous physical activity
80 - active, but tired more quickly
70 - greater restriction of play and less time spent in play activity
60 - up and around, but active playminimal; keeps busy by being involved in quieter activities
50 - lying around much of the day, but gets dressed; no active playing participates in all quiet play and activities
40 - mainly in bed; participates in quiet activities
30 - bedbound; needing assistance even for quiet play
20 - sleeping often; play entirely limited to very passsive activities
10 - doesn't play; does not get out of bed
0 - unresponsive

References

Performance status calculator (FDA)
A table with the Karnofsky Performance Status.
Karnofsky and Zubrod/WHO score

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