Prognostic Value of Self-Reported Subjective Exercise Capacity in Patients With Acute Dyspnea

Figures

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  Figure 1. Original Duke Activity Status Index 12 original DASI questions and corresponding points which result in the DASI-score ranging from 0 (lowest) to 58.2 (highest exercise capacity). DASI = Duke Activity Status Index.

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  Figure 2. DASI in Predicting Future Risk of 90-Day Death From Any Cause Patients stratified according to DASI into quartiles and referenced to fourth quartile (highest self-reported exercise capacity). (A) Kaplan–Meier curves with P value (log-rank test), unadjusted HR with corresponding 95% CI and numbers at risk. (B) Adjusted HRs on logarithmic scale. Adjustments made for age, sex, natural log of blood urea nitrogen (mmol/L), hemoglobin (g/L), and natural log of N-terminal pro B-type natriuretic peptide (ng/L). Squares represent HRs; horizontal lines, 95% CI; vertical line, a HR of 1.00. aHR = adjusted hazard ratio; BUN = blood urea nitrogen; CI = confidence interval; DASI = Duke Activity Status Index; HR = hazard ratio; NT-proBNP = N-terminal pro-B-type natriuretic peptide.

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  Central Illustration. The DASI Predicting Future Risk of 720-Day Death From Any Cause Patients stratified into DASI quartiles and referenced to fourth quartile (highest self-reported exercise capacity). Kaplan–Meier curves with P value (log-rank test), unadjusted HRs with corresponding 95% CI and numbers at risk. DASI = Duke Activity Status Index; ED = emergency department.

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  Figure 3. DASI in Predicting Future Risk of 720-Day Death From Any Cause Patients stratified into DASI quartiles and referenced to fourth quartile (highest self-reported exercise capacity). Adjusted hazard ratios (aHR) illustrated on logarithmic scale. Adjustments made for age (years), sex, systolic blood pressure (mm Hg), peripheral oxygen saturation (SpO2, %), leg edema on presentation, history of hypertension, diabetes, coronary artery disease, atrial fibrillation, heart failure, chronic obstructive pulmonary disease/asthma, natural logarithm of blood urea nitrogen (mmol/L), levels of serum creatinine (μmol/L), hemoglobin (g/L) and natural logarithm of N-terminal pro B-type natriuretic peptide (ng/L), sodium (mmol/L), intake of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEI/ARB), beta-blockers, and diuretics on admission. Squares represent HRs; horizontal lines, 95% confidence intervals; vertical line, a HR of 1.00. BUN = blood urea nitrogen; COPD = chronic obstructive pulmonary disease; DASI = Duke Activity Status Index; NT-proBNP = N-terminal pro-B-type natriuretic peptide.

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  Figure 4. Prognostic Accuracy of DASI for All-Cause Mortality Within 720 days of Follow-Up Compared to Natriuretic Peptide Peptide Concentrations on Admission and to the Voors Score Time-dependent area under the receiver operating characteristics curve within 720 days of follow-up in patients presenting with acute dyspnea using the DASI, B-type natriuretic peptide (BNP) (A), N-terminal pro-B-type natriuretic peptide (NT-proBNP) (B) levels on admission, and the Voors score (C) with previously described cut-off points (NT-proBNP >4,000 pg/mL, blood urea nitrogen (BUN) >11 mmol/L, age >70 years, hemoglobin <12 g/dL, and beta-blocker use at baseline). Calculated with “timeROC” package R statistical software. AUROC = area under the receiver operating characteristics curve; BNP = B-type natriuretic peptide; BUN = blood urea nitrogen; DASI = Duke Activity Status Index; NT-proBNP = N-terminal pro-B-type natriuretic peptide.