Use of Decision Tree in Treating an Emergency Patient with Upper Gastrointestinal Hemorrhage_Chinese Journal of Evidence-Based Medicine

Authors：

WANG Lina ,  PAN Shuming

Emergency Center, Xin Hua Hospital Affiliated to School of Medicine of Shanghai Jiao Tong University, Shanghai 200092, China;

Corresponding author：

PAN Shuming, Email: aorta.wang@gmail.com

Keywords：

Upper gastrointestinal hemorrhage; Clinical decision analysis; Decision tree

DOI：

10.7507/1672-2531.20110103

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective 　To apply the method of evidence-based medicine to identify the best therapy option for an emergency patient with upper gastrointestinal hemorrhage.
Methods 　According to time and logical sequence of clinical events, a complete decision tree was built after the following steps to find the best treatment: clear decision-making, drawing decision tree graphics, listing the outcome probability, giving appropriate values to the final outcome, calculating and determining the best strategies.
Results 　The performance of endoscopic therapy for the patient with upper gastrointestinal hemorrhage within the first six hours had little effect on the prognosis. Interventional therapy after the failure of endoscopic therapy had less mortality than direct surgical exploration.
Conclusion 　Making clinical decision analyses via drawing the decision tree can help doctors clarify their ideas, get comprehensive views of clinical problems, and ultimately choose the best treatment strategy for patients.

Citation： WANG Lina,PAN Shuming. Use of Decision Tree in Treating an Emergency Patient with Upper Gastrointestinal Hemorrhage. Chinese Journal of Evidence-Based Medicine, 2011, 11(5): 591-593. doi: 10.7507/1672-2531.20110103 Copy

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4.	6 Eriksson LG, Ljungdahl M, Sunmdbom M, et al . Transcatheter arterial embolization versus surgery in the treatment of upper gastrointestinal bleeding after therapeutic endoscopy failure. Vasc Interv Radiol , 2008, 19(10): 1413-1418.
5.	高云, 胡道予, 孟令山, 等. DSA及介入治疗在消化道出血中的诊治价值. 医学临床研究, 2007, 24(4): 1671-7171.
6.	严山. 上消化道动脉性大出血治疗后再出血栓塞治疗与手术治疗的比较分析. 实用医学杂志, 2006, 22(5): 543-544.

1. 1 Larssen L, Moger T, Bjornbeth BA, et al . Transcatheter arterial embolization in the management of bleeding duodenal ulcer:a 5.5-year retrospective study of treatment and outcome. Scand J Gastroenterol , 2008, 43(2): 217-222.
2. 2 Li JP, Tang GS, Huang YH, et al . Application of digital subtraction angiography and interventional treatment in gastrointestinal arterial hemorrhage. Zhonghua Wei Chang Wai Ke Za Zhi , 2009, 12(3): 252-256.
3. 5 Targownik LE, Murthy S, Keyvani L, et al . The role of rapid endoscopy for high-risk patients with acute nonvariceal upper gastrointestinal bleeding. Can J Gastroenterol , 2007, 21(7): 425-429.
4. 6 Eriksson LG, Ljungdahl M, Sunmdbom M, et al . Transcatheter arterial embolization versus surgery in the treatment of upper gastrointestinal bleeding after therapeutic endoscopy failure. Vasc Interv Radiol , 2008, 19(10): 1413-1418.
5. 高云, 胡道予, 孟令山, 等. DSA及介入治疗在消化道出血中的诊治价值. 医学临床研究, 2007, 24(4): 1671-7171.
6. 严山. 上消化道动脉性大出血治疗后再出血栓塞治疗与手术治疗的比较分析. 实用医学杂志, 2006, 22(5): 543-544.

Chinese Journal of Evidence-Based Medicine

Use of Decision Tree in Treating an Emergency Patient with Upper Gastrointestinal Hemorrhage

Abstract Full text Figures/Tables Video References Cited by

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