Duke Activity Status Index in Coronary Patients Undergoing Abdominal Nonvascular Surgery

Background: Poor functional capacity is a predictor of higher morbidity and mortality in cardiac patients undergoing noncardiac surgery in general anesthesia. The objective of our prospective observational clinical study was to verify that the number of perioperative cardiologic complications significantly increased with the decline of functional capacity estimated by “Duke Activity Status Index” (DASI) criteria, in patients with angiographically verified coronary artery disease having undergone an open abdominal nonvascular surgery in general anesthesia. Design and Methods: The group of 111 consecutive patients was divided into three stratification subgroups according to DASI criteria, with poor 1<4MET 45(36.9%), moderate 4-7MET 43(38.7%) and good 7-10MET 23(20.7%) outcome. They were compared in relation to the incidence of perioperative cardiologic complications. During the surgery and in the following postoperative 72 hours, the patients were evaluated by continuous ST-T segment monitoring. 12-lead electrocardiogram was performed in all patients immediately after surgery, then on days 1, 2 and 7 after the operation and one day before their discharge. The patients were followed till the 30th postoperative day on daily basis. Results: Significant difference of the incidence of total mortality till the 30th postoperative day between three stratification subgroups according to DASI criteria was found in group I-5(11.1%) vs group II-1(2.3%) vs group III-0(0.0%) (p<0.05). Conclusions: History data obtained by DASI criteria were adequate evaluation of the functional capacity in coronary patients having undergone an open abdominal nonvascular surgery in general anesthesia. The incidence of perioperative cardiologic complications significantly increased with decline of the functional capacity evaluated by DASI criteria.