Application value of the aortic dissection detection risk score plus D-dimer for the early diagnosis of acute aortic dissection
10.3760/cma.j.cn341190-20220427-00354
- VernacularTitle:主动脉夹层检测风险评分联合D-二聚体在急性主动脉夹层早期诊断中的价值
- Author:
Xinwei ZHOU
1
;
Wei CHEN
;
Dongzhe CHAI
;
Chunlun CHEN
;
Huayi ZHANG
;
Wenhao LU
;
Yao JIN
Author Information
1. 嘉兴市第二医院血管外科，嘉兴 314000
- Keywords:
Aneurysm, dissecting;
Aorta;
Acute aortic dissection risk score;
D-2 polymer;
Chest pain;
Early diagnosis;
Diagnosis;
ROC curve
- From:
Chinese Journal of Primary Medicine and Pharmacy
2023;30(2):225-229
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the application value of aortic dissection detection risk score (ADD-RS) combined with D-dimer (DD) in the early diagnosis of acute aortic dissection (AAD).Methods:The clinical data of 70 patients with suspected aortic dissection detection admitted to The Second Hospital of Jiaxing from August 2019 to April 2020 were collected. All patients were scored using the ADD-RS, and grouped according to the scoring results. The sensitivity and specificity of ADD-RS plus DD in the early diagnosis of AAD were calculated. The areas under the receiver operating characteristic (ROC) curves that were plotted for drADD-RS plus DD versus DD alone to screen AAD were compared to evaluate efficacy. Results:CT angiography results showed that among 70 patients with suspected AAD, 29 patients had AAD and 41 patients had no AAD. A total of 21 patients were scored 0, 41 patients were scored > 1, and 8 patients were scored > 0. ADD-RS > 0 had an overall sensitivity of 79.31% and a specificity of 36.59% for AAD diagnosis. DD test results had an overall sensitivity of 86.20% and a specificity of 36.50% for AAD diagnosis. The area under the ROC curve of ADD-RS = 0 plus DD-negative result and the area under the ROC curve of DD-negative result alone in ruling out AAD were 0.885 with 95% CI (0.786-0.949) and 0.787 with 95% CI (0.673-0.876), respectively. The difference between the two groups was statistically significant ( P = 0.024). Conclusion:Compared with DD-negative result alone, the ADD-RS = 0 plus DD-negative result strategy offers greater specificity to rule out AAD. The combined strategy has a greater efficacy in ruling out AAD. However, a multi-center study involving a large sample is required for in-depth evaluation.
