Aortic dissection detection risk score plus D-dimer
Citation, DOI and article data
The use of the aortic dissection detection risk score plus D-dimer is a proposed standardized 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.
- 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.
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