DASI Calculator
Professional Duke Activity Status Index Assessment Tool
Assess functional capacity • Estimate VO₂ max • Evaluate cardiovascular risk • Enhanced clinical risk adjustment
Duke Activity Status Index Assessment
📋 Clinical Information (Optional - for Enhanced Risk Assessment)
Please select all activities that the patient is able to perform without symptoms of dyspnea or angina:
Personal Care
Mobility & Walking
Recreation & Sports
Household Activities
DASI Results & Clinical Assessment
Risk Level: Not assessed
No activities selected
📋 Clinical Recommendations
- •Consider cardiopulmonary exercise testing for detailed functional assessment
- •Cardiology consultation recommended for preoperative optimization
- •Consider cardiac rehabilitation referral to improve functional capacity
Example Calculation with Clinical Risk Adjustment
Patient Example
Clinical Profile: 72-year-old male with CHF, scheduled for major abdominal surgery
Functional Status: Can perform most activities except running, heavy housework, and strenuous sports
Activities selected: 9 out of 12 activities
Raw DASI Score: 34.7 points
Clinical Risk Adjustment
Base Risk Multiplier: 1.0
Age >70: +0.3
CHF: +0.3
Major Abdominal Surgery: +0.15
Total Risk Multiplier: 1.75
Adjusted Threshold: 34 × 1.75 = 59.5
Final Assessment
DASI Score: 34.7 points
Standard Interpretation: Borderline risk (score = 34.7)
Adjusted Interpretation: HIGH RISK (34.7 < 59.5)
Clinical Action: Enhanced preoperative evaluation and optimization needed
Score Interpretation
Increased risk of postoperative complications and cardiovascular events
Moderate functional capacity with some activity limitations
Good functional capacity with ability to perform most activities
Clinical Applications
Preoperative Assessment
Risk stratification before surgery
Cardiovascular Disease
Functional capacity in heart failure, CAD
Cardiac Rehabilitation
Monitor treatment effectiveness
Quality of Life
Assess daily living capabilities
MET Reference Values
MET = Metabolic Equivalent of Task. 1 MET = oxygen consumption at rest (3.5 mL/kg/min)
Understanding the Duke Activity Status Index (DASI)
What is DASI?
The Duke Activity Status Index (DASI) is a 12-item self-administered questionnaire developed by Hlatky and colleagues in 1989. It's designed to evaluate functional capacity in patients with cardiovascular diseases and estimate peak oxygen uptake (VO₂ max).
Clinical Applications
- •Measuring functional capacity in cardiovascular disease
- •Assessing quality of life aspects
- •Estimating peak oxygen uptake without exercise testing
- •Evaluating treatment effectiveness and cardiac rehabilitation
Scoring System
Each activity is weighted based on its metabolic cost (MET values):
- • Personal care activities: 1.75-2.75 points
- • Light-moderate activities: 2.7-5.5 points
- • Strenuous activities: 6.0-8.0 points
Calculation Formulas
VO₂ Max: 0.43 × DASI + 9.6 (mL/kg/min)
METs: VO₂ Max ÷ 3.5
These formulas provide estimates based on validated correlations with exercise testing
Clinical Significance
Research has shown that a DASI score of ≤34 is associated with increased risk of:
- • Postoperative myocardial injury
- • Myocardial infarction
- • Moderate-to-severe complications
- • New postoperative disability
⚠️ Medical Disclaimer
This DASI calculator is for educational and informational purposes only and should not replace professional medical assessment. The results provide estimates based on self-reported functional capacity and should be interpreted by qualified healthcare professionals.
Important considerations:
- Results should be interpreted in the context of the patient's overall clinical condition
- The questionnaire relies on self-reported ability, which may not reflect actual performance
- Exercise testing may be needed for definitive functional assessment
- Risk stratification should consider multiple clinical factors
- Always consult healthcare providers for medical decision-making
This tool should be used only by healthcare professionals familiar with cardiovascular risk assessment and functional capacity evaluation.
Frequently Asked Questions (FAQ)
What is the DASI calculator used for?
The DASI (Duke Activity Status Index) calculator is a validated clinical tool used to assess functional capacity in patients with cardiovascular disease. It estimates peak oxygen uptake (VO₂ max), evaluates exercise tolerance, and helps predict perioperative risk in surgical patients.
How accurate is the DASI score?
The DASI has been validated against formal cardiopulmonary exercise testing with strong correlation (r = 0.81-0.85). However, it's based on self-reported functional capacity and should be interpreted alongside clinical judgment and other assessment tools.
What does a DASI score of 34 or less mean?
A DASI score ≤34 indicates increased risk of postoperative complications including myocardial injury, myocardial infarction, moderate-to-severe complications, and new disability in surgical patients. This threshold has been validated in multiple clinical studies.
Can DASI replace formal exercise testing?
While DASI provides valuable functional assessment, it cannot completely replace formal cardiopulmonary exercise testing. It's best used as a screening tool and when exercise testing is not feasible or available.
How often should DASI be reassessed?
Reassessment frequency depends on the clinical context. For cardiac rehabilitation, monthly assessments may be appropriate. For stable patients, quarterly or semi-annual assessments can track functional changes over time.
What conditions is DASI most useful for?
DASI is particularly valuable for patients with coronary artery disease, heart failure, valvular disease, and those undergoing preoperative risk assessment. It's also useful in cardiac rehabilitation programs and research settings.
Are there limitations to the DASI assessment?
DASI relies on self-reported ability rather than actual performance. Patients may overestimate or underestimate their capabilities. Cultural, social, and psychological factors can also influence responses.
How does age affect DASI interpretation?
Age is an important factor in risk stratification. Older patients (>70 years) may have increased risk even with moderate DASI scores. Our enhanced calculator incorporates age-adjusted risk assessment for more accurate clinical interpretation.
Clinical Evidence and Research
Original Development
Hlatky et al. (1989) - Original development and validation study
Developed the 12-item DASI questionnaire and established correlation with peak oxygen uptake (r = 0.81) in 850 patients with known or suspected coronary artery disease.
Validation Studies
Surgical Risk Prediction
Key Finding: DASI ≤34 predicts increased perioperative risk
- • 3-fold increase in postoperative myocardial injury
- • 2-fold increase in moderate-severe complications
- • Significant predictor of new disability
- • Independent of other clinical risk factors
Clinical Guidelines
Recommended by:
- • ACC/AHA Perioperative Guidelines
- • European Society of Cardiology
- • Canadian Cardiovascular Society
- • Multiple cardiac rehabilitation programs
Advanced Clinical Interpretation Guide
High Risk (DASI ≤34)
Clinical Actions
- • Consider cardiology consultation
- • Evaluate for stress testing
- • Optimize medical therapy
- • Consider cardiac rehabilitation
- • Enhanced perioperative monitoring
Risk Factors
Dyspnea on minimal exertion, limited mobility, inability to perform basic activities without symptoms.
Moderate Risk (DASI 35-45)
Clinical Actions
- • Regular monitoring and reassessment
- • Encourage graduated exercise
- • Optimize risk factor management
- • Consider exercise prescription
- • Standard perioperative care
Functional Status
Can perform most daily activities but limited in strenuous activities. May experience symptoms with exertion.
Low Risk (DASI >45)
Clinical Actions
- • Routine follow-up care
- • Maintain current activity level
- • Continue preventive measures
- • Standard surgical clearance
- • Annual reassessment
Functional Status
Excellent functional capacity with ability to perform vigorous activities without limitations.