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Bedside screening tool capable of detecting acute aortic dissection
Rogers A. Circulation. 2011;123:2213-2218.
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The aortic dissection detection risk score provided physicians in a recent study with a highly sensitive bedside tool for the detection of acute aortic dissection.
“The results from this study suggest that the (aortic dissection detection) risk score, with the use of only information that is available at the bedside, offers adequate sensitivity to capture the vast majority of patients presenting with acute aortic dissection,” the researchers wrote.
Published in the 2010 thoracic aortic disease guidelines, the aortic dissection detection risk score ranks patients who are at low (risk score 0), intermediate (risk score 1) or high (risk score 2 or 3) risk, determined by the number of risk factor categories — high-risk predisposing conditions, pain features and physical examination findings — a patient meets.
In the current study, researchers used the risk score on patients (n=2,538) who were enrolled in the International Registry of Acute Aortic Dissection from 1996 to 2009. In all, 95.7% of patients had one or more of 12 proposed clinical risk markers, 83.6% had two or more clinical risk markers and 46.4% had three or four risk markers at the time of presenting.
Additionally, 4.3% of patients scored 0, 36.5% scored 1 and 59.2% scored 2 or 3 on the aortic dissection detection risk score. Of those at low risk, 66.7% had a chest X-ray, 48.6% of whom demonstrated a widened mediastinum.
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