The Use of a Questionnaire and Simple Exercise Test in the Preoperative Assessment of Vascular Surgery Patients

Abstract

We aimed to assess the reliability of patients as historians in terms of the self assessment of functional capacity and also examined the usefulness of a simple ward exercise tolerance test. One hundred consecutive elective vascular surgery patients were interviewed preoperatively using a modified Duke Activity Status Index (DASI) questionnaire. To test reliability in reference to an independent observer, the questionnaire concerning the patient was also applied to each patient's closest relative who was blinded to the patient's responses. Patients were then asked to walk up two flights of stairs and the time taken to complete the task or the reason for failing to complete the task was recorded. The DASI questionnaire was successfully applied to 98 of 100 patients. The average time for completion was five minutes. There was significant correlation between the scores obtained by each patient and that of their closest relative (r=0.883, P<0.01). Mean percentage score was 48.6, range 0 to 100. Fifty-nine of 100 patients selected were able to undergo the simple ward exercise test. DASI scores (mean, SD) were significantly different between those who completed two flights (67.2, 21.5), one flight (45.5, 15.6) or who were unable to climb at all (28.8, 25) (Mann-Whitney U test corrected for multiple comparisons, P<0.05). Patients with higher DASI scores were able to complete the task at a faster rate. The DASI questionnaire is easy to administer and a useful method for quantifying exercise tolerance. We also demonstrated a high correlation between the responses of patients and relatives.