Aortic dissection detection risk score plus d-dimer

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. 

Interpretation

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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Article information

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

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