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Aortic Dissection Detection Risk Score

Stratifies acute aortic syndrome risk using three groups of clinical findings.

When to use

Adults with chest or back pain compatible with acute aortic syndrome at initial assessment.

Pearls and pitfalls
  • The score adds one point per group: high-risk condition, high-risk pain and high-risk examination.
  • A score of 0 is low risk, 1 is intermediate and 2 or 3 is high risk.
  • The score does not exclude dissection; the imaging decision considers the clinical picture and protocol.
  • High-risk pain includes abrupt onset, severe intensity or tearing character.

High-risk condition (Marfan, Loeys-Dietz, vascular Ehlers-Danlos, aortic aneurysm or repair, bicuspid aortic valve, recent aortic manipulation)

Chest, back or abdominal pain of abrupt onset, severe intensity or tearing character

High-risk examination finding (pulse deficit, interarm blood pressure difference, focal neurologic deficit, new diastolic murmur, hypotension or shock)

0/3 risk groups

Low risk

Use D-dimer and imaging according to clinical probability and local protocol.

Formula

Add 1 point for each high-risk group present: condition, pain and examination.

Evidence

Score derived from AHA guidelines to identify patients with acute aortic syndrome.

References

  1. Rogers AM, Hermann LK, Booher AM, et al. Sensitivity of the aortic dissection detection risk score, a novel guideline-based tool, for identifying acute aortic dissection. Circulation. 2011;123(19):2213-2218. doi:10.1161/CIRCULATIONAHA.110.000265

Frequently asked questions

What is Aortic Dissection Detection Risk Score?

Stratifies acute aortic syndrome risk using three groups of clinical findings. Adults with chest or back pain compatible with acute aortic syndrome at initial assessment.

How is the result calculated?

Add 1 point for each high-risk group present: condition, pain and examination.

How should the result be interpreted?

Score derived from AHA guidelines to identify patients with acute aortic syndrome.

What are the sources?

Rogers AM, Hermann LK, Booher AM, et al. Sensitivity of the aortic dissection detection risk score, a novel guideline-based tool, for identifying acute aortic dissection. Circulation. 2011;123(19):2213-2218.

Updated