Value of aortic dissection detection risk score combined with D-dimer in patients with suspected acute aor-tic dissection / 实用医学杂志

ABSTRACT

Objective To assess the diagnostic value of combining aortic dissection detection risk score (ADDRS)with D-dimer in patients with suspected acute aortic dissection(AAD). Methods We retrospectively identified 525 patients with chest pain and with calculated ADDRS and available D-dimer on admission between January 2015 and December 2016. ADDRS ≤1 was defined as ′low probability′ and that >1 as ′high probability′. Results AAD were diagnosed in 106(20.2%)patients. In patients with ADDRS of 0,1 case of AAD was identi-fied and in those with ADDRS of 1,40 were identified while in 76 patients with ADDRS of 2 and 3,71 cases of AAD were identified. D-dimer with threshold of 0.5 mg/L had a negative predictive value of 100%and a specificity of 76.6% in patients with ADDRS of 0. In patients with ADDRS of 1,D-dimer had a negative predictive value of 98.6%. D-dimer showed a negative predictive value of 99.6% and a positive predictive value of 22.3% in patients with low probability. Conclusions High ADDRS benefits confirming AAD. Low ADDRS combined with negative D-dimer is safe and efficient for ruling out AAD ,while low ADDRS with positive D-dimer needs further aortic imaging.