Aortic dissection detection risk score plus D-dimer
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At the time the article was created Henry Smith had no recorded disclosures.View Henry Smith's current disclosures
At the time the article was last revised Sonam Vadera had no recorded disclosures.View Sonam Vadera's current disclosures
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.
The score utilizes 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.
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