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Prognostic value of the duke activity Status Index Questionnaire in predicting mortality in patients with chronic
Aldair Darlan Santos-de-Araújo1, Daniela Bassi-Dibai2, Izadora Moraes Dourado1
1Cardiopulmonary Physiotherapy Laboratory, Universidade Federal de São Carlos, Federal University of Sao Carlos Rodovia Washington Luiz, São Carlos, 13565-905, SP, Brazil.
Insights
A Duke Activity Status Index (DASI) questionnaire score of 23 or less strongly predicts mortality in chronic heart failure (CHF) patients over 36 months. This threshold aids in risk stratification for CHF management.
Area of Science:
- Cardiology
- Clinical Medicine
- Public Health
Background:
- The Duke Activity Status Index (DASI) questionnaire is utilized for assessing functional capacity in chronic heart failure (CHF) patients.
- While its prognostic value is recognized, optimal threshold scores for predicting mortality require further investigation.
Purpose of the Study:
- To determine optimal DASI questionnaire threshold values for predicting mortality in a CHF cohort.
- To evaluate mortality rates using identified DASI questionnaire thresholds.
Main Methods:
- Prospective cohort study with 36-month follow-up in 124 CHF patients.
- Utilized Receiver Operating Characteristic (ROC) curve analysis and Kaplan-Meier survival analysis.
- Assessed DASI questionnaire scores, pulmonary function, and echocardiography.
Main Results:
- A DASI questionnaire score threshold of ≤/>23 was identified as a significant predictor of 36-month mortality in the CHF cohort.
- Kaplan-Meier analysis confirmed the strong predictive capacity of this threshold.
Conclusions:
- A DASI questionnaire score of ≤/>23 effectively discriminates 36-month mortality risk in CHF patients, particularly those with reduced ejection fraction.
- Key mortality risk factors identified include age, ejection fraction, DASI score, and digoxin use.
Background:
The Duke Activity Status Index (DASI) questionnaire has been the focus of numerous investigations - its discriminative and prognostic capacity has been continuously explored, supporting its use in the clinical setting, specifically during rehabilitation in patients with chronic heart failure (CHF).However, studies exploring optimal DASI questionnaire threshold scores are limited.
Objective:
To investigate optimal DASI questionnaire thresholds values in predicting mortality in a CHF cohort and assess mortality rates based on the DASI questionnaire using a thresholds values obtained.
Methodology:
This is a prospective cohort study with a 36-month follow-up in patients with CHF. All patients completed a clinical assessment, followed by DASI questionnaire, pulmonary function, and echocardiography. The Receiver Operating Characteristic (ROC) curve analysis was used to discriminate the DASI questionnaire score in determining the risk of mortality. For survival analysis, the Kaplan-Meier model was used to explore the impact of ≤/>23 points on mortality occurring during the 36-month follow-up.
Results:
One hundred and twenty-four patients were included, the majority being elderly men. Kaplan Meier analysis revealed that ≤/> 23 was a strong predictor of CHF mortality over a 36-month follow-up.
Conclusion:
A score of ≤/>23 presents good discriminatory capacity to predict mortality risk in 36 months in patients with CHF, especially in those with reduced or mildly reduced ejection fraction. Age, ejection fraction, DASI questionnaire score and use of digoxin are risk factors that influence mortality in this population.
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