ToolsCalculators
Aortic dissection detection risk score (ADD-RS)
Pre-test risk of acute aortic dissection across three feature categories.
Aortic dissection detection risk score (ADD-RS)
High-risk condition present
Marfan or connective-tissue disease, family history of aortic disease, known aortic valve disease, recent aortic manipulation, or known thoracic aortic aneurysm
High-risk pain feature present
Chest, back, or abdominal pain that is abrupt in onset, severe in intensity, or ripping/tearing in quality
High-risk examination feature present
Pulse deficit or systolic BP differential, focal neurological deficit with pain, new aortic diastolic murmur, or hypotension/shock
Result0 points
No category positive: low risk — consider D-dimer or an alternative diagnosis.
- Categories positive
- 0 of 3
When to use
- Screening patients with possible acute aortic dissection to guide D-dimer testing versus expedited imaging.
Formula
One point for each category containing ≥1 high-risk feature: (1) predisposing conditions, (2) pain features, (3) examination features. Range 0–3. Score ≥1 (or ≥2) increases dissection probability.
Pearls and pitfalls
- An ADD-RS of 0–1 combined with a negative D-dimer has a high negative predictive value for acute aortic syndrome.