1718 Another CT aortogram request? A 1 year retrospective case note review of all ED-requested CT aortograms
Conclusion 201 CTA were requested by ED in a single year (2019). 5 (2.4%) scans diagnosed acute aortic syndrome (AAS), with an additional 3 scans that identified thoracic aortic aneurysm without AAS. 13 (6.5%) abdominal aortic aneurysms were identified of which 2 had ruptured. In addition, 24 (11.9%) patients had non aortic pathologies identified from the scan (6 gallstones, 3 pneumonia, 3 renal colic, 2 metastatic disease, 2 pancreatitis, 2 pulmonary embolism, 6 ‘other’ diagnoses). Of those with confirmed AAS, only one had an ADD-RS (aortic dissection detection risk score) of 2 (>2 recommend straight to CTA), four had a score of 0 or 1 and none had a D-dimer recorded. It is sometimes perceived that CTA has a low diagnostic yield, but 23% of patients scanned in our cohort were able to have a positive diagnosis made after their scan, with approximately half of identified pathology being non-aortic.