Duke Activity Status Index (DASI)
Estimates functional capacity (metabolic equivalents, METs) from self-reported ability to perform 12 common activities of daily living. Used for pre-operative cardiac risk assessment.
Score interpretation
DASI < 16: Estimated functional capacity < 4 METs. Poor exercise tolerance.
→ High-risk indicator for major perioperative cardiac events. Pre-operative cardiology evaluation recommended. Consider pharmacological stress testing if planned non-cardiac surgery with intermediate–high cardiac risk.
DASI 16–34: Estimated functional capacity 4–7 METs. Moderate exercise tolerance.
→ Satisfactory for most surgical risk. Clinical judgement required. May proceed to surgery with appropriate monitoring.
DASI > 34: Estimated functional capacity > 7 METs. Excellent functional status.
→ Low perioperative cardiac risk from functional standpoint. Safe to proceed with most elective surgery.
Interpretation bands for the DASI. Apply clinical judgement and local guidance.
References
- Hlatky MA, et al. A brief self-administered questionnaire to determine functional capacity (the Duke Activity Status Index). Am J Cardiol. 1989;64(10):651–654.
- Wijeysundera DN, et al. Association of Echocardiography Before Major Elective Non-cardiac Surgery With Postoperative Survival and Length of Hospital Stay: Population Based Cohort Study. BMJ. 2011;343:d4009.
Related
Curated clinical cross-links plus same-class fallbacks.
- Lidocaine IV (Cardiac Arrhythmia) · Antiarrhythmic
- Protamine Sulphate (Heparin Reversal) · Heparin Reversal / Cardiac Surgery
- Mavacamten · Cardiac myosin inhibitor
- Pindolol · Non-selective β-blocker (with intrinsic sympathomimetic activity)
- Phenytoin / Fosphenytoin · Antiepileptic — Status Epilepticus (Second-Line)
- Levetiracetam (IV) · Antiepileptic — Status Epilepticus (Second-Line)
- Acute Heart Failure · ESC 2021 Heart Failure Guidelines; NICE NG106
- NSTEMI / Unstable Angina · ESC 2020 NSTEMI Guidelines; NICE NG185
- New-Onset Atrial Fibrillation · ESC 2020 AF Guidelines; NICE NG196
- Hypertensive Emergency · ESC/ESH 2018 Hypertension Guidelines; NICE NG136
- Bradycardia Management · Resuscitation Council UK ABCDE; ESC 2021 Pacing Guidelines
- Ventricular Tachycardia / Fibrillation · Resuscitation Council UK ACLS; ESC 2022 Ventricular Arrhythmia Guidelines
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.