A simplified (modified) Duke Activity Status Index (M-DASI) to characterise functional capacity: a secondary analysis of the Measurement of Exercise Tolerance before Surgery (METS) study.


Journal

British journal of anaesthesia
ISSN: 1471-6771
Titre abrégé: Br J Anaesth
Pays: England
ID NLM: 0372541

Informations de publication

Date de publication:
01 2021
Historique:
received: 14 01 2020
revised: 13 04 2020
accepted: 05 06 2020
pubmed: 22 7 2020
medline: 29 1 2021
entrez: 22 7 2020
Statut: ppublish

Résumé

Accurate assessment of functional capacity, a predictor of postoperative morbidity and mortality, is essential to improving surgical planning and outcomes. We assessed if all 12 items of the Duke Activity Status Index (DASI) were equally important in reflecting exercise capacity. In this secondary cross-sectional analysis of the international, multicentre Measurement of Exercise Tolerance before Surgery (METS) study, we assessed cardiopulmonary exercise testing and DASI data from 1455 participants. Multivariable regression analyses were used to revise the DASI model in predicting an anaerobic threshold (AT) >11 ml kg Five questions were identified to have dominance in predicting AT>11 ml kg The M-DASI provides a simple screening tool for further preoperative evaluation, including with cardiopulmonary exercise testing, to guide perioperative management.

Sections du résumé

BACKGROUND
Accurate assessment of functional capacity, a predictor of postoperative morbidity and mortality, is essential to improving surgical planning and outcomes. We assessed if all 12 items of the Duke Activity Status Index (DASI) were equally important in reflecting exercise capacity.
METHODS
In this secondary cross-sectional analysis of the international, multicentre Measurement of Exercise Tolerance before Surgery (METS) study, we assessed cardiopulmonary exercise testing and DASI data from 1455 participants. Multivariable regression analyses were used to revise the DASI model in predicting an anaerobic threshold (AT) >11 ml kg
RESULTS
Five questions were identified to have dominance in predicting AT>11 ml kg
CONCLUSIONS
The M-DASI provides a simple screening tool for further preoperative evaluation, including with cardiopulmonary exercise testing, to guide perioperative management.

Identifiants

pubmed: 32690247
pii: S0007-0912(20)30462-1
doi: 10.1016/j.bja.2020.06.016
pii:
doi:

Types de publication

Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

181-190

Investigateurs

S Wallace (S)
B Thompson (B)
M Ellis (M)
B Borg (B)
R K Kerridge (RK)
J Douglas (J)
J Brannan (J)
J Pretto (J)
M G Godsall (MG)
N Beauchamp (N)
S Allen (S)
A Kennedy (A)
E Wright (E)
J Malherbe (J)
H Ismail (H)
B Riedel (B)
A Melville (A)
H Sivakumar (H)
A Murmane (A)
K Kenchington (K)
Y Kirabiyik (Y)
U Gurunathan (U)
C Stonell (C)
K Brunello (K)
K Steele (K)
O Tronstad (O)
P Masel (P)
A Dent (A)
E Smith (E)
A Bodger (A)
M Abolfathi (M)
P Sivalingam (P)
A Hall (A)
T W Painter (TW)
S Macklin (S)
A Elliott (A)
A M Carrera (AM)
N C S Terblanche (NCS)
S Pitt (S)
J Samuels (J)
C Wilde (C)
K Leslie (K)
A MacCormick (A)
D Bramley (D)
A M Southcott (AM)
J Grant (J)
H Taylor (H)
S Bates (S)
M Towns (M)
A Tippett (A)
F Marshall (F)
C D Mazer (CD)
J Kunasingam (J)
A Yagnik (A)
C Crescini (C)
S Yagnik (S)
C J L McCartney (CJL)
S Choi (S)
P Somascanthan (P)
K Flores (K)
S Au (S)
W S Beattie (WS)
K Karkouti (K)
H A Clarke (HA)
A Jerath (A)
S A McCluskey (SA)
M Wasowicz (M)
L Day (L)
J Pazmino-Canizares (J)
P Oh (P)
R Belliard (R)
L Lee (L)
K Dobson (K)
V Chan (V)
R Brull (R)
N Ami (N)
M Stanbrook (M)
K Hagen (K)
D Campbell (D)
T Short (T)
J Van Der Westhuizen (J)
J K Higgie (JK)
H Lindsay (H)
R Jang (R)
C Wong (C)
D Mcallister (D)
M Ali (M)
J Kumar (J)
E Waymouth (E)
C Kim (C)
J Dimech (J)
M Lorimer (M)
J Tai (J)
R Miller (R)
R Sara (R)
A Collingwood (A)
S Olliff (S)
S Gabriel (S)
H Houston (H)
P Dalley (P)
S Hurford (S)
A Hunt (A)
L Andrews (L)
L Navarra (L)
A Jason-Smith (A)
H Thompson (H)
N McMillan (N)
G Back (G)
M Lum (M)
D Martin (D)
S S James (S)
H Filipe (H)
M Pinto (M)
S Kynaston (S)
M Phull (M)
C Beilstein (C)
P Bodger (P)
K Everingham (K)
Y Hu (Y)
E Niebrzegowska (E)
C Corriea (C)
T Creary (T)
M Januszewska (M)
T Ahmad (T)
J Whalley (J)
R Haslop (R)
J McNeil (J)
A Brown (A)
N MacDonald (N)
M Pakats (M)
K Greaves (K)
S Jhanji (S)
R Raobaikady (R)
E Black (E)
M Rooms (M)
H Lawrence (H)
M Koutra (M)
K Pirie (K)
M Gertsman (M)
S Jack (S)
M Celinski (M)
D Levett (D)
M Edwards (M)
K Salmon (K)
C Bolger (C)
L Loughney (L)
L Seaward (L)
H Collins (H)
B Tyrell (B)
N Tantony (N)
K Golder (K)
G L Ackland (GL)
R C M Stephens (RCM)
L Gallego-Paredes (L)
A Reyes (A)
A Gutierrez Del Arroyo (A)
A Raj (A)
R R Lifford (R)
M Melo (M)
M Mamdani (M)
G Hillis (G)
H C Wijeysundera (HC)

Commentaires et corrections

Type : CommentIn

Informations de copyright

Copyright © 2020. Published by Elsevier Ltd.

Auteurs

Bernhard Riedel (B)

Department of Anaesthesia, Perioperative and Pain Medicine, Peter MacCallum Cancer Centre, Melbourne, Australia; Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia; Centre for Integrated Critical Care Medicine, University of Melbourne, Melbourne, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia. Electronic address: bernhard.riedel@petermac.org.

Michael H-G Li (MH)

Department of Anaesthesia, Perioperative and Pain Medicine, Peter MacCallum Cancer Centre, Melbourne, Australia.

C H Angus Lee (CHA)

Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia.

Hilmy Ismail (H)

Department of Anaesthesia, Perioperative and Pain Medicine, Peter MacCallum Cancer Centre, Melbourne, Australia; Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia; Centre for Integrated Critical Care Medicine, University of Melbourne, Melbourne, Australia.

Brian H Cuthbertson (BH)

Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, ON, Canada; Institute of Health, Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.

Duminda N Wijeysundera (DN)

Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, ON, Canada; Institute of Health, Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada; Department of Anesthesia, St Michael's Hospital, Toronto, ON, Canada.

Kwok M Ho (KM)

Department of Intensive Care Medicine, Royal Perth Hospital, Perth, Australia; Medical School, University of Western Australia, Perth, Australia; School of Veterinary and Life Sciences, Murdoch University, Perth, Australia.

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