{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T13:02:03Z","timestamp":1790254923319,"version":"4.1.0"},"reference-count":31,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,1,25]],"date-time":"2026-01-25T00:00:00Z","timestamp":1769299200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,1,25]],"date-time":"2026-01-25T00:00:00Z","timestamp":1769299200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001516","name":"National Heart Foundation of New Zealand","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001516","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Emerg Medicine Australasia"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      Acute aortic syndrome (AAS) refers to a group of life\u2010threatening cardiovascular emergencies that require computerised tomographic aortography (CTA) for definitive diagnosis. However, there is currently no validated risk\u2010stratification tool for AAS in low or intermediate risk patients using the aortic dissection detection risk score (ADD\u2010RS). This study evaluated the efficacy of\n                      <jats:sc>d<\/jats:sc>\n                      \u2010dimer in low or intermediate risk patients who underwent CTA for suspected AAS.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective, cross\u2010sectional study included all atraumatic thoracic CTAs performed at Auckland City Hospital (Aotearoa New Zealand) between 2009 and 2019 for adults with suspected AAS presenting to the emergency department (ED). Pre\u2010test probability for AAS was determined using the ADD\u2010RS. The sensitivity and negative predictive value (NPV) of a negative\n                      <jats:sc>d<\/jats:sc>\n                      \u2010dimer (&lt;\u2009500\u2009ng\/mL) for ruling out AAS in low or intermediate risk patients (ADD\u2010RS\u2009\u2264\u20091) were calculated. Trends in\n                      <jats:sc>d<\/jats:sc>\n                      \u2010dimer requests over time were also analysed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      <jats:sc>d<\/jats:sc>\n                      \u2010dimers were assessed in 181 low or intermediate risk patients with thoracic CTAs. Negative\n                      <jats:sc>d<\/jats:sc>\n                      \u2010dimer had a sensitivity of 100% (95% CI: 66%\u2013100%) and NPV of 100% (95% CI: 97%\u2013100%) for ruling out AAS. There was a significant rise in the annual number of\n                      <jats:sc>d<\/jats:sc>\n                      \u2010dimer requests among patients who underwent CTA scans (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0059). Significantly more of these requests returned negative values (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0036), while the number of positive results (\u2265\u2009500\u2009ng\/mL) remained unchanged (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.15).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Our findings suggest that\n                      <jats:sc>d<\/jats:sc>\n                      \u2010dimer\u2009&lt;\u2009500\u2009ng\/mL may be used to forgo unfavourable CTA scans in low or intermediate risk patients within our small AoNZ cohort in whom AAS is suspected.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1742-6723.70217","type":"journal-article","created":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T07:25:47Z","timestamp":1769412347000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["<scp>d<\/scp>\n                    \u2010Dimer With the Aortic Dissection Detection Risk Score May Improve Patient Selection for Acute Aortic Syndrome Diagnostic Imaging"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3770-8996","authenticated-orcid":false,"given":"Sameer","family":"Bhat","sequence":"first","affiliation":[{"name":"Department of Surgery, Faculty of Medical and Health Sciences The University of Auckland  Auckland New Zealand"},{"name":"Department of General Surgery Wellington Regional Hospital, Te Whatu Ora\u2014Capital, Coast and Hutt Valley  Wellington New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shreya","family":"Bhat","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Palmerston North Hospital, Te Whatu Ora MidCentral  Palmerston North New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franco","family":"Schreve","sequence":"additional","affiliation":[{"name":"Adult Emergency Department Auckland City Hospital, Te\u00a0Whatu Ora\u2014Te Toka Tumai  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colleen J.","family":"Bergin","sequence":"additional","affiliation":[{"name":"Department of Radiology Auckland City Hospital, Te Whatu Ora\u2014Te Toka Tumai  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter G.","family":"Jones","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medical and Health Sciences The University of Auckland  Auckland New Zealand"},{"name":"Adult Emergency Department Auckland City Hospital, Te\u00a0Whatu Ora\u2014Te Toka Tumai  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0360-9423","authenticated-orcid":false,"given":"Steve W. 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R.","family":"Waqanivavalagi","sequence":"additional","affiliation":[{"name":"Cardiothoracic Surgical Unit Auckland City Hospital, Te Whatu Ora\u2014Te Toka Tumai  Auckland New Zealand"},{"name":"Department of Medicine, Faculty of Medical and Health Sciences The University of Auckland  Auckland New 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