Accuracy of D-Dimers to diagnose aortic dissection and its different types keeping CT angiogram as gold standard.

Abstract

Objective: To determine diagnostic accuracy of D-dimers levels to diagnose aortic dissection and its different types keeping computed tomographic angiogram as gold standard. Study Design: Cross-sectional Validation study. Setting: Department of Vascular Surgery, Combined Military Hospital, Rawalpindi. Period: 1^st December 2023 to 31^st May 2024. Methods: Patients presenting with acute onset “tearing” chest pain with suspicion of aortic dissection were included in the study. Their D-dimer levels and CT angiography were performed in all patients. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of D-dimers to diagnose aortic dissection were calculated. Data was analyzed using SPSS 22. Results: A total number of 74 patients were included in this study. In this study, sensitivity of D-dimer levels to diagnose aortic dissection was 90.00% while specificity was 71.43%. For aortic dissection diagnosis positive predictive value, negative predictive value and accuracy of D-dimers levels were 93.10%, 62.50% and 86.49%, respectively. Based on CT Angiogram, there were 47 (63.51%) Stanford type A – Aortic dissection patients while 27 (36.49%) patients were of Stanford type B – Aortic dissection. In Stanford type A – Aortic dissection patients’ sensitivity and specificity were 95% and 41% while in Stanford type B – aortic dissection patients’ sensitivity and specificity were 80% and 22.22%. Accuracy of D-dimers levels to diagnose Type A – Aortic dissection and Type B – Aortic dissection was 70.27% & 37.84% respectively. Conclusion: D-dimers levels can serve as an effective tool to diagnose aortic dissection, in particular for Stanford Type A – Aortic dissection.