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Karnofsky Performance Score (karnofsky + performance_score)
Selected AbstractsKarnofsky performance score in acute renal failure as a predictor of short-term survivalNEPHROLOGY, Issue 6 2007JOSE RAMON PEREZ VALDIVIESO SUMMARY: Background: Karnofsky Performance Scale Index (KPS) is a measure of functional status that allows patients to be classified according to their functional impairment. We aim to assess if the prior KPS may predict the risk of death among patients with acute renal failure (ARF). Methods: A cohort of 668 consecutive patients who had been admitted in an university-affiliated hospital between June 2000 and June 2006, and had been diagnosed with ARF, were studied. Three hundred and eighty-six patients with ARF who matched at least one of the RIFLE (Risk, Injury, Failure, Loss and End stage) criteria on increased serum creatinine were included for subsequent analysis. The group was divided into four categories, according to different Karnofsky scores measured by a nephrologist (,80, 70, 60 and ,50). We used an adjusted logistic regression model to assess the relationship between the Karnofky score and mortality. Results: A significant risk of in-hospital mortality within 90 days was observed when the other groups were compared with the ,80 Karnofsky group. Adjusted odds ratios were 8.87 (95% confidence interval (CI) 3.03,25.99), 6.78 (95% CI 2.61,17.58) and 2.83 (95% CI 1.04,7.68), for Karnofsky groups of ,50, 60 and 70, respectively. An adjusted odds ratio of 1.75 (95% CI 1.37,2.23) was observed for every 10 point decrease in KPS score. Conclusion: Functional status as indicated by the KPS is an independent predictor of death in this cohort of patients with ARF. Patients who presented lower scores had increased mortality rates. [source] Predictors of weight loss during radiotherapy in patients with stage I or II head and neck cancerCANCER, Issue 9 2010Alice Nourissat MD Abstract BACKGROUND: The purpose of the study was to identify predictors of weight loss during radiotherapy (RT) in patients with stage I or II head and neck (HN) cancer. METHODS: This study was conducted as part of a phase 3 chemoprevention trial. A total of 540 patients were randomized. The patients were weighed before and after RT. Their baseline characteristics, including lifestyle habits, diet, and quality of life, were assessed as potential predictors. Predictors were identified using multiple linear regressions. The reliability of the model was assessed by bootstrap resampling. A receiver operating characteristics curve was generated to estimate the model's accuracy in predicting critical weight loss (,5%). RESULTS: The mean weight loss was 2.2 kg (standard deviation, 3.4). Five factors were associated with a greater weight loss: all HN cancer sites other than the glottic larynx (P<.001), higher pre-RT body weight (P<.001), stage II disease (P = .002), dysphagia and/or odynophagia before RT (P = .001), and a lower Karnofsky performance score (P = .028). There was no association with pre-RT lifestyle habits, diet, or quality of life. The bootstrapping method confirmed the reliability of this predictive model. The area under the curve was 71.3% (95% confidence interval, 65.8-76.9), which represents an acceptable ability of the model to predict critical weight loss. CONCLUSIONS: These results could be useful to clinicians for screening patients with early stage HN cancer treated by RT who require special nutritional attention. Cancer 2010. © 2010 American Cancer Society. [source] High incidence of disease recurrence in the brain and leptomeninges in patients with nonsmall cell lung carcinoma after response to gefitinibCANCER, Issue 11 2005Antonio M. P. Omuro M.D. Abstract BACKGROUND Gefitinib is an epidermal growth factor receptor tyrosine kinase inhibitor that induces an early and dramatic response in 10% of patients with advanced nonsmall cell lung carcinoma (NSCLC). Long- term outcome and patterns of disease recurrence after response have not been described. METHODS The authors evaluated 139 patients with NSCLC treated with gefitinib at Memorial Sloan-Kettering Cancer Center (New York, NY) between 1998 and 2002. They focused on patterns of disease recurrence, risk of brain metastases (BM) and leptomeningeal metastasis (LM), and long-term outcome after initial response to gefitinib. RESULTS Of the 139 patients treated with gefitinib, 21 (15%) achieved a partial response. The median age of the responders was 64 years (range, 38,87 years), the median Karnofsky performance score was 80 (range, 60,90), and 4 of the patients were men. All responders had adenocarcinoma. The central nervous system (CNS) was the initial site of disease recurrence in 7 (33%) patients (BM in 5 and LM in 2). In 9 (43%) patients, the initial site of disease recurrence was the lung and in 1 it was the liver and bone. Four (57%) of the patients with disease recurrence in the CNS had lung disease under control. BM also developed in 2 patients who had initial disease recurrence in the lungs. The actuarial 5-year incidence of CNS metastases was 60%. The median overall survival periods were 15 months and 23 months for patients with and without CNS metastases, respectively (P = 0.24). CONCLUSIONS The CNS was a frequent site of disease recurrence in patients with NSCLC after an initial response to gefitinib, regardless of disease control in the lungs. Patients should be carefully monitored for neurologic symptoms. Intrinsic resistance of metastatic clones, incomplete CNS penetrance of the drug, and longer survival are possible explanations for this high incidence. Cancer 2005. © 2005 American Cancer Society. [source] Donor quality of life before and after adult-to-adult right liver live donor liver transplantationLIVER TRANSPLANTATION, Issue 10 2006See Ching Chan Donor right hepatectomy for adult-to-adult live donor liver transplantation (ALDLT) is a major surgical operation for the benefit of the recipient. Justification of procedure mandates knowledge of the possible physical and psychological negative effects on the donor. We prospectively and longitudinally quantified donor quality of life using generic and condition-specific questionnaires up to 1 year. The generic questionnaires were the Karnofsky Performance Status scale and the Chinese (Hong Kong) version of the Medical Outcomes Study 36-Item Short-Form Survey, which measures 8 health concepts: 4 physical components and 4 mental components. Within 1 year, 30 consecutive donors were included. These 11 male and 19 female donors (36.7% and 63.3%, respectively) had a median age of 35 years (range, 21-56 years). There was no donor mortality or major complications. Donor quality-of-life worsening was most significant in the first 3 postoperative months, particularly among the physical components. The physical and mental components returned to the previous levels in 6 to 12 months' time, though the Karnofsky performance scores were slightly lower at 1 year (P = 0.011). Twenty-six (86.7%) donors declared that they would donate again if there were such a need and it were technically possible. It was noticed that older donors were more likely to express unwillingness to donate again. In conclusion, the temporary worsening of donor quality of life substantiates ALDLT as an acceptable treatment modality. Liver Transpl 12:1529,1536, 2006. © 2006 AASLD. [source] | ||||||||||