{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T04:25:02Z","timestamp":1771475102007,"version":"3.50.1"},"reference-count":27,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,4,12]],"date-time":"2022-04-12T00:00:00Z","timestamp":1649721600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Emerg Medicine Australasia"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Acute aortic syndrome (AAS) comprises a triad of life\u2010threatening aortic conditions that are difficult to diagnose because of their non\u2010specific clinical presentations. Contrast\u2010enhanced computed tomography aortography (CTA) has a high sensitivity and specificity for these conditions. However, under\u2010 and over\u2010investigation of patients with suspected AAS using CTA carries significant risk. The aim of the present study was to evaluate the diagnostic imaging practices of CTA use for patients presenting to an ED with suspected AAS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All atraumatic thoracic CTAs performed on patients aged \u226515\u2009years old with suspected AAS who presented to Auckland City Hospital between 2009 and 2019 were included. Outcomes of interest were the annual ED and population incidences of AAS, and the rate of CTAs performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 1646 CTAs were included. There were 135 (8.2%) cases of at least one AAS diagnosis and 220 (13.4%) cases where an alternative diagnosis was made. The population\u2010adjusted number of AAS diagnoses remained relatively stable over the study period, with a mean annual AAS incidence of 19.6 (95% confidence interval 9.9\u201333.7) per 100\u2009000 patients, and 3.2 (95% confidence interval 1.6\u20135.4) per 100\u2009000 population. The number of ED presentations increased during the study period, along with the population\u2010adjusted rate of CTAs performed, from approximately 150 per 100\u2009000 patients (2009) to 350 per 100\u2009000 patients (2019).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Thoracic CTA use for investigating suspected AAS in our ED has recently increased. However, the annual incidence of AAS did not increase over the same period, but was higher than reported in overseas institutions.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1742-6723.13974","type":"journal-article","created":{"date-parts":[[2022,4,13]],"date-time":"2022-04-13T00:29:22Z","timestamp":1649809762000},"page":"769-778","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Trends in computed tomography aortography and acute aortic syndrome in an emergency department within Aotearoa New Zealand"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0360-9423","authenticated-orcid":false,"given":"Steve WFR","family":"Waqanivavalagi","sequence":"first","affiliation":[{"name":"Adult Emergency Department Auckland City Hospital, Auckland District Health Board  Auckland New Zealand"},{"name":"Department of Medicine The University of Auckland  Auckland New Zealand"},{"name":"Green Lane Cardiothoracic Surgical Unit Auckland City Hospital, Auckland District Health Board  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3770-8996","authenticated-orcid":false,"given":"Sameer","family":"Bhat","sequence":"additional","affiliation":[{"name":"Department of Surgery The University of Auckland  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Franco","family":"Schreve","sequence":"additional","affiliation":[{"name":"Adult Emergency Department Auckland City Hospital, Auckland District Health Board  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paget","family":"Milsom","sequence":"additional","affiliation":[{"name":"Green Lane Cardiothoracic Surgical Unit Auckland City Hospital, Auckland District Health Board  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Colleen J","family":"Bergin","sequence":"additional","affiliation":[{"name":"Department of Radiology Auckland City Hospital, Auckland District Health Board  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1560-1186","authenticated-orcid":false,"given":"Peter G","family":"Jones","sequence":"additional","affiliation":[{"name":"Adult Emergency Department Auckland City Hospital, Auckland District Health Board  Auckland New Zealand"},{"name":"Department of Surgery The University of Auckland  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,4,12]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.105.534198"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2009.11.022"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2003.027599"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.117.029457"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2006.10.055"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2013.06.005"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10140-018-1587-x"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2013.10.015"},{"key":"e_1_2_9_10_1","first-page":"897","article-title":"Improving emergency department flow: reducing turnaround time for emergent CT scans","volume":"5","author":"Perotte R","year":"2018","journal-title":"AMIA Annu. 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