Palliative Performance Scale v2 (PPSv2)
Functional Assessment
Select the level that best describes the patient's ambulation, activity/disease evidence, self-care, intake, and conscious level.
Guidelines & Evidence
Verified
Last Review: 2026
When to Use
Overview
The Palliative Performance Scale version 2 (PPSv2) is a modification of the Karnofsky Performance Scale specifically designed for palliative care settings. It evaluates five dimensions of functional status — ambulation, activity & evidence of disease, self-care, intake, and conscious level — on a 11-level scale from 100% (normal function) to 0% (death) in 10% increments.
When to Use
Initial functional assessment at palliative care consultation or hospice admission
Determining hospice eligibility: PPSv2 ≤ 50% is a commonly applied threshold
Prognosis estimation: PPSv2 predicts median survival in combination with other tools (PPI, PaP Score)
Tracking functional decline over time — trajectory of PPSv2 decline is more informative than a single score
Guiding intensity of nursing care, rehabilitation input, and daily care plans
Staffing decisions in hospice and palliative inpatient units
PPSv2 as a Prognostic Anchor
PPSv2 ≤ 20% is associated with median survival of 1–2 weeks; PPSv2 ≤ 30% with days to weeks; PPSv2 50% with weeks to months. The rate of PPSv2 decline over serial assessments is as important as the absolute score — a fall of ≥ 20 points over 2 weeks indicates rapidly declining trajectory.
Related Scores in Practice
In clinical practice, this assessment is frequently evaluated alongside other validated measures. Depending on the patient's presentation and specific diagnostic requirements, you may also need to utilize the Palliative Prognostic Index (PPI), e-PaP Score, Akps Performance Status or the Fast Scale Functional Assessment Staging to formulate a comprehensive care plan.
Last Comprehensive Review: 2026