Amiel J Rawicki1, Sharon Klim2, Anne-Maree Kelly1,2,3. 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.
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.
OBJECTIVE: To determine the distribution of Aortic Dissection Detection Risk Score (ADDRS) in undifferentiated chest painpatients. 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.