What does this research mean for the field?

D-dimer testing demonstrates high sensitivity (96.6%) and negative predictive value (97.3%) for ruling out acute aortic dissection in emergency department patients. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

October 1, 2010The Anatolian Journal of Cardiology

Can D-dimer testing help emergency department physicians to detect acute aortic dissections?

Q: What are the key findings of this study?

D-dimer testing demonstrated a sensitivity of 96.6% and a negative predictive value of 97.3% for detecting acute aortic dissection, with an AUC of 0.764.

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Suspected acute aortic dissection (n=99). Intervention: D-dimer testing vs. Non-acute aortic dissection. Primary outcome: Diagnostic accuracy for acute aortic dissection (AUC 0.764, 95% CI 0.674-0.855, p=<0.001).

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Key result

D-dimer shows ~97% sensitivity for detecting acute aortic dissection.

AUC 0.764
95% CI 0.674-0.855
P<0.001
n=99

Why the study?

The diagnostic accuracy of D-dimer testing for detection of acute aortic dissection in the emergency department was uncertain.

Comparison

D-dimer positive versus negative results for acute aortic dissection detection

Design

Retrospective chart review observational study

Authors

MEMurat ErselIntersil (United States)EAErsin AksayIzmir University SKSelahattin KıyanEge University

Discussion

Member takes

Implication

D-dimer may aid ruling out acute aortic dissection in suspected cases; hypothesis-generating and requires prospective validation.

Study Design

Type

Observational (n=99)

Multicenter

PICO

Population

99 patients evaluated for suspected acute aortic dissection in the emergency department who underwent D-dimer testing prior to further imaging.

Exposure / Comparator

D-dimer testing vs Non-acute aortic dissection

Primary Outcome

Diagnostic accuracy for acute aortic dissection — AUC 0.764 (0.674-0.855), p=<0.001

Main Result

Effect estimate: AUC 0.764 (95% CI 0.674-0.855)

p-value: p=<0.001

Limitations

Retrospective nature of the study
Evaluation and management were not standardized
Selection bias may have influenced the results
Exact D-dimer levels over 0.771 µg/ml were not assessed

Cite This Study

Ersel et al. (2010) conducted an observational in Suspected acute aortic dissection (n=99). D-dimer testing vs. Non-acute aortic dissection was evaluated on Diagnostic accuracy for acute aortic dissection (AUC 0.764, 95% CI 0.674-0.855, p=<0.001). D-dimer testing demonstrated a sensitivity of 96.6% and a negative predictive value of 97.3% for detecting acute aortic dissection, with an AUC of 0.764.

synapsesocial.com/papers/6ac4647566415e99ebacbdbb https://doi.org/10.5152/akd.2010.142

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Can D-dimer testing help emergency department physicians to detect acute aortic dissections?

Discussion

Member takes

Implication

Study Design

PICO

Main Result

Limitations

Cite This Study

Can D-dimer testing help emergency department physicians to detect acute aortic dissections?

Discussion

Member takes

Implication

Study Design

PICO

Main Result

Limitations

Cite This Study

Also Consider

Also Consider