ArticleInternal and emergency medicine2017
The frequency of initial misdiagnosis of acute aortic dissection in the emergency department and its impact on outcome.
Article in Internal and emergency medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Diagnostic strategies for suspected acute aortic syndrome: systematic review, meta-analysis, decision-analytic modelling and value of information analysis.Health technology assessment (Winchester, England) · 2025Pooled it
- A Narrative Review of Biomarkers and Imaging in the Diagnosis of Acute Aortic Syndrome.Diagnostics (Basel, Switzerland) · 2025Review
- Delayed Diagnosis and Outcomes in Acute Aortic Dissection: A 10-Year Single-Center Retrospective Study.Open access emergency medicine : OAEM · 2025Article
- Artificial intelligence in aortic CT angiography: current applications and future perspectives.Frontiers in cardiovascular medicine · 2025Review
- Decision analytical modelling of strategies for investigating suspected acute aortic syndrome.Emergency medicine journal : EMJ · 2024Article
- Acute aortic syndrome.BMJ (Clinical research ed.) · 2024Article
- Diagnostic Performance of a Deep Learning-Powered Application for Aortic Dissection Triage Prioritization and Classification.Diagnostics (Basel, Switzerland) · 2024Article
- Mortality after non-surgically treated acute type A aortic dissection is higher than previously reported.European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery · 2024Observational
- Three cases of diagnostic delay of type A acute aortic dissection.The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology · 2024Article
- Routine Use of a Pocket-Sized Handheld Echoscopic Device Plus a Biomarker by Emergency Medicine Residents with an Early Screening Algorithm for Suspected Type A Acute Aortic Syndrome.Journal of clinical medicine · 2023Article
- Development and validation of nomogram models to discriminate between acute aortic syndromes and non-SFrontiers in cardiovascular medicine · 2023Article
- Impact of unintentional coronary angiography on outcomes of emergency surgery in acute type A aortic dissection: a retrospective study.BMC cardiovascular disorders · 2022Article
- Emergency CT misdiagnosis in acute aortic syndrome.The British journal of radiology · 2021Article
- Serum Ceruloplasmin Is the Candidate Predictive Biomarker for Acute Aortic Dissection and Is Related to Thrombosed False Lumen: a Propensity Score-Matched Observational Case-Control Study.Biological trace element research · 2021Observational
- Lysophosphatidic Acid May Be a Novel Biomarker for Early Acute Aortic Dissection.Frontiers in surgery · 2021Article
- A study of aortic dissection screening method based on multiple machine learning models.Journal of thoracic disease · 2020Article
- Prospective diagnostic accuracy study of plasma soluble ST2 for diagnosis of acute aortic syndromes.Scientific reports · 2020Article
- Stanford - A Aortic Dissection Presenting as a Triple Mimic and Role of Point of Care Ultrasound in Deciphering It.Journal of emergencies, trauma, and shockArticle
Corrections and comments
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
We determine the frequency of initial misdiagnosis and inappropriate treatment with antiplatelets/anticoagulants in the emergency department (ED) and the resultant clinical outcomes in patients with acute type A aortic dissection (AAOD). Medical records of patients with a final diagnosis of AAOD admitted from March 2004 through October 2015 to our tertiary-level heart hospital were evaluated. Patients with suspected dissection in ED were compared to those with initial misdiagnosis regarding demographics and clinical presentation, laboratory and echocardiographic findings. Our primary outcome was hospital mortality in two groups. Long-term mortality after discharge was our secondary outcome. Among 189 patients, 47 (24.8 %) were initially misdiagnosed and received antiplatelets/anticoagulants in ED (Group F), and 142 (75.1 %) were appropriately diagnosed in ED (Group T). The mean age in group F was 60.4 ± 15.0 vs. 57.4 ± 16.0 years in group T (p = 0.260). In group F, 70.2 % were male vs. 60.6 % in group T (p = 0.311). Hospital mortality was 48.9 % in group F vs. 43.7 % in group T (p = 0.645). Long-term mortality was significantly higher in group F (55.6 vs. 21.2 %, p = 0.007). Univariate hazard ratio (HR) of initial misdiagnosis for long-term mortality was 2.56 (95 % CI 1.08-6.06, p = 0.031). In multivariate Cox regression analysis with adjustment for age and type of management (surgical/medical), initial misdiagnosis lost its significance for predicting long-term mortality (HR 2.14, 95 % CI 0.89-5.13, p = 0.086). Initial misdiagnosis of AAOD is a common problem. Hospital mortality is not significantly affected by receiving antiplatelets/anticoagulants. Although long-term mortality is higher in patients with initial misdiagnosis, it is not an independent predictor for long-term mortality.
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