CFS Grade | CFS | PPS—description | KPS description | AKPS—description | PPS/AKPS/KPS Grade | ECOG Grade | ECOG Status |
1 Very fit 2 Well | People who are robust, active, energetic and motivated. These people commonly exercise regularly. They are among the fittest for their age. People who have no active disease symptoms but are less fit than category 1. Often, they exercise or are very active occasionally, for example, seasonally. | Full ambulation, normal activity and work no evidence of disease, full self-care, normal intake, full conscious level | Normal no complaints; no evidence of disease. | Normal, no complaints, no evidence of disease | 100 | 0 | Fully active, able to carry on all predisease performance without restriction |
3 Managing Well | People whose medical problems are well controlled but are not regularly active beyond routine walking. | Full ambulation, normal activity and work some evidence of disease, full self-care, normal intake, full conscious level | Able to carry on normal activity; minor signs or symptoms of disease. | Able to carry on normal activities. Minor signs or symptoms of disease | 90 | 1 | 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 |
4 Vulnerable | While not dependent on others for daily help, often symptoms limit activities. A common complaint is being ‘slowed up’ and/or being tired during the day. | Full ambulation, normal activity with effort some evidence of disease, full self-care, normal or reduced intake, full conscious level | Normal activity with effort; some signs or symptoms of disease | Normal activity with effort, some signs or symptoms of disease | 80 | 1 | 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 |
4 Vulnerable | While not dependent on others for daily help, often symptoms limit activities. A common complaint is being ‘slowed up’ and/or being tired during the day. | Reduced ambulation, unable to do normal job/work, significant evidence of disease, occasional assistance necessary with self-care, normal or reduced intake, full conscious level or confusion | Cares for self; unable to carry on normal activity or to do active work. | Care for self. Unable to carry on normal activity or to do active work | 70 | 2 | Ambulatory and capable of all selfcare but unable to carry out any work activities. Up and about more than 50% of waking hours |
5 Mildly Frail | These people often have more evident slowing, and need help in high order instrumental activities of daily living (IADLs) (finances, transportation, heavy housework, medications). Typically, mild frailty progressively impairs shopping and walking outside alone, meal preparation and housework | Reduced ambulation, unable to do housework significant disease occasional assistance necessary, normal, or reduced intake, full conscious level or confusion | Requires occasional assistance, but is able to care for most of his personal needs | Able to care for most needs, but requires occasional assistance | 60 | 2 | Ambulatory and capable of all selfcare but unable to carry out any work activities. Up and about more than 50% of waking hours |
6 Moderately Frail | People need help with all outside activities and with keeping house. Inside, they often have problems with stairs and need help with bathing and might need minimal assistance (cuing, standby) with dressing. | Mainly sit to lie unable to do any work extensive disease, considerable assistance required, normal or reduced intake, full or drowsy conscious level±confusion. | Requires considerable assistance and frequent medical care. | Considerable assistance and frequent medical care required | 50 | 3 | Capable of only limited selfcare, confined to bed or chair more than 50% of waking hours |
6 Moderately Frail | People need help with all outside activities and with keeping house. Inside, they often have problems with stairs and need help with bathing and might need minimal assistance (cuing, standby) with dressing. | Mainly in bed, unable to do most activity, extensive disease, mainly assistance, normal or reduced intake, full or drowsy±confusion | Disabled; requires special care and assistance. | In bed more than 50% of the time | 40 | 3 | Capable of only limited selfcare, confined to bed or chair more than 50% of waking hours |
7 Severely Frail | Completely dependent for personal care, from whatever cause (physical or cognitive). | Totally bed bound unable to do any activity extensive disease total care normal or reduced intake full or drowsy conscious level±confusion | Severely disabled; hospital admission is indicated although death not imminent. | Almost completely bedfast | 30 | 4 | Completely disabled. Cannot carry on any selfcare. Totally confined to bed or chair |
8 Very Severely Frail | Completely dependent, approaching the end of life. Typically, they could not recover even from a minor illness. | Totally bed bound unable to do any activity extensive disease total care minimal intake full or drowsy conscious level±confusion | Very sick; hospital admission necessary; active supportive treatment necessary | Totally bedfast and requiring extensive nursing care by professionals and/or family | 20 | 4 | Completely disabled. Cannot carry on any selfcare. Totally confined to bed or chair |
8 Very Severely Frail | Completely dependent, approaching the end of life. Typically, they could not recover even from a minor illness. | Totally bed bound unable to do any activity extensive disease total care mouth care only drowsy conscious level±confusion | Moribund; fatal processes progressing rapidly. | Comatose or barely arousable, unable to care for self, requires equivalent of institutional or hospital care, disease may be progressing rapidly | 10 | 4 | Completely disabled. Cannot carry on any selfcare. Totally confined to bed or chair |
Dead | Dead | Dead | 0 | 5 | Dead | ||
9.Terminally Ill | Approaching the end of life. This category applies to people with a life expectancy <6 months, who are not otherwise evidently frail. | Multiple | Multiple | Multiple | Multiple | Multiple | Multiple |
AKPS, Australia-modified Karnofsky Performance Status Scale; CFS, Clinical Frailty Scale; ECOG, Eastern Cooperative Oncology Group Performance Status; KPS, Karnofsky Performance Scale; PPS, Palliative Performance Scale.