Prognostic value of estimating functional capacity with the use of the duke activity status index in stable patients

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Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit

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Justin L Grodin1, Muhammad Hammadah2, Yiying Fan3

  • 1Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland, Ohio.

Journal of Cardiac Failure
|September 2, 2014
PubMed

Insights

The Duke Activity Status Index (DASI) offers valuable prognostic information for heart failure patients. Low functional capacity, measured by DASI, independently predicts increased mortality risk in stable heart failure.

Area of Science:

  • Cardiology
  • Clinical Prognostics
  • Health Outcomes Research

Background:

  • Quantifying functional capacity is crucial in heart failure management.
  • Prognostic value of functional capacity tools beyond biomarkers in stable chronic heart failure remains under-investigated.

Purpose of the Study:

  • To evaluate the prognostic significance of the Duke Activity Status Index (DASI) for all-cause mortality in stable heart failure patients.
  • To determine if DASI provides incremental prognostic value beyond established cardiorenal biomarkers.

Main Methods:

  • A cohort of 1,700 stable heart failure patients undergoing elective coronary angiography were assessed using the DASI questionnaire.
  • All-cause mortality was tracked over a 5-year follow-up period.
  • B-type natriuretic peptide (BNP) and estimated glomerular filtration rate (eGFR) were measured in a subset.

Main Results:

  • Low DASI scores (median 26.2) independently predicted a 3.3-fold increase in 5-year mortality risk.
  • Even after adjusting for traditional risk factors, BNP, and eGFR, low DASI scores remained a significant predictor (HR 2.57).
  • The DASI questionnaire is a self-assessment tool comprising 12 questions.

Conclusions:

  • The Duke Activity Status Index (DASI) is a simple, self-administered tool that offers independent prognostic value.
  • Functional capacity assessment via DASI provides incremental predictive information for mortality in stable chronic heart failure patients.
  • DASI's prognostic utility extends beyond established cardiorenal biomarkers.
Abstract

Keywords:
Chronic heart failurefunctional statusprognosis

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