title: Diagnostic score to differentiate acute aortic dissection in the emergency room.
abstract: BACKGROUND
  Acute aortic dissection (AAD) is a life-threatening cardiovascular disorder that is similar to acute coronary syndrome (ACS), which means differentiating AAD and ACS is sometimes difficult in an emergency.
  
  
  RESULTS
  Specific information from 131 patients with AAD or ACS was analyzed between April 2001 and March 2002. The emergency room AAD (ERAAD) score was defined as the total number of specific indexes for AAD among 15 indexes that were obtainable in the emergency room (Study 1). The clinical applicability of the ERAAD score was also investigated in another 711 patients with AAD or ACS between April 2002 and March 2006 (Study 2). The ERAAD score was based on (1) presence of back pain, (2) mediastinal thoracic ratio >30%, (3) aortic regurgitation and (4) aortic diameter >30 mm on ultrasonography in Study 1. The ERAAD score was significantly higher in patients with AAD than with ACS (3.19+/-0.83 vs 1.17+/-0.99) in Study 2. The sensitivity and specificity for AAD were 93.1% and 77.6%, respectively, when the ERAAD score was >or=3.
  
  
  CONCLUSIONS
  The ERAAD score enables clinical diagnosis of AAD and correct treatment.
authors.affiliation: Division of Intensive Care Unit, Chiba Hokusoh Hospital, Nippon Medical School, 1715 Kamagari, Inbagun, Chiba 270-1694, Japan. s6042@nms.ac.jp
authors.forename: Akihiro
authors.initials: A
authors.lastname: Shirakabe
authors.forename: Noritake
authors.initials: N
authors.lastname: Hata
authors.forename: Shinya
authors.initials: S
authors.lastname: Yokoyama
authors.forename: Takuro
authors.initials: T
authors.lastname: Shinada
authors.forename: Yuuichirou
authors.initials: Y
authors.lastname: Suzuki
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Kobayashi
authors.forename: Arifumi
authors.initials: A
authors.lastname: Kikuchi
authors.forename: Teruo
authors.initials: T
authors.lastname: Takano
authors.forename: Kyoichi
authors.initials: K
authors.lastname: Mizuno
mesh_terms: D000208:Acute Disease; D000368:Aged; D000784:Aortic Dissection / Q000000981:diagnostic imaging*; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging; D001014:Aortic Aneurysm / Q000000981:diagnostic imaging*; D001416:Back Pain / Q000000981:diagnostic imaging; D003937:Diagnosis, Differential; D004632:Emergency Medical Services / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D008482:Mediastinum / Q000000981:diagnostic imaging; D008875:Middle Aged; D015999:Multivariate Analysis; D013902:Radiography, Thoracic / Q000379:methods / Q000592:standards*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index