What is the distribution of Aortic Dissection Detection Risk Score in an undifferentiated emergency department chest pain population?

Amiel J Rawicki; Sharon Klim; Anne-Maree Kelly

doi:10.1111/1742-6723.13603

What is the distribution of Aortic Dissection Detection Risk Score in an undifferentiated emergency department chest pain population?

Emerg Med Australas. 2020 Oct;32(5):872-874. doi: 10.1111/1742-6723.13603. Epub 2020 Aug 18.

Authors

Amiel J Rawicki¹, Sharon Klim², Anne-Maree Kelly^{1

2

3}

Affiliations

¹ Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia.
² Joseph Epstein Centre for Emergency Medicine Research, Western Health, Melbourne, Victoria, Australia.
³ Department of Medicine, Western Health, Melbourne, Victoria, Australia.

PMID: 32808448
DOI: 10.1111/1742-6723.13603

Abstract

Objective: To determine the distribution of Aortic Dissection Detection Risk Score (ADDRS) in undifferentiated chest pain patients.

Methods: Prospective observational study of adult patients presenting to the ED with non-traumatic chest pain.

Results: Of 139 patients studied, more than 75% of patients has an ADDRS ≥1, mainly because of the report of severe pain. There were no aortic dissections. In patients with non-specific chest pain, testing driven by the ADDRS protocol would have seen a 280% increase in d-dimer testing and 2200% increase in computed tomography aortogram rates.

Conclusion: Widespread use of the ADDRS and its investigation protocol cannot be supported.

Keywords: aortic dissection; chest pain; clinical decision rule; risk score.

Publication types

Observational Study

MeSH terms

Adult
Aortic Dissection* / complications
Aortic Dissection* / diagnosis
Chest Pain* / diagnosis
Chest Pain* / etiology
Emergency Service, Hospital
Humans
Risk Factors
Tomography, X-Ray Computed