What is the distribution of Aortic Dissection Detection Risk Score in an undifferentiated emergency department chest pain population?

OBJECTIVE: To determine the distribution of Aortic Dissection Detection Risk Score (ADDRS) in undifferentiated chest pain patients. METHODS: Prospective observational study of adult patients presenting to the ED with non-traumatic chest pain. RESULTS: Of 139 patients studied, more than 75% of patients has an ADDRS ≥1, mainly because of the report of severe pain. There were no aortic dissections. In patients with non-specific chest pain, testing driven by the ADDRS protocol would have seen a 280% increase in d-dimer testing and 2200% increase in computed tomography aortogram rates. CONCLUSION: Widespread use of the ADDRS and its investigation protocol cannot be supported.