関: Karnofsky performance status

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take by attacking with scaling ladders; "The troops scaled the walls of the fort"
a specialized leaf or bract that protects a bud or catkin (同)scale leaf
an ordered reference standard; "judging on a scale of 1 to 10" (同)scale of measurement, graduated table, ordered series
relative magnitude; "they entertained on a grand scale"
size or measure according to a scale; "This model must be scaled down"
the ratio between the size of something and a representation of it; "the scale of the map"; "the scale of the model"
a measuring instrument for weighing; shows amount of mass (同)weighing machine
a flattened rigid plate forming part of the body covering of many animals
an indicator having a graduated sequence of marks
(music) a series of notes differing in pitch according to a specific scheme (usually within an octave) (同)musical scale
a thin flake of dead epidermis shed from the surface of the skin (同)scurf, exfoliation
remove the scales from; "scale fish" (同)descale
reach the highest point of; "We scaled the Mont Blanc" (同)surmount
climb up by means of a ladder
measure by or as if by a scale; "This bike scales only 25 pounds"
measure with or as if with scales; "scale the gold"
pattern, make, regulate, set, measure, or estimate according to some rate or standard
the act of arranging in a graduated series (同)grading
act of measuring or arranging or adjusting according to a scale
ascent by or as if by a ladder
(used of armor) having overlapping metal plates attached to a leather backing

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《しばしば複数形で》『てんびん』,はかり / てんびんのさら / 《重量を表す副詞[句]を伴って》…の目方(体重)がある / …‘を'てんびんではかる
(蛇・魚類などの)うろこ / うろこ状の物;(ペンキ・さび・ふけなどの)爆片 / 〈魚など〉‘の'うろこを取る;…‘の'皮をはぐ / (…から)〈ペンキなどの薄泰〉‘を'そぎ取る《+『名』+『off』(『from』)+『名』》 / (…から)〈ペンキなどが〉かげ落ちる《+『off』(『from』)+『名』》
『段階』,等級,階級 / 『比率』,縮尺 / (物差しなどの)『目盛り』 / (目盛りの付いた)『物差し』;温度計,(各種の)スケール / 『規模』,スケール / 音階 / 記数法,…進法 / …‘を'よじ登る / (…に合わせて)…‘を'調整する《+『名』+『to』+『名』》 / …‘を'縮尺で製図(設計)する

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/02/02 21:22:33」(JST)

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In medicine (oncology and other fields), performance status is an attempt to quantify cancer patients' general well-being and activities of daily life. 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.

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. Another common system is the Eastern Cooperative Oncology Group (ECOG) system.

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 practitioners occasionally assign performance scores in between standard intervals of 10. This scoring system is named after Dr. David A. Karnofsky, who described the scale with Dr. Joseph H. Burchenal in 1949. ^[1] The primary purpose of its development was to allow physicians to evaluate a patient's ability to survive chemotherapy for cancer.

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 disease.
70 - Cares for self; unable to carry on normal activity or to do active work.
60 - Requires occasional assistance, but is able to care for most of his personal needs.
50 - Requires considerable assistance and frequent medical care.
40 - Disabled; requires special care and assistance.
30 - Severely disabled; hospital admission is indicated although death not imminent.
20 - Very sick; hospital admission necessary; active supportive treatment necessary.
10 - Moribund; fatal processes progressing rapidly.
0 - Dead

ECOG/WHO/Zubrod score

The Eastern Cooperative Oncology Group (ECOG) score (published by Oken et al. in 1982), also called the WHO or Zubrod score (after C. Gordon Zubrod), runs from 0 to 5, with 0 denoting perfect health and 5 death:^[2] Its advantage over the Karnofsky scale lies in its simplicity.

0 – Asymptomatic (Fully active, able to carry on all predisease activities without restriction)
1 – Symptomatic but completely ambulatory (Restricted in physically strenuous activity but ambulatory and able to carry out work of a light or sedentary nature. For example, light housework, office work)
2 – Symptomatic, <50% in bed during the day (Ambulatory and capable of all self care but unable to carry out any work activities. Up and about more than 50% of waking hours)
3 – Symptomatic, >50% in bed, but not bedbound (Capable of only limited self-care, confined to bed or chair 50% or more of waking hours)
4 – Bedbound (Completely disabled. Cannot carry on any self-care. Totally confined to bed or chair)
5 – Death

Lansky score

Children, who might have more trouble expressing their experienced quality of life, require a somewhat more observational scoring system suggested and validated by Lansky et al. in 1987:^[3]

100 – fully active, normal
90 – minor restrictions in strenuous physical activity
80 – active, but gets tired more quickly
70 – greater restriction of play and less time spent in play activity
60 – up and around, but active play minimal; 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 passive activities
10 – doesn't play; does not get out of bed
0 – unresponsive

Comparison

A translation between the Zubrod and Karnofsky scales that works especially well for healthy patients has been validated in a large sample of lung cancer patients:^[4]

Zubrod 0-1 equals Karnofsky 80-100
Zubrod 2 equals Karnofsky 60-70
Zubrod 3-4 equals Karnofsky 10-50

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.
^ Oken MM, Creech RH, Tormey DC, et al. (1982). "Toxicity and response criteria of the Eastern Cooperative Oncology Group". Am. J. Clin. Oncol. 5 (6): 649–55. doi:10.1097/00000421-198212000-00014. PMID 7165009.
^ Lansky SB, List MA, Lansky LL, Ritter-Sterr C, Miller DR (1987). "The measurement of performance in childhood cancer patients". Cancer 60 (7): 1651–6. doi:10.1002/1097-0142(19871001)60:7<1651::AID-CNCR2820600738>3.0.CO;2-J. PMID 3621134.
^ Buccheri G, Ferrigno D, Tamburini M. Karnofsky and ECOG performance status scoring in lung cancer: a prospective, longitudinal study of 536 patients from a single institution. Eur J Cancer. 1996 Jun;32A(7):1135-41.

External links

A table with the Karnofsky Performance Status.

UpToDate Contents

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1. 末期進行癌における生存期間の推定 survival estimates in advanced terminal cancer
2. 癌患者における機能的問題 functional problems in the patient with cancer
3. Chronic myelomonocytic leukemia
4. 高齢者における癌に対する全身化学療法 systemic chemotherapy for cancer in elderly persons
5. 癌患者に対する包括的老年医学的評価 comprehensive geriatric assessment for patients with cancer

English Journal

Treatment of elderly patients with glioblastoma: From clinical evidence to molecular highlights.

Chargari C, Feuvret L, Bauduceau O, Ricard D, Cuenca X, Delattre JY, Mazeron JJ.SourceMedical and Radiation Oncology, Hôpital d'Instruction des Armées du Val-de-Grâce, Service de Santé des Armées, Paris, France. Electronic address: chargari-vdg@hotmail.fr.
Cancer treatment reviews.Cancer Treat Rev.2012 Dec;38(8):988-95. doi: 10.1016/j.ctrv.2011.12.010. Epub 2012 Jan 30.
Elderly patients with glioblastoma are characterized by a high rate of associated morbidities, and a poor prognosis. Therefore, they have been excluded from most prospective clinical trials. However, the poorer outcome retrospectively reported in these patients might be also related to that those ar
PMID 22289687

Health-related quality of life supersedes other psychosocial predictors of long-term survival in cancer patients undergoing radiotherapy.

Sehlen S, Marten-Mittag B, Herschbach P, Schweden M, Book K, Henrich G, Dühmke E, Dinkel A.SourceDepartment of Radiotherapy and Radiooncology, Klinikum Großhadern, Ludwig-Maximilians-Universität München , Munich , Germany.
Acta oncologica (Stockholm, Sweden).Acta Oncol.2012 Nov;51(8):1020-8. doi: 10.3109/0284186X.2012.683879. Epub 2012 May 23.
Abstract Background. To investigate the prognostic value of several psychosocial factors for long-term survival in cancer patients. Material and methods. Baseline data were gathered in routine radiotherapy practice during 44 months. The analysis is based on 938 patients for whom follow-up data wer
PMID 22616951

Japanese Journal

通院透析患者への血清アルブミン値と複数の評価法を用いた栄養状態・ADLの評価

川上純子,三上憲子,飛田美穂,倉田康久,兵藤透
相模女子大学紀要. B, 自然系 76, 1-6, 2012-00-00
… and explore feasible tools for high risk patients, by comparing index of serum albumin values and other assessment tools : Mini Nutritional Assessment-Short Form (MNA-SF) as a well validated nutrition screening and assessment tool, Barthel Index (BI) as an index of activities of daily living, Karnofsky Performance Scale (KPS) as a tool for assessing patients functional impairment, and Geriatric Nutritional risk Index (GNRI) as based on serum albumin values and the discrepancy between real and ideal weight for the …
NAID 110009577165

Therapeutic Strategy and Long-term Outcome of Meningiomas Located in the Posterior Cranial Fossa

MATSUI Toru
Neurologia medico-chirurgica 52(10), 704-713, 2012
… Mean preoperative performance status (Karnofsky scale) was 83% (range 40-100%). …
NAID 130001912473

25年の長期血液透析患者の栄養学的特徴の解析 : 体格と栄養素等摂取量の推移

武政睦子,市川和子,佐々木環
日本透析医学会雑誌 = Journal of Japanese Society for Dialysis Therapy 44(11), 1095-1102, 2011-11-28
日本の慢性透析者数は年々増加し，25年以上の長期継続患者は総透析患者の3.8％を占めている．長期透析患者は低栄養状態に陥ることが多く報告され，その改善のための適切な栄養管理が必要とされる．本研究は，25年以上継続している透析患者48名（男性：25，女性：23）を対象とし血液透析導入時，導入後15年経過した時点および25年経過した時点の身体状況，栄養素等摂取量および血液生化学検査を同一患者で追跡調査 …
NAID 10030389554

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★リンクテーブル★

リンク元	「カルノフスキ尺度」「Karnofsky performance status」「Karnofsky尺度」
関連記事	「scale」「scaling」

「カルノフスキ尺度」

　　[★]

英: Karnofsky scale
関: Karnofsky尺度、カルノフスキー・パフォーマンス・ステータス

「Karnofsky performance status」

　　[★]

カルノフスキー・パフォーマンス・ステータス

関: Karnofsky scale

「Karnofsky尺度」

　　[★]

英: Karnofsky scale
関: カルノフスキ尺度

「scale」

　　[★]

n.

1. (魚・は虫類の)うろこ。(チョウ・ガの)鱗粉。(皮膚の)鱗屑。薄片。(植物)芽鱗、鱗片。(動物)カイガラムシ。(金属を熱したときにできる)薄い酸化膜、スケール。(ボイラーややかんの内側にできる)湯垢。歯石。
2. 目盛り、定規、物差し、尺度、基準。(地図などの)縮尺比、縮尺目盛り。階級、等級。規模、スケール
3. はかり、てんびん

vt.
vi.

「scaling」

　　[★]

n.

スケーリング

縮尺や変換係数を定めること、歯石とプラークを除去すること

[1] 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.

[2] Oken MM, Creech RH, Tormey DC, et al. (1982). "Toxicity and response criteria of the Eastern Cooperative Oncology Group". Am. J. Clin. Oncol. 5 (6): 649–55. doi:10.1097/00000421-198212000-00014. PMID 7165009.

[3] Lansky SB, List MA, Lansky LL, Ritter-Sterr C, Miller DR (1987). "The measurement of performance in childhood cancer patients". Cancer 60 (7): 1651–6. doi:10.1002/1097-0142(19871001)60:7<1651::AID-CNCR2820600738>3.0.CO;2-J. PMID 3621134.

[4] Buccheri G, Ferrigno D, Tamburini M. Karnofsky and ECOG performance status scoring in lung cancer: a prospective, longitudinal study of 536 patients from a single institution. Eur J Cancer. 1996 Jun;32A(7):1135-41.

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Karnofsky scale