Aortic dissection detection risk score plus d-dimer

The use of the aortic dissection detection risk score plus d-dimer is a proposed standardised strategy of safely ruling out the diagnosis of an acute aortic syndrome. Similar to how the pulmonary embolism rule-out criteria (PERC) negates the need for further workup of a pulmonary embolism. 

Interpretation

The score utilises the aortic dissection detection risk score (ADD-RS) and a d-dimer blood test:

  • patients with an ADD-RS score >1 should proceed directly to imaging regardless of the d-dimer result
  • patients with ADD-RS of 0 or 1 with a positive d-dimer (>500 ng/mL) should proceed to further imaging
  • in patients with ADD-RS of 0 or 1 with a negative d-dimer (<500 ng/mL) the diagnosis of an acute aortic syndrome can be excluded

This strategy was found to miss approximately 1/300 cases of acute aortic syndromes but also may reduce the rates of imaging by up to a half. The use of this algorithm has not been prospectively tested or widely implemented in clinical practice and care should be taken whilst using it. 

Share article

Article information

rID: 61249
System: Vascular, Chest
Synonyms or Alternate Spellings:

Support Radiopaedia and see fewer ads

Updating… Please wait.
Loadinganimation

Alert accept

Error Unable to process the form. Check for errors and try again.

Alert accept Thank you for updating your details.