Prognostication in Serious Chronic Illness
Some very nonspecific changes suggest progression of illness, are usually associated with an increase in emergency department visits and frequency of hospitalizations, and are typically taken to mean a prognosis measured in months. This includes, for example, a decline in performance status, as measured using the Karnofsky Performance Status (KPS), the Palliative Performance Scale (PPS), or the Eastern Cooperative Oncology Group (ECOG) scale. These scales can be used equivalently. The Karnofsky scale is the oldest and the most commonly used (Figure 2), and the PPS scale is preferred by palliative care specialists. A KPS or PPS score of <70% may indicate hospice eligibility.
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