Karnofsky/Lansky Performance Status

The CIBMTR uses Karnofsky/Lansky performance status to determine the functional status of a recipient. Recipient performance status is a critical data field that has been determined to be essential for all outcome-based analyses. The Karnofsky Scale is designed for recipients aged 16 years and older, and the Lansky Scale is designed for recipients one year old to less than 16 years old. Use this scale (see table 1) to determine the score (10-100) that best represents the recipient’s activity status at the requested time point.

Table 1. Karnofsky/Lansky Scale

Karnofsky Scale (recipient age ≥ 16 years) Lansky Scale (recipient age ≥ 1 year and <16 years)
Able to carry on normal activity; no special care is needed Able to carry on normal activity; no special care is needed
100 Normal, no complaints, no evidence of disease 100 Fully active
90 Able to carry on normal activity 90 Minor restriction in physically strenuous play
80 Normal activity with effort 80 Restricted in strenuous play, tires more easily, otherwise active
Unable to work, able to live at home, cares for most personal needs, a varying amount of assistance is needed Mild to moderate restriction
70 Cares for self, unable to carry on normal activity or to do active work 70 Both greater restrictions of, and less time spent in active play
60 Requires occasional assistance but is able to care for most needs 60 Ambulatory up to 50% of time, limited active play with assistance/supervision
50 Requires considerable assistance and frequent medical care 50 Considerable assistance required for any active play, fully able to engage in quiet play
Unable to care for self, requires equivalent of institutional or hospital care, disease may be progressing rapidly Moderate to severe restriction
40 Disabled, requires special care and assistance 40 Able to initiate quite activities
30 Severely disabled, hospitalization indicated, although death not imminent 30 Needs considerable assistance for quiet activity
20 Very sick, hospitalization necessary 20 Limited to very passive activity initiated by others (e.g., TV)
10 Moribund, fatal process progressing rapidly 10 Completely disabled, not even passive play

Karnofsky/Lansky Performance Score vs. ECOG performance score:

Some transplant centers may prefer to collect and use the ECOG performance score as opposed to the Karnofsky/Lansky score. Although the ECOG and Karnofsky/Lansky performance score systems are based on similar principles, the scales are not the same. For centers that collect only the ECOG performance score, see the memorandum and worksheet example here.

Manual Updates:
Sections of the Forms Instruction Manual are frequently updated. The most recent updates to the manual can be found below. For additional information, select the manual section and review the updated text.

If you need to reference the historical Manual Change History for this form, please click here or reference the retired manual section on the Retired Forms Manuals webpage.

Date Manual Section Add/Remove/Modify Description
4/4/17 Appendix L Modify Age range for Lansky Scale has been updated from recipients less than 16 years old to recipients one year old to less than 16 years old.
Last modified: Apr 04, 2017

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