論文

国際誌
2020年1月23日

Accuracy of aortic dissection detection risk score alone or with D-dimer: A systematic review and meta-analysis.

European heart journal. Acute cardiovascular care
  • Yusuke Tsutsumi
  • ,
  • Yasushi Tsujimoto
  • ,
  • Sei Takahashi
  • ,
  • Asuka Tsuchiya
  • ,
  • Shingo Fukuma
  • ,
  • Yosuke Yamamoto
  • ,
  • Shunichi Fukuhara

開始ページ
2048872620901831
終了ページ
2048872620901831
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1177/2048872620901831

BACKGROUND: To evaluate the diagnostic accuracy and clinical utility of the acute aortic dissection detection risk score (ADD-RS) alone or with D-dimer as a screening test to exclude acute aortic syndrome. METHODS: We conducted a systematic review and meta-analysis of studies examining the diagnostic accuracy of ADD-RS. We searched MEDLINE, Embase and Cochrane Controlled Register of Trials up to 12 December 2018. RESULTS: We identified nine studies involving 26,598 patients for ADD-RS alone and 3421 patients with D-dimer. Overall, the methodological quality based on the Quality Assessment of Diagnostic Accuracy Studies 2 was moderate to high. Bivariate meta-analyses showed that the pooled sensitivities were 0.94 (95% confidence interval (CI) 0.90, 0.96) at the threshold of ADD-RS ≥1, 0.46 (95% CI, 0.34, 0.59) at ADD-RS ≥2, 1.00 (95% CI 0.99, 1.00) at ADD-RS ≥1 with D-dimer and 0.99 (95% CI 0.97, 1.00) at ADD-RS ≥2 with D-dimer. For the low prevalence population, failure rate and efficiency were 0.8% and 38.3% at ADD-RS ≥1, 0.03% and 14.5% at ADD-RS ≥1 with D-dimer, and 0.1% and 33.6% at ADD-RS ≥2 with D-dimer, respectively. For the high prevalence population, failure rate and efficiency were 3.8% and 33.3% at ADD-RS ≥1, 0.2% and 12.3% at ADD-RS ≥1 with D-dimer and 0.6% and 28.4% at ADD-RS ≥2 with D-dimer, respectively. CONCLUSIONS: ADD-RS alone or with D-dimer was a useful screening test with high sensitivity to exclude acute aortic syndrome. However, the optimal threshold of ADD-RS alone or with D-dimer may depend on the clinical setting.

リンク情報
DOI
https://doi.org/10.1177/2048872620901831
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/31970996

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