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
Estimated peak VO₂ = 0.43 × DASI + 9.6 mL/kg/min (Hlatky 1989): below 4 METs (DASI below about 10.2).
→ Poor functional capacity is a high-risk marker before major noncardiac surgery; follow the perioperative guideline pathway (e.g. biomarkers, specialist review).
At least 4 METs estimated, but a DASI below 34 was associated with higher odds of 30-day death or myocardial infarction after major noncardiac surgery (Wijeysundera 2020).
→ Consider preoperative risk evaluation in line with the perioperative guideline.
DASI 34 or more (about 7 METs estimated): above the METS-study threshold.
→ Functional capacity does not by itself call for further cardiac testing before 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, Beattie WS, Hillis GS, et al. Integration of the Duke Activity Status Index into preoperative risk evaluation: a multicentre prospective cohort study. Br J Anaesth. 2020;124(3):261–270.
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.