• Exercise tolerance, in metabolic equivalents of the task (METs), is the most sensitive predictor of postoperative cardiac and pulmonary complications.
  • 4 METs = cleaning few flights of stairs, heavy house work
  • An inability to function beyond 4 METS is associated with increased perioperative cardiac events.

If a patient is able to perform greater than 4 METs of activity, it is recommended to proceed with surgery without further cardiac investigation even in a patient with known cardiac risk factors.

The Duke activity status (below) gives a list of common activities with their approximate MET equivalents.