Karnofsky Performance Status Scale

Karnofsky Performance Status is descriptive tool which can be used to check the patients tolerance towards the chemotheraputic agents.
Patient Description
Normal no complaints; no evidence of disease 100
Able to carry on normal activity; minor signs or symptoms of disease 90
Normal activity with effort; some signs or symptoms of disease 80
Cares for self; unable to carry on normal activity or to do active work 70
Requires occasional assistance, but is able to care for most of his personal needs 60
Requires considerable assistance and frequent medical care 50
Disabled; requires special care and assistance 40
Severely disabled; hospital admission is indicated although death not imminent 30
Very sick; hospital admission necessary; active supportive treatment necessary 20
Moribund; fatal processes progressing rapidly 10
Dead 0


Measured Factor
Karnofsky Performance Status Scale
Measured Factor Disease
  • Cancer
Measured Factor Detail
Karnofsky Performance Status Scale provides patient's ability to tolerate chemotherapy and classifies based on the points. More point scored indicates that a person can do normal activites easily compared to person with less points.
Body System
Multiple body systems
Measured Factor Low Impact
  • A minimum score of 0 point states that patient is dead
Measured Factor High Impact
  • A maximum score of 100 indicates no presentation of disease and no complaints

Result Interpretation

Ranges Ranges
  • Critical High: 0%
  • Normal: 100
  • Normal Adult Male: 10000%
  • Normal Adult Female: 10000%
  • Normal Pediatric: 100
  • Normal Neonate Female: 100
  • Normal Geriatric Male: 10000%
  • Normal Geriatric Female: 10000%
Test Limitations
KPS limits its applicability in care settings where clinical options extend to non-hospital-based care directed at support rather than cure, such as palliative care settings.
References: 2


Study Validation 1
The study aimed to evaluate the interrater reliability of the KPS (Karnofsky performance status) were analysed using three different methods, i.e. reliability, validity, and evaluation of the components of KPS. Off 75 subjects, seven behaviorally based questions (weight loss, weight gain, reduced energy, difficulty walking, driving, grooming, and working part-time) empirically identified by using the multiple regression techniques to predict KPS scores. An interview approach with behaviorally based guidelines makes more accurate KPS ratings. The study concluded that the more investigation is needed with this revised method of assessing KPS.
References: 3
Study Validation 2
The purpose of this study is for the validation and development of the prognostic tool for ambulatory patients with advanced cancer. Off 497 subjects, 221 were included in the training and 276 in the validation sets; respectively, the C-index was 0.71, and the values of the area under the curve (AUC) of the receiver operating characteristic (ROC) curve were 0.84, 0.74, and 0.74 at 30, 90, and 180 days. The median survival times were 313, 129, and 37 days for the BPN scores <25th percentile, 25th to 75th percentile and >75th percentile. The study concluded that the BPN is a valid prognostic tool with adequate calibration and discrimination properties as well as used in the prognostication of adult patients with advanced solid tumours.
References: 4
Study Validation 3
The study aimed to quantify the functional status of cancer patients by using the Karnofsky Performance Status Scale (KPS). Interviewers were instructed in and tested on guidelines for determining the KPS levels of the patient; respectively,  The interrater reliability of 47 NHS interviewers was found to be 0.97. The relationship of the KPS to longevity (r = 0.30) in a population of terminal cancer subjects documents its predictive validity. The study concluded that the utility of the KPS as a valuable research tool when employed by trained observers.
References: 5
Study Additional 1
The study aimed to describe the determination of outcomes and risk in geriatric outpatients by using the Karnofsky Performance Scale (KPS); included three issues such as its strength of association, its ability to predict patient outcomes and its ability to serve as an identifier of high-risk patients. Off 134 subjects, the KPS was also highly predictive of outcomes, performing better or equally well as the ADL and IADL. However, the KPS was shown to serve as the effective proxy score for a patient's health and functional status. The study concluded that the KPS was shown to adequately differentiate risk groups to aid in the targeting of services for the ambulatory geriatric subjects.
References: 6
Study Additional 2
The purpose of this study is to validate the prediction tool for chemotherapy toxicity in older adults with cancer. Off 250 subjects had a mean age of 73 years, more than one-half of patients experienced grade ≥3 toxicity; respectively, the risk of toxicity increased with increasing risk score (36.7% low, 62.4% medium, 70.2% high risk). The area under the curve of the receiver-operating characteristic curve (AUROC) was 0.65 as well as no association between Karnofsky Performance Status and chemotherapy toxicity. The study concluded that this predictive model should be considered when discussing the risks and benefits of chemotherapy in older adults.
References: 7
Study Additional 3
The aim of the this study was to compare the performance of convention Karnofsky Performance Status (KPS) scale with newly modified scale called, the Thorne-KPS (TKPS). 78 home-hospice patients with cancer were assessed in the study. The median score for both the scales was 60 and overall agreement among scales was 47%. Results showed that scores of TKPS were lower than KPS scores and were spread over a wider range of the scale. At higher levels of performance both scales agreed strongly and the weakest agreement was within the middle levels of the scales. This study concludes that TKPS may be a more objective and sensitive scale in measuring the performance in home hospice patients but further studies are warranted to conclude which scale is more clinically effective.
References: 8


  1. Péus D, Newcomb N, Hofer S. Appraisal of the Karnofsky Performance Status and proposal of a simple algorithmic system for its evaluation. BMC Med Inform Decis Mak. 2013;13:72.
  2. Abernethy AP, Shelby-James T, Fazekas BS, Woods D, Currow DC. The Australia-modified Karnofsky Performance Status (AKPS) scale: a revised scale for contemporary palliative care clinical practice [ISRCTN81117481]. BMC Palliative Care. 2005;4:7.
  3. Schag CC, Heinrich RL, Ganz PA. Karnofsky performance status revisited: reliability, validity, and guidelines. J Clin Oncol. 1984;2(3):187-93.
  4. Paiva CE, Paiva BSR, De paula pântano N, et al. Development and validation of a prognostic nomogram for ambulatory patients with advanced cancer. Cancer Med. 2018; URL:
  5. Mor V, Laliberte L, Morris JN, Wiemann M. The Karnofsky Performance Status Scale. An examination of its reliability and validity in a research setting. Cancer. 1984;53(9):2002-7.
  6. Crooks V, Waller S, Smith T, Hahn TJ. The use of the Karnofsky Performance Scale in determining outcomes and risk in geriatric outpatients. J Gerontol. 1991;46(4):M139-44.
  7. Hurria A, Mohile S, Gajra A, Klepin H, Muss H, Chapman A, et al. Validation of a Prediction Tool for Chemotherapy Toxicity in Older Adults With Cancer. Journal of Clinical Oncology. 2016;34(20):2366-2371. doi:10.1200/JCO.2015.65.4327.
  8. Nikoletti S, Porock D, Kristjanson LJ, Medigovich K, Pedler P, Smith M. Performance status assessment in home hospice patients using a modified form of the Karnofsky Performance Status Scale. J Palliat Med. 2000;3(3):301-11.

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