Mendel Jacobs MD

Perioperative risk

DASI Calculator — Duke Activity Status Index

Answer 12 activity questions to calculate your Duke Activity Status Index, estimated peak oxygen uptake, and estimated METs for a structured assessment of functional capacity before noncardiac surgery.

Answer all 12 activities

Choose Yes if you are able to do the activity, even if you do not routinely do it. Leave uncertain answers unanswered and discuss them with your clinician. Do not attempt an activity to complete this questionnaire. 0 of 12 answered.

Answer every factor; no answers are assumed
Can you manage personal care?

Eating, getting dressed, bathing, and using the toilet.

Can you walk around inside your home?
Can you walk one or two blocks on flat ground?
Can you climb one flight of stairs or go uphill on foot?
Can you run for a short distance?
Can you do light household tasks?

For example, dusting surfaces or doing the dishes.

Can you do moderately demanding household tasks?

For example, vacuuming, sweeping, or bringing groceries inside.

Can you do heavy household tasks?

For example, scrubbing a floor or lifting or shifting heavy furniture.

Can you do yard or garden work?

For example, removing weeds, raking leaves, or pushing a powered mower.

Can you engage in sexual activity?
Can you take part in moderately demanding recreation?

For example, bowling, golf, dancing, doubles tennis, or tossing a baseball or football.

Can you take part in strenuous sports?

For example, swimming, singles tennis, basketball, football, or skiing.

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Calculated result

—/ 58.2 points

Complete every required field to calculate a result.

DASI = sum of weights for Yes answers. Estimated peak VO₂ = 0.43 × DASI + 9.6 mL/kg/min. Estimated METs = estimated peak VO₂ / 3.5.

Educational use only. This tool and its outputs do not constitute medical advice, diagnosis, or treatment and do not replace clinical judgment. Independently verify the inputs, equations, assumptions, units, and outputs, and confirm that the tool is appropriate for your intended use before relying on a result.

What is DASI?

The Duke Activity Status Index is a self-reported functional-capacity questionnaire developed by Hlatky and colleagues. It asks about daily activities and recreation. Each Yes answer adds an activity-specific weight; the total ranges from 0 to 58.2. Higher scores reflect greater reported capacity.

How is it calculated?

DASI = sum of weights for Yes answers. Estimated peak VO₂ = 0.43 × DASI + 9.6 mL/kg/min. Estimated METs = estimated peak VO₂ / 3.5.

DASI score and METs: two different interpretations

The score threshold of 34 is not equivalent to 4 METs in the conversion formula. A DASI of 34 gives an estimated VO₂ of 24.22 mL/kg/min, or 6.92 METs. Use the published DASI threshold directly rather than substituting the calculated MET value into a perioperative pathway.

The conversion is a regression estimate. Even a score of zero gives a nonzero estimate because the equation has an intercept; it does not prove that the person can perform at that intensity. Objective exercise testing measures capacity differently.

Clinical interpretation

The 2024 AHA/ACC perioperative guideline uses DASI ≤34 as a poor-functional-capacity threshold. A score above 34 is above that threshold, but does not establish low overall surgical risk. Interpret DASI together with symptoms, urgency, procedure risk, and a cardiac risk tool such as RCRI.

Clinical considerations

Answer all 12 activities. Unanswered or uncertain items are not treated as No, and no partial score is presented. Judge ability rather than how often an activity is performed.

Pain, arthritis, neurologic conditions, mobility limitations, and other noncardiac factors can affect responses. Discuss limitations and uncertain responses with the clinician assessing the patient.

DASI does not calculate an individualized complication percentage, provide surgical clearance, or automatically trigger a stress test. This is an educational tool and does not replace clinical judgment.

Common questions

What is a good DASI score before surgery?

Higher scores indicate greater reported functional capacity. The 2024 AHA/ACC framework uses ≤34 for poor functional capacity; exceeding 34 alone does not clear someone for surgery.

Is DASI the same as RCRI?

No. DASI assesses reported activity capacity. RCRI estimates cardiac risk from clinical and surgical factors. They answer different questions within the preoperative assessment.

Are the calculated METs measured exercise capacity?

No. METs and peak VO₂ are estimated from questionnaire responses. They are not measured by a treadmill test or cardiopulmonary exercise test.

References

  1. Hlatky et al. Original Duke Activity Status Index study. American Journal of Cardiology, 1989. ↗
  2. NHLBI BioLINCC: DASI activity questionnaire used in the WAVE trial. ↗
  3. 2024 AHA/ACC multisociety perioperative cardiovascular management guideline: functional capacity and DASI. ↗
  4. Wijeysundera et al. METS study: functional capacity before major noncardiac surgery. Lancet, 2018. ↗

These calculators are educational tools. Their outputs do not constitute medical advice and do not replace clinical judgment.