What You Need to Know About the Duke Treadmill Score

The Duke Treadmill Score was originally developed based on the number of minutes of exercise performed using the Bruce protocol.​

Duke Treadmill Score = [exercise duration in minutes, by Bruce protocol] – [ 5 × (maximal ST elevation or depression, in millimeters)] – [4 × (treadmill angina index)]

This scoring system combines three important variables from the treadmill test:

1. Exercise time - how long the patient can exercise on the treadmill

2. ST-segment deviation - changes in the ECG that indicate heart stress or ischemia

3. Exercise-induced angina - whether the patient experiences chest pain during the test

   
   

The Duke Treadmill Score is calculated using a formula that considers various factors to produce a score predicting the risk of future cardiac events. These scores are categorized as low, moderate, or high risk, which helps determine the need for further testing or treatment.

Duke treadmill scores generally range from -25 (indicating the highest risk) to +15 (indicating the lowest risk). The one-year mortality and five-year survival rates associated with these scores are outlined below:

- A score of -11 or lower: 5.25% annual mortality rate.

- A score between -10 and 4: 1.25% annual mortality rate.

- A score of 5 or higher: 0.25% annual mortality rate.

Calculating the Duke treadmill score using online tools is available for calculating this score as part of clinical risk assessments.

Summary

The Duke Treadmill Score is a crucial tool for interpreting treadmill test results, as it combines exercise time, ST-segment deviation, and exercise-induced angina to predict cardiac risk.