Interpretation
| Result | Meaning |
|---|---|
| 0–58.2 | Higher = better functional capacity |
| ≤ 34 | Associated with more 30-day myocardial injury/MI and complications (METS study) |
| > 34 | Lower risk; roughly equivalent to ≥4 METs |
Formula
DASI = sum of item weights answered "yes": self-care 2.75, walk indoors 1.75, walk 1–2 blocks 2.75, stairs/hill 5.50, run 8.00, light housework 2.70, moderate housework 3.50, heavy housework 8.00, yard work 4.50, sexual relations 5.25, moderate recreation 6.00, strenuous sports 7.50. Peak VO₂ = 0.43 × DASI + 9.6 mL/kg/min; METs = VO₂ ÷ 3.5.
Clinical pearls
- Ask what the patient CAN do, not what they choose to do; limitations from orthopaedic problems reduce the score without implying cardiac risk.
- In the METS study, the DASI predicted outcomes better than subjective clinician assessment of functional capacity.
Examples
dasi: can do self care, walk indoors, walk 2 blocks, climb stairs, light and moderate housework, yard work; cannot run, no heavy housework, no sexual relations, no moderate recreation or strenuous sportsduke activity status index all yesfunctional capacity questionnaire for preop, patient can walk indoors and do self care only
FAQ
What DASI score equals 4 METs?
Using VO₂ = 0.43 × DASI + 9.6, a DASI of about 10 corresponds to 4 METs (14 mL/kg/min), but the prognostic threshold before surgery is 34 points from the METS study.
How is the DASI converted to METs?
Estimated peak VO₂ = 0.43 × DASI + 9.6 mL/kg/min, and METs = VO₂ ÷ 3.5.
Evidence
- Hlatky MA et al. A brief self-administered questionnaire to determine functional capacity (the Duke Activity Status Index). Am J Cardiol 1989;64:651–4.
- Wijeysundera DN et al. Integration of the Duke Activity Status Index into preoperative risk evaluation (METS). Br J Anaesth 2020;124:261–70.
- Wijeysundera DN et al. Assessment of functional capacity before major non-cardiac surgery (METS). Lancet 2018;391:2631–40.