Document Type

Conference Proceeding

Publication Date

5-2024

Publication Title

Academic Emergency Medicine

Abstract

Background and Objectives: Acute aortic syndromes (AS), including aortic dissection, are rare and life-threatening diagnoses. Early diagnosis is critical as mortality increases by 1%–2% per hour after symptom onset. D-dimer (DD) Methods: In this retrospective chart review, we identified all patients who presented to any Emergency Department (ED) at a multicenter health system between 2012 and 2021, received a D-dimer test, and underwent CTA Dissection, CTA Coronary Study, or CTA Triple Rule-Out. Patients under the age of 18, pregnant, had prior dissection or thoracic aorta repair, or who presented altered/unresponsive were excluded. For patients with multiple presentations, the first visit was utilized. Sensitivity and specificity for AS (including aortic dissections, intramural hematomas, and ulcerations) were calculated for both DD Results: There were 5984 patient encounters in our cohort with the appropriate studies ordered, of which 5818 unique encounters remained after applying our exclusion criteria. Among our cohort, 47.6% were male, the average age was 51 years-old, and 5.6% were on an anticoagulation or antiplatelet agent. In the DD Conclusion: Our results indicate that AADD is non-inferior to DD when ruling out AS. Future steps would include a prospective trial on patients presenting to the ED for AS rule-out. Limitations in this study include the bias of excluding CTA where no D-dimer was sent

Volume

31

Issue

S1

First Page

288

Comments

Society for Academic Emergency Medicine SAEM Annual Meeting, May 14-17, 2024, Phoenix, AZ

DOI

10.1111/acem.14533

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