What is the Metabolic Equivalent of Task (METs) score?

From the Guidelines

A patient's functional capacity is considered adequate for noncardiac surgery if they have a METs score of 4 or more without symptoms. When evaluating a patient's functional capacity, it is essential to consider their ability to perform daily activities and their overall cardiovascular health 1. The American College of Cardiology/American Heart Association guidelines suggest that patients with a functional capacity of 4 METs or more without symptoms can proceed with planned surgery 1.

Estimating METs Score

To estimate a patient's METs score, clinicians can use various methods, including:

• The Duke Activity Status Index, which contains questions to estimate functional capacity 1
• Other activity scales, such as the Specific Activity Scale 1
• Knowledge of the METs levels required for physical activities, such as walking, cycling, or climbing hills 1

Interpreting METs Score

A METs score of:

• Less than 4 METs indicates poor functional capacity and increased perioperative cardiac and long-term risks 1
• 4 to 6 METs indicates moderate functional capacity
• 7 to 10 METs indicates good functional capacity
• Greater than 10 METs indicates excellent functional capacity 1

Clinical Implications

Patients with a METs score of less than 4 should undergo further cardiovascular evaluation and consideration of perioperative heart rate control with beta blockade 1. In contrast, patients with a METs score of 4 or more without symptoms can typically proceed with planned surgery without further cardiovascular testing 1.

From the Research

Mets Score Overview

• The METSSS score is a prognostic tool used to predict overall survival in cancer patients after palliative radiotherapy in the last phase of life 2.
• The score was validated in a study of 274 patients with metastatic cancer who received palliative radiotherapy, with a median actual overall survival of 40 days from the start of radiotherapy 2.

Calculation and Prediction

• The METSSS score calculates the mortality risk score, followed by stratification of patients into prognostic risk groups 2.
• The prediction of 1-year overall survival estimates is subsequently calculated, with the score correctly predicting the survival of patients by assigning them to the highest risk category 2.

Clinical Application

• The METSSS score can serve as a decision-making tool when assigning patients to symptomatic radiotherapy 2.
• There is no direct mention of the METSSS score in the other studies, which focus on different aspects of cancer treatment, such as endocrine and targeted therapy for hormone-receptor-positive breast cancer 3, HER2-positive breast cancer therapies 4, and combination therapies for metastatic breast cancer 5, 6.