Karnosfsky index as a mortality predicting factor in patients on home-based enteral nutrition

Karnofsky Index (KI) is a widely used functional scale developed for oncology patients. It has proved useful as outcome predictor with cancer and geriatric patients. Theoretically, KI could be used to predict mortality in patients with home enteral nutrition (HEN). To determine baseline KI and its 6-month evolution in HEN patients, and to assess its relation with the mortality rate. Observational and prospective study carried out during 2002 and 2003 with tube feeding neurologic and cancer patients followed during 10 months since their HEN programme inclusion. 201 patients were included, 131 (65.2%) with neurological diseases and 70 (34.8%) with neoplasm. There were not significant differences between groups in age, days with HEN and mortality rate at the end of the study period (35.1% in neurologic patients and 40% in cancer ones). 27.1% of cancer patients had resumed full oral nutrition after ten months from the beginning of the study, whereas only 10.7% of neurologic patients did (p < 0.05). In the three measurement phases (initial, past-3 and past-6 months) KI values were higher for cancer patients than for neurologic ones (p < 0.001). In both groups we didn't found statistically significant differences in KI along the three measurements. A significant relation was observed overall between initial KI values and average survival after 10 months (p < 0.001), and an inverse relation was found between the former and mortality rate (p < 0.001). KI is a useful tool to predict mortality rate in cancer and neurologic patients under HEN.