Aortic dissection detection risk score

High-risk clinical conditions
Recent aortic manipulation Known aortic valve disease Known thoracic aortic aneurysm Family history of aortic disease Marfan syndrome^*
High-risk pain features
Abrupt onset of pain Ripping or tearing pain Severe pain intensity
High-risk examination findings
Focal neurologic deficit (in conjunction with pain) Hypotension or shock state New murmur of aortic insufficiency (in conjunction with pain) Pulse deficit or systolic blood pressure differential between extremities
Total number of risk markers	Risk	Patients with aortic dissection (n = 2538) having this total number of markers
0	Low	4.3%
1	Intermediate	36.5%
≥2	High	59.2%

High-risk pain features, such as abrupt onset of pain (79.3%), severe intensity of pain (72.7%), and pain described as ripping or tearing (21.7%) were most frequently present in patients with acute aortic dissection (AD). The most common high-risk predisposing conditions identified were known thoracic aortic aneurysm (14.7%) and known aortic valve disease (11.9%), whereas the most common high-risk examination features included a new murmur of aortic insufficiency in conjunction with pain (23.6%) and a pulse deficit or systolic blood pressure differential between extremities (20.3%).

* Other genetically mediated connective tissue disorders (eg, Ehlers-Danlos syndrome) are also associated with increased risk of aortic dissection, but were not included in the derivation of this score.

Adapted from: Rogers AM, Hermann LK, Booher AM, et al. Sensitivity of the aortic dissection detection risk score, a novel guideline-based tool for identification of acute aortic dissection at initial presentation: results from the international registry of acute aortic dissection. Circulation 2011; 123:2213.

Graphic 144995 Version 1.0

خرید پکیج

Aortic dissection detection risk score