Preliminary assessment on Risk Score Scale for aortic dissection in early triage stage / 中国实用护理杂志

ABSTRACT

Objective We aimed to assess effectiveness of Risk Score Scale (RSS) for aortic Dissection (AD) in early triage stage.Methods A total of 251 patients with acute chest or back pain complaints were allocated by triage nurses according to the pre-established RSS from 2011 to 2013.87 cases were assessed to have 5 points or more,and 80 cases were assessed to have 6 points or more from 95 patients diagnosed as aortic dissection (the diagnosed group) by CT angiography and magnetic resonance imaging while excluded 156 cases of control after discharge (control group).The general conditions,distribution of aortic dissection risk factors,aortic dissection risk score,sensitivity and specificity of RSS between two groups were compared.The misdiagnosis rate,missed diagnosis rate,RSS triage sensitivity and specificity and OR value were compared between RSS ≥5 points and RSS ≥6 points.Results There was significant differences in abrupt onset of severe pain intensity,ripping or tearing pain,pulse deficit or systolic blood pressure differential between extremities [upper extremity≥20 mmHg (1 mmHg=0.133 kPa) or lower extremity≥ 10 mmHg],x2 value was 62.6,94.2 and 20.2.RSS≥5 points had high sensitivity and specificity,lower missed diagnosis rate and high OR value for triage application.Conclusion RSS≥5 points could serve as a reliable evidence for early triage of aortic dissection.