• Danielle Aston, Thomas Burgess, Sarah Badach, Komal Paladugu, Brian Thompson, Elizabeth Schoenfeld, and Gavin Budhram.
• Department of Emergency Medicine, University of Massachusetts Medical School, Baystate Medical Center, Springfield, Massachusetts. Electronic address: d.aston515@gmail.com.
• J Emerg Med. 2024 Sep 1; 67 (3): e288e297e288-e297.

BackgroundAortic dissection (AD) is a vascular emergency with time-dependent mortality. Point-of-care ultrasound (POCUS) and AD risk score (ADRS) have been proposed as diagnostic tools to risk stratify patients and reduce time to diagnosis.Study ObjectiveWe evaluate POCUS findings and ADRS in a retrospective cohort of patients with known type A AD. The objective of this study is to describe the prevalence of POCUS findings and ADRS in this population.MethodsThis is a retrospective cohort study of patients with acute type A AD as confirmed on computed tomography scan over a 12-year period from 2008 to 2020, with a subgroup analysis of patients who received POCUS in the emergency department. ADRS was calculated and POCUS findings were reviewed. Descriptive statistics were used to describe the distribution of POCUS findings.ResultsNinety-one patients met inclusion criteria. POCUS was performed in 41 but only 35 had images of adequate quality for inclusion. Of the POCUS images available, 30/35 (86%) patients had a POCUS finding consistent with dissection and 5/35 (14%) had no findings on POCUS. Twelve percent (11/91) of patients had ADRS = 0. Two patients with ADRS = 0 received POCUS, and one patient had no findings on POCUS.ConclusionAlthough POCUS provides rapid information in the diagnosis of type A AD, 14% of patients with images available for review had no findings on POCUS. Of the whole cohort, 12% had an ADRS = 0. Further studies are needed to identify an optimal diagnostic pathway for this catastrophic disease.Copyright © 2024 Elsevier Inc. All rights reserved.

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