预测急性大动脉综合征使用大动脉剖析检测风险评分,D-二次数和X射线
Dae Ho Song1, Jin Ho Choi2, Jang Young Lee1
1Department of Emergency Medicine, Daejeon Eulji Medical Center, Eulji University School of Medicine, Daejeon, Republic of Korea.
Heliyon
|October 6, 2023
概括
结合大动脉剖析检测风险评分 (ADD-RS),年龄调整的D-二次数 (DDage-adj) 和胸部放射检测结果,可显著改善急性大动脉综合征 (AAS) 诊断. 这一策略在低风险患者中实现了0%的失败率,提高了这种关键疾病的诊断准确性.
科学领域:
- 心脏病学 心脏病学
- 紧急医疗 紧急医疗
- 放射学 放射学是一门学科.
背景情况:
- 急性大动脉综合征 (AAS) 是一种危及生命的疾病,死亡率高.
- 以前的查工具,如大动脉剖析检测风险评分 (ADD-RS) 和D-二次数 (DD) 已经显示了查失败.
- 在急诊室 (ED) 需要更准确的AAS诊断工具.
研究的目的:
- 为了研究结合ADD-RS,年龄调整的D-二次体 (DDage-adj) 和AAS的胸部X光学发现的诊断疗效.
- 评估这种综合策略对减少ED患者查失败的影响.
主要方法:
- 一个单一中心的回顾性病例控制研究,涉及93名AAS患者和465名非AAS胸痛患者.
- 首次临床表现和实验室发现的比较,包括DDage-adj和胸部X射线.
- 多变量后勤回归分析以确定AAS的显著预测因素.
主要成果:
- 根据年龄调整的DD (DDage-adj) 显示了92.5%的AAS敏感度和76.3%的特异性.
- 阳性胸部X射线检测结果显示89.2%的灵敏度和80.9%的特异性.
- 在低风险患者 (ADD-RS ≤1) 中,胸部放射和DDage-adj的组合实现了100%的灵敏度,67.1%的特异性和0%的失败率.
结论:
- 结合ADD-RS,DDage-adj和胸部X光学,显著降低了AAS排除的失败率.
- 这种综合方法的失败率很低 (<3%),AAS诊断的特异性为67.8%.
- 特定的放射性发现,如扩大中,大动脉轮扩大和大动脉曲,是AAS诊断的关键指标,特别是在低风险组.
相关概念视频
Aneurysm II: Clinical Manifestations and Diagnostic Studies
10
Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
10
Aortic Regurgitation II: Clinical Features and Diagnostic Tests
23
Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
23
Acute Coronary Syndrome III: Diagnostic Studies
9
Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
9
Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
22
Calcium-Scoring CT ScanA calcium-scoring CT scan, also known as coronary artery calcium (CAC) scan, detects calcium deposits in the coronary arteries. This test assesses the risk of coronary artery disease (CAD), which can lead to cardiovascular events such as angina, heart failure, and sudden cardiac arrest.A calcium-scoring CT scan is generally recommended for individuals at intermediate risk of CAD without symptoms. It includes:Men aged 40-75 and women aged 50-75: Especially those with a...
22
Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
37
The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
37
Atherosclerosis II: Clinical Manifestations and Diagnostic Tests
11
Atherosclerosis is a progressive disorder that leads to the thickening and narrowing of arterial walls due to plaque buildup. This condition can cause various symptoms depending on the arteries affected:Coronary Artery Disease (CAD): This condition affects the coronary arteries and may lead to chest pain (angina), shortness of breath (dyspnea), heart attacks, and other heart disease symptoms.Cerebrovascular Disease: This affects blood flow to the brain, causing transient ischemic attacks (TIAs)...
11


