2002 Sep;36(3):492-9. doi: 10.1067/mva.2002.126543. The RCRI was created following a study that involved a cohort of 4315 patients of age 50 and above who were to undergo an elective major noncardiac procedure in a tertiary-care teaching hospital. Integration of the Duke Activity Status Index into preoperative risk evaluation: a multicentre prospective cohort study. official website and that any information you provide is encrypted Intraperitoneal; intrathoracic; suprainguinal vascular (see, History of myocardial infarction (MI); history of positive exercise test; current chest pain considered due to myocardial ischemia; use of nitrate therapy or ECG with pathological Q waves, Pulmonary edema, bilateral rales or S3 gallop; paroxysmal nocturnal dyspnea; chest x-ray (CXR) showing pulmonary vascular redistribution, Prior transient ischemic attack (TIA) or stroke, Pre-operative creatinine >2 mg/dL / 176.8 mol/L, Calcs that help predict probability of a disease, Subcategory of 'Diagnosis' designed to be very sensitive, Disease is diagnosed: prognosticate to guide treatment, Note: this content was updated January 2019 to reflect the substantial body of evidence, namely external validation studies, suggesting that the original RCRI had significantly underestimated the risk (see. The Goldman Risk Index (GRI), also known as the Cardiac Risk Index in Non-cardiac Surgery, was developed by Dr. Goldman in 1977. Any score below 7 should trigger concern. [11]The more recent ESC/ESA guidelines recommend its use in addition to the traditional RCRI (Class I recommendation, level of evidence B). Read our. Identifies patients with higher risk of having a MACE (all-cause mortality, myocardial infarction, or coronary revascularization) in the following 6 weeks. Scores. You can further save the PDF or print it. National Library of Medicine 2009;360(5):491499. A surgical safety checklist to reduce morbidity and mortality in a global population. Key Facts Instruction: Check whether the patient is able to: 1 Take care of self e.g. Moreover, these tools can be useful in combination with past medical history, family history, and past surgical outcomes to determine an appropriate form of action for the treatment of their patients. Using this as a baseline, scientists have given common activities MET scores. Accessibility official version of the modified score here. Evaluates the functional capacity of patients with cardiovascular disease (CVD) for preoperative risk assessment. There were no significant differences in both groups in the late cardiovascular interventions (p = 0.91) and major events including stroke and myocardial infarction (p = 0.4) monitored during the follow up period. Dr. Lee Goldman on original Goldman Cardiac Risk Index for MDCalc: The Revised Cardiac Risk Index was published 22 years after the original index became the first multifactorial approach to assessing the cardiac risk of non-cardiac surgery and one of the first such approaches for any common clinical problem. Estimates risk of cardiac complications after noncardiac surgery. 2009 ACCF/AHA focused update on perioperative beta blockade incorporated into the ACC/AHA 2007 guidelines on perioperative cardiovascular evaluation and care for noncardiac surgery: a report of the American college of cardiology foundation/American heart association task force on practice guidelines. How it Works We will demonstrate how the calculator works with a simple example: This risk index should be used in the context of the ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery. The POSSUM may overestimate risk in hepatopancreaticobiliary surgery. Association between postoperative troponin levels and 30-day mortality among patients undergoing noncardiac surgery. [23]Because compared with other types of noncardiac operations, vascular surgicalinterventionsare associated with a twofold to a fourfold higher risk of MACEs,and the Vascular Study Group of New England (VSGNE) has been designed to assess cardiac risk in this surgical setting. About. 4: severe systemic disease that is a constant threat to life (i.e., patient could die acutely without intervention), 5: moribund, not expected to survive without surgery. official version of the modified score here. in 1989, that correlates well with peak oxygen uptake (Spearman correlation coefficient 0.80). It estimates the likelihood of perioperative cardiac events and therefore can support clinical decision making as to the benefits and risks surgery has over other treatment options that might be available for individual cases. Duke Activity Status Index for cardiovascular diseases: validation of the Portuguese translation. The Duke Activity Status Index is a patient-reported estimate of functional capacity, maximal oxygen consumption (VO2 max) and maximum metabolic equivalent of tasks (METs). Table 1 shows a comparison between RCRI and MICA indices. In: StatPearls [Internet]. official version of the modified score here. eating, dressing, bathing, using the toilet No (0) Yes (+2.75) 2 Walk indoors No (0) Yes (+1.75) 3 Walk 1-2 blocks on level ground No (0) Yes (+2.75) J Vasc Surg. Class II [1 predictores] correlates with a 0.9% 30-day risk of death, MI, or CA. Framingham Risk Score (Hard Coronary Heart Disease), Originally created using minutes of exercise under. Some patients undergoing noncardiac surgery are at risk for an adverse cardiovascular event (ie, myocardial ischemia, myocardial infarction [MI], heart failure, arrhythmia, stroke, or cardiac death). This index can identify patients at higher risk for complications such as myocardial infarction, pulmonary edema, ventricular fibrillation or primary cardiac arrest, and complete heart block. For example, preoperative evaluation requires at least 4 METS performed. In this retrospective cohort study, we evaluated the metabolic equivalent of task (MET) in the preoperative risk assessment with clinical outcome in a cohort of consecutive patients. Prediction of cardiac risk before abdominal aortic reconstruction: comparison of a revised Goldman Cardiac Risk Index and radioisotope ejection fraction. 1999; 100(10):1043-9. Epub 2020 Aug 24. doi: 10.1002/14651858.CD008493.pub2. Please note that once you have closed the PDF you need to click on the Calculate button before you try opening it again, otherwise the input and/or results may not appear in the pdf. The POSSUM should NOT dictate the decision to operate, which is a clinical decision. Indeed, guidelines on the topic suggest avoiding indiscriminate routine preoperative cardiac exams, as this approach result time- and cost-consuming, resource-limiting, and does not improve perioperative outcome. Cardiovascular testing is rarely indicated in low-risk patients, or in those able to perform 4 METs of exercise; routine referral for preoperative revascularization does not improve postoperative outcome and is not recommended. View Functional capacity is often expressed in terms of metabolic equivalents (METS), where 1 MET is the resting or basal oxygen consumption of a 40-year-old, 70-kg man. Liakopoulos OJ, Kuhn EW, Slottosch I, Wassmer G, Wahlers T. Cochrane Database Syst Rev. Then you can click on the Print button to open a PDF in a separate window with the inputs and results. Controversial results of the Revised Cardiac Risk Index in elective open repair of abdominal aortic aneurysms: Retrospective analysis on a continuous series of 899 cases. The prognostic value of pre-operative and post-operative B-type natriuretic peptides in patients undergoing noncardiac surgery: B-type natriuretic peptide and N-terminal fragment of pro-B-type natriuretic peptide: a systematic review and individual patient data meta-analysis. [19][20][21]Again, it underestimates the risk of myocardial ischemia compared with the RCRI. Revised Cardiac Risk Index for Pre-Operative Risk. The RCRI is simple and straightforward to calculate: the presence of either of the criteria counts as 1 point towards the final score which varies between 0 and 6. [13][14] Other patient-important outcomes not included in the assessment include the risk of stroke, major bleeding, prolonged hospitalization, and intensive care unit (ICU) admission. Class III [2 predictores] correlates with a 6.6% 30-day risk of death, MI, or CA. Class I (0 to 5 points): correlateswith a 1.0% risk of cardiac complications during or around noncardiac surgery. Compared with other risk prediction tools, MIRACLE2 outperformed the OHCA score proposed by Adrie and colleagues in 2006 and the Cardiac Arrest Hospital Prognosis score, but it performed as well as the Target Temperature Management score. These are real scientific discoveries about the nature of the human body, which can be invaluable to physicians taking care of patients. Get in touch with MDApp by using the following contact details: 2017 - 2023 MDApp. Thomas H. Lee, MD, SM; Edward R. Marcantonio, MD, SM; Carol M. Mangione, MD, SM; Eric J. Thomas, MD, SM; Carisi A. Polanczyk, MD; E. Francis Cook, ScD; David J. Sugarbaker, MD; Magruder C. Donaldson, MD; Robert Poss, MD; Kalon K. L. Ho, MD, SM; Lynn E. Ludwig, MS, RN; Alex Pedan, PhD; Lee Goldman, MD, MPH. The POSSUM is more comprehensive than the SAS (which is calculated based on 3 parameters), but the SAS is more objective. Multifactorial index of cardiac risk in noncardiac surgical procedures. 10, 11. JAMA. The .gov means its official. ", Clinical Cardiology: "Metabolic equivalents (METS) in exercise testing, exercise prescription, and evaluation of functional capacity. Some doctors use MET scores to prescribe exercise for their patients, recommending, for example, 1,000 MET minutes a week. By clicking Subscribe, I agree to the WebMD, Smart Grocery Shopping When You Have Diabetes, Surprising Things You Didn't Know About Dogs and Cats, Mediterranean, Low-Fat Diets Are Best for Heart Problems, Least Amount of Exercise You Need to Stay Healthy, Nerve 'Pulse' Therapy May Help Ease Sciatica, New Book: Take Control of Your Heart Disease Risk, MINOCA: The Heart Attack You Didnt See Coming, Health News and Information, Delivered to Your Inbox, Walking on a firm, level surface at a very brisk pace: 5.0, Running at the rate of a 10-minute mile: 9.8. official version of the modified score here. The score was derived 1 in 2014, and compared to another CDR for chest pain in a prospective RCT 2 of 558 patients. Am J Cardiol. Even stress test results and beta-blocker therapy were not a part of that source. The same activity can have more than one score. You Will Likely Need a METS Test to Receive Disability Obviously, most people don't fit that age and weight profile. The higher the score (ranges from 0 to 58.2) the higher the functional status. METs are used to estimate how many calories are burned during many common physical activities. The Vascular Study Group of New England Cardiac Risk Index (VSG-CRI) predicts cardiac complications more accurately than the Revised Cardiac Risk Index in vascular surgery patients. Development and validation of a risk calculator for prediction of cardiac risk after surgery. Increased odds of 30-day death or myocardial infarction (odds ratio: 1.05 per 1 point decrease below 34; 95% CI: 1.001.09); Moderate-to-severe complications (odds ratio: 1.03 per 1 point decrease below 34; 95% CI: 1.011.05). government site. The best way of measuring CRF is with a VO2 max test, which requires the person being tested to use a treadmill while wearing an oxygen mask. scrubbing floors, lifting or moving heavy furniture, e.g. Duceppe E, Parlow J, MacDonald P, Lyons K, McMullen M, Srinathan S, Graham M, Tandon V, Styles K, Bessissow A, Sessler DI, Bryson G, Devereaux PJ. Major adverse cardiac events (MACEs), including nonfatal cardiac arrest, myocardial infarction (MI), congestive heart failure (HF), or new cardiac arrhythmias, are relatively common in patientsundergoing non-cardiac surgery. 2. A 40-year-old man who weighed 70 kilograms (about 154 pounds) was used in the original calculations. External validation of the Revised Cardiac Risk Index and update of its renal variable to predict 30-day risk of major cardiac complications after non-cardiac surgery: rationale and plan for analyses of the VISION study. Log in to create a list of your favorite calculators! Click here for full notice and disclaimer. Providesindependent prognostic information in addition to coronary anatomy, left ventricular ejection fraction, and clinical data. ", Intermountain Healthcare: "The Fitness Test That Tells the Truth About Your Health. Again, it seems to have poor reliability in particular settings such asvascular surgery (e.g., elective open abdominal aortic aneurysm repairs) or other settings such as selected types of major abdominal surgery and lung resection. [26]There is also a recent prospectively derived score. Thomas DC, Blasberg JD, Arnold BN, Rosen JE, Salazar MC, Detterbeck FC, Boffa DJ, Kim AW. Goldman L, Caldera DL, Nussbaum SR, Southwick FS, Krogstad D, Murray B, Burke DS, O'Malley TA, Goroll AH, Caplan CH, Nolan J, Carabello B, Slater EE. This website also contains material copyrighted by 3rd parties. Since this topic is of enormous importance, scientific societies of cardiologists and anesthesiologists have repeatedly collaborated to define the most effective strategy, including indications. ( golf, bowling, dancing, doubles tennis, throwing a baseball or football, e.g. In this retrospective cohort study, we evaluated the metabolic equivalent of task (MET) in the preoperative risk assessment with clinical outcome in a cohort of consecutive patients. -. A score of 10 is good. Biccard BM, Rodseth RN. Conversely, patients with a good exercise capacity (>10 METs) often have an excellent prognosis independent of the extent of anatomical CAD. Should be used with caution in patients undergoing testing with other protocols. The higher the score, the higher the risk of post operative cardiac events. Predicts 6-week risk of major adverse cardiac event. In the text below the calculator there is more information on the criteria used and on how the result is interpreted. In patients with elevated risk (RCRI greater than or equal to 1, age 65 and over, or age 45 to 64 with significant cardiovascular disease), it helps direct further preoperative risk stratification (e.g., with B-type natriuretic peptide, BNP) and determines appropriate postoperative cardiac monitoring (EKG, troponins). The original Goldman index and derivates originated several years ago. They are less accurate when they are used to estimate the number of calories actually burned by an individual during a task. These are real scientific discoveries about the nature of the human body, which can be invaluable to physicians taking care of patients. Doctors recommend 150 minutes a week of moderate exercise or 75 minutes a week if the exercise is vigorous. The RCRI, currently used today, utilizes six independent variables with known associations with increased perioperative risk. Cardiac No failure Diuretic, digoxin or angina/hypertension meds Peripheral edema, warfarin, or borderline cardiomegaly on chest X-ray (CXR) Raised jugular venous pressure, or cardiomegaly on CXR Respiratory No dyspnea Exertional dyspnea or mild COPD on CXR Limiting dyspnea or moderate COPD on CXR Dyspnea at rest or fibrosis/consolidation on CXR Since the time of their development, there have been significant changes in the management of surgical patients. Tickets. Br J Anaesth. Italso received a recommendation from the American College of Cardiology (ACC) and the American Heart Association (AHA).[9][10]. Predicts risk of MI or cardiac arrest after surgery. Generally, an improvement in health requires 500-1000 MET minutes a week. Derivation and Validation of a Geriatric-Sensitive Perioperative Cardiac Risk Index. HEART is an acronym of its components: History, EKG, Age, Risk factors, and troponin. 2012;307(21):2295304. Ferrante AMR, Moscato U, Snider F, Tshomba Y. and also went by the name of the Lee Index. The subgroup after open surgical technique with less than 4 MET had the lowest mean survival of 38.8 months. 2007;46(4):694700. 1 point: No ST deviation but LBBB, LVH, repolarization changes (e.g. It evaluates six independent variables associated with increased cardiac risk. There is no resource limitation, as if the tool was hosted on your site, so all your users can make use of it 24/7; The necessary tool updates will take place in real time with no effort on your end; A single click install to embed it into your pages, whenever you need to use it. Fill in the calculator/tool with your values and/or your answer choices and press Calculate. Methods: Retrospective analysis of prospectively collected data in a single center unit of 296 patients undergoing open or endovascular aortic repair from 2009 to . http://creativecommons.org/licenses/by-nc-nd/4.0/. MET scores, or metabolic equivalents, are one way to bring better understand., A MET score of 1 represents the amount of energy used when a person is at rest. 1989; 64(10):651-654. [22], Other RCRI-derived indices have undergone development to overcome most of these limits. Derivation and prospective validation of a simple index for prediction of cardiac risk of major noncardiac surgery, Multifactorial index of cardiac risk in noncardiac surgical procedures. Spence J, LeManach Y, Chan MTV, Wang CY, Sigamani A, Xavier D, Pearse R, Alonso-Coello P, Garutti I, Srinathan SK, Duceppe E, Walsh M, Borges FK, Malaga G, Abraham V, Faruqui A, Berwanger O, Biccard BM, Villar JC, Sessler DI, Kurz A, Chow CK, Polanczyk CA, Szczeklik W, Ackland G, X GA, Jacka M, Guyatt GH, Sapsford RJ, Williams C, Cortes OL, Coriat P, Patel A, Tiboni M, Belley-Ct EP, Yang S, Heels-Ansdell D, McGillion M, Parlow S, Patel M, Pettit S, Yusuf S, Devereaux PJ. Many factors influence the rate at which you use energy. -, Haynes AB, Weiser TG, Berry WR, Lipsitz SR, Breizat AH, Dellinger EP, et al. ", Harvard Health Publishing: "The case for measuring fitness. [2] Thus, cardiac risk stratification is of paramount importance for identifying those who need preoperative preventive strategies as well as for developing safer perioperative strategies encompassing careful monitoring and pre-operative medical cardiac optimization. Wijeysundera et al. Perioperative myocardial infarction. CHADS-VASc Score for Atrial Fibrillation Stroke Risk Calculates stroke risk for patients with atrial fibrillation, possibly better than the CHADS Score. The Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM) assesses morbidity and mortality for general surgery. J Vasc Surg. Keywords: Class I [0 predictores] correlateswith a 0.4% 30-day risk of death, myocardial ischemia (MI), or cardiac arrest (CA). doi: 10.1016/j.jvs.2007.05.060. The risk to miss a potential need for cardiac optimization in patients > 4MET was 7%. Disclaimer. Unauthorized use of these marks is strictly prohibited. MDCalc loves calculator creators - researchers who, through intelligent and often complex methods, discover tools that describe scientific facts that can then be applied in practice. N Engl J Med. Exercise is important, but conversations about it hit a snag when they turn to how much exercise you need. Pre-operative creatinine more than 2 mg/dL. The site is secure. A brief self-administered questionnaire to determine functional capacity (the Duke Activity Status Index). Gialdini G, Nearing K, Bhave PD, Bonuccelli U, Iadecola C, Healey JS, Kamel H. Perioperative atrial fibrillation and the long-term risk of ischemic stroke. MET scores, or metabolic equivalents, are one way to bring better understand. Implications for preoperative clinical evaluation. Coutinho-Myrrha MA, Dias RC, Fernandes AA, Arajo CG, Hlatky MA, Pereira DG, Britto RR. Poor functional capacity is associated with increased cardiac complications in noncardiac surgery. 2012 Apr 18;(4):CD008493. Because validation studies have shown its effectiveness, it represents the most recommended tool for rapid perioperative risk assessment. Each tool assesses the risk of developing a perioperative cardiac complication during a specific procedure. Duke Activity Status Index (DASI) Explained, A brief self-administered questionnaire to determine functional capacity (the Duke Activity Status Index), Duke Activity Status Index for cardiovascular diseases: validation of the Portuguese translation, Criterion validity of the Duke Activity Status Index for assessing functional capacity in patients with chronic obstructive pulmonary disease, Integration of the Duke Activity Status Index into preoperative risk evaluation: a multicentre prospective cohort study. Cookie Preferences. It can be used for both emergency and elective surgery. Patients with < 4MET had a higher incidence of diabetes mellitus (p = 0.0002), peripheral arterial disease (p < 0.0001), history of smoking (p = 0.003), obesity (p = 0.03) and chronic obstructive pulmonary disease (p = 0.05). Boersma E, Kertai MD, Schouten O, Bax JJ, Noordzij P, Steyerberg EW, Schinkel AF, van Santen M, Simoons ML, Thomson IR, Klein J, van Urk H, Poldermans D. Perioperative cardiovascular mortality in noncardiac surgery: validation of the Lee cardiac risk index. The presence of any of the above three symptoms indicates history of CHF. METS X 3.5 X BW (KG) / 200 = KCAL/MIN. Bookshelf Reliable prediction of the preoperative risk is of crucial importance for patients undergoing aortic repair. The user needs some experience taking a detailed chest pain history and reading EKGs to adequately apply these two components of the score. [10]Meanwhile, other tools, such as the Myocardial Infarction &CardiacArrest (MICA) developed by Gupta et al., in 2011, on the database of the National Surgical Quality Improvement Program (NSQIP),have been proposed. Level: Heavy (five to seven METS) splitting wood shoveling snow climbing ladder putting on storm windows walking (4-5 mph) tennis (singles) softball stream fishing square dancing cross country skiing (2.5 mph) ice or roller skating gymnastics cricket archery heavy farming heavy industry occasional lifting (50-100 pounds Would you like email updates of new search results? doi: 10.1002/14651858.CD008493.pub3. Myocardial infarction and heart failure are common causes of morbidity and mortality in any type of serious surgery. Roshanov PS, Walsh M, Devereaux PJ, MacNeil SD, Lam NN, Hildebrand AM, Acedillo RR, Mrkobrada M, Chow CK, Lee VW, Thabane L, Garg AX. This calculator estimates atherosclerotic cardiovascular disease (ASCVD) risk in adults using logic from the 10-year Multi-Ethnic Study of Atherosclerosis (MESA), ASCVD pooled cohort risk equations, and Framingham 30-year ASCVD risk. Cookie Preferences. Diagnoses and prognoses suspected CAD based on the treadmill exercise test. Landesberg G, Beattie WS, Mosseri M, Jaffe AS, Alpert JS. Despite this, even the most recent indexes have strengths and limitations that do not allow their application to all the settings, and further research is needed to establish the gold standard. This strategy is only apparently more complex. 2022 Feb;76:110559. doi: 10.1016/j.jclinane.2021.110559. They then assign higher MET scores to other, more strenuous tasks that require more oxygen.. For example, if a 30-year-old man weighing 170lbs (77.3kg) performs 45 minutes of running at 7mph, the amount of calories he would burn per minute would be: 11.5 (3.5) (77.3kg)/200 = 15.6 kcals/min So in 45 minutes, this man would burn 700 calories running at 7mph. Trial registration clinicaltrials.gov, registration number NCT03617601 (retrospectively registered). Wijeysundera DN, Beattie WS, Hillis GS, et al. Epub 2021 Oct 20. Emergency (within 24h), resuscitation >2h possible, Calcs that help predict probability of a disease, Subcategory of 'Diagnosis' designed to be very sensitive, Disease is diagnosed: prognosticate to guide treatment. The main outcome measure considered was major cardiac complications, which occurred in 2% of the 2893 patients from the derivation cohort. Proposed research plan for the derivation of a new Cardiac Risk Index. The risk is related to patient- and surgery-specific factors. The ACS NSQIP risk calculator is a newer, similar assessment. Designed to risk stratify patients with undifferentiated chest pain. One MET can also be expressed as oxygen uptake of 3.5 ml/kg/min. No part of this service may be reproduced in any way without express written consent of QxMD. Steps on how to print your input & results: 1. The rationale is that these indices may help identify high-risk patients who need further preoperative assessment through a noninvasiveor invasive approach and for characterizing low-risk patients in whom further evaluation is unlikely to be helpful. Preoperative statin therapy for patients undergoing cardiac surgery. 2014; 102(4):383-90. Fenestrated and Branched Thoraco-abdominal Endografting after Previous Open Abdominal Aortic Repair. -, Vascular Events In Noncardiac Surgery Patients Cohort Evaluation Study I. Devereaux PJ, Chan MT, Alonso-Coello P, Walsh M, Berwanger O, et al. Determines risk of perioperative cardiac events in patients undergoing heart surgery. Ford MK, Beattie WS, Wijeysundera DN. -, McFalls EO, Ward HB, Moritz TE, Littooy F, Santilli S, Rapp J, et al. Activities can be light, moderate, or vigorous, according to their MET score. The DASI is a 12-item scale (in the form of a self-administered questionnaire) developed by Hlatky et al. in 1999 as a revision of the original cardiac risk evaluation by Goldman (from 1977). To reach 1,000 MET minutes, a person could combine brisk walking and low-impact aerobics, both with a MET score of 5, for 200 minutes a week (5 x 200 = 1,000). Two people doing a particular activity are unlikely to consume the same amount of energy, even though the MET score for the activity would be the same. Roster. Methods: Cookie Preferences. The figure that emerges from this close collaboration is that any surgical non-cardiac intervention should be risk-stratified using the perioperative risk assessment path. Sabat S, Mases A, Guilera N, Canet J, Castillo J, Orrego C, Sabat A, Fita G, Parramn F, Paniagua P, Rodrguez A, Sabat M., ANESCARDIOCAT Group. raking leaves, weeding, pushing a power mower, Participate in moderate recreational activities, e.g. Please note that once you have closed the PDF you need to click on the Calculate button before you try opening it again, otherwise the input and/or results may not appear in the pdf. Creating an account is free and takes less than 1 minute. See About section for examples of surgeries in each category. The inclusion of these indexes in dedicated algorithms (e.g., from guidelines) must be an essential step in a tailored path leading to an individualized cardiac risk assessment. MetS Calc, the metabolic syndrome (MetS) severity calculator, is a browser-based form that calculates an individual's metabolic syndrome severity score using established and well-researched equations. Gupta PK, Gupta H, Sundaram A, Kaushik M, Fang X, Miller WJ, Esterbrooks DJ, Hunter CB, Pipinos II, Johanning JM, Lynch TG, Forse RA, Mohiuddin SM, Mooss AN. Aortic repair; Functional capacity; Metabolic equivalent of task (MET); Preoperative assessment. Framingham Risk Score (Hard Coronary Heart Disease). Calcs that help predict probability of a disease, Subcategory of 'Diagnosis' designed to be very sensitive, Disease is diagnosed: prognosticate to guide treatment. Activities with a MET score of 5-8 are classified as moderate and would be appropriate for those who are older or sedentary.
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