The use of Karnofsky Performance Status (KPS) as a predictor of 3 month post discharge mortality in cirrhotic patients

Is Karnofsky Performance Status (KPS) a predictor of 3 month post discharge mortality in cirrhotic patients? Cirrhotic patients often experience an abrupt decline in their health, which often leads to frequent hospitalization and
can cause morbidity and mortality. Various models are currently used to predict mortality in cirrhotics however these have their
limitations. The Karnofsky Performance Status (KPS) being one of the oldest performance status scales, is a health care provider–
administered assessment that has been validated to predict mortality across the elderly and in the chronic disease populations. We used the KPS performance status scale to envisage short-term mortality in cirrhotic and HCC patients who survive to
be discharged from hospital. Our study showed that KPS one week post-discharge, child pugh score, hospital stay, international normalized ratio, serum
albumin, total bilirubin and serum creatinine showed statistical significance on univariate analysis. On multivariate analysis, KPS was
found to be statistical significant predictor of 3-month mortality. Hence KPS can be utilized to identify cirrhotic patients at risk of 3-month post discharge mortality.
Keywords: Karnofsky Performance Status (KPS), Cirrhosis, 3 months mortality
(Please cite as: Khalid MA, Achakzai IK, Ahmed Khan S, Majid Z, Hanif FM, Iqbal J, et al. The use of Karnofsky
Performance Status (KPS) as a predictor of 3 month post discharge mortality in cirrhotic patients Gastroenterol
Hepatol Bed Bench 2018;11(4):301-305). 1 Hospitalization is a marker of poor outcomes
including readmission and death. Patients with cirrhosis
experience abrupt deterioration in their health that leads
to repeated hospitalizations along with increased
morbidity and mortality (1-3). Currently, the models
used to predict mortality in cirrhotics are liver-specific
and kidney-specific prognostic indicators such as the
Model for End-Stage Liver Disease (MELD) score (4).
However the MELD score has several limitations (5-7)
one of them being its lack of ability to account for an
individual’s performance status.
It is now a well-known fact that performance status and
the linked concept of infirmity are strong predictors of